Risk Pregnancies Overview
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Questions and Answers

What is a possible complication of PID?

  • Uterine bleeding (correct)
  • Closed cervix
  • Chromiorhitis
  • Cullen's sign

Which condition is indicated by a tinge of blush in the umbilicus?

  • Cullen's sign (correct)
  • Threatened abortion
  • Chronic hypertension
  • Closed cervix

What is a characteristic symptom of PID?

  • Sudden, severe abdominal pain
  • Fever (correct)
  • Emotional support
  • Closed cervix

What is the primary treatment approach for a ruptured ectopic pregnancy?

<p>Surgical intervention (D)</p> Signup and view all the answers

Which of the following is NOT a type of abortion?

<p>Cullen's sign (D)</p> Signup and view all the answers

What is the recommended duration for using a reliable contraceptive before engaging in pregnancy planning?

<p>6 months (B)</p> Signup and view all the answers

Which of the following symptoms is associated with high levels of HCG during early pregnancy?

<p>Rapid development of the uterus (C)</p> Signup and view all the answers

What is a potential complication associated with vaginal bleeding during pregnancy?

<p>Choriocarcinoma (D)</p> Signup and view all the answers

What is the recommended treatment of choice (DOC) for choriocarcinoma?

<p>Methotrexate (B)</p> Signup and view all the answers

What is considered a normal Beta HCG level in a healthy pregnancy?

<p>400,000 IU (A)</p> Signup and view all the answers

What is the primary purpose of misoprostol in early pregnancy management?

<p>To induce uterine contractions (A)</p> Signup and view all the answers

What characterizes an elective abortion?

<p>It is performed at the request of the client. (B)</p> Signup and view all the answers

What is typically expected during the first trimester after taking misoprostol?

<p>Heavy vaginal discharge with possible cramping. (C)</p> Signup and view all the answers

In therapeutic management of early pregnancy failure, what is a possible approach if the fetus is non-viable?

<p>Waiting for spontaneous abortion. (B)</p> Signup and view all the answers

What best describes a habitual abortion?

<p>Two or more consecutive pregnancy losses. (D)</p> Signup and view all the answers

What does a high level of HCG titers suggest in the context of gestational trophoblastic disease?

<p>Malignant transformation (D)</p> Signup and view all the answers

How often should serum HCG tests be conducted after a diagnosis of gestational trophoblastic disease?

<p>Every 2 to 4 weeks for 6 months (C)</p> Signup and view all the answers

What guideline should women with a history of a hydatidiform mole follow regarding future pregnancies?

<p>They should wait for at least 1 year (B)</p> Signup and view all the answers

What is the significance of low HCG titers in the context of gestational trophoblastic disease?

<p>Suggests no complications (A)</p> Signup and view all the answers

From which developmental stage does the trophoblast originate?

<p>Zygote (C)</p> Signup and view all the answers

Flashcards

Induced abortion

The termination of a pregnancy before the fetus becomes viable, typically before 24 weeks.

Missed abortion

The natural loss of a fetus before viability, where the fetus dies in the womb.

Expectant management

Treatment for early pregnancy loss that involves waiting for the body to naturally expel the pregnancy.

Misoprostol

Medication used to terminate a pregnancy in early stages, often combined with mifepristone.

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Mifepristone

A medication that stops progesterone production, which is needed for pregnancy to continue.

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Threatened Miscarriage

A condition where the cervix is closed, but the pregnancy is not viable. It's a type of miscarriage.

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Incomplete Miscarriage

A type of miscarriage where the cervix is open and bleeding is heavier. It's a more serious type of miscarriage.

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Missed Miscarriage

A type of miscarriage where the fetal tissue is still inside the uterus, but the pregnancy is no longer viable. It's a more advanced stage of miscarriage.

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Complete Miscarriage

A type of miscarriage where the fetal tissue has been completely expelled from the uterus.

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Inevitable/Imminent Miscarriage

A type of miscarriage where bleeding and cramps are severe, and it's an emergency situation.

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Gestational Trophoblastic Mole

A rare condition where the trophoblast, the outer layer of cells that normally develops into the placenta, grows abnormally, forming grape-sized cysts instead of a fetus. This results in a pregnancy with no baby and only a mass of fluid-filled vesicles.

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HCG

A hormone produced during pregnancy, used to detect and monitor pregnancy, it can tell if a woman is pregnant and its levels increase with the progress of pregnancy.

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HCG serum test

A type of serum test used to measure HCG levels which is helpful in diagnosing and monitoring gestational trophoblastic disease.

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Hydatidiform Mole

A type of gestational trophoblastic disease that is usually benign and often resolves on its own, but can potentially progress into a malignant form. It is characterized by the development of trophoblastic tissue in the uterus without a fetus.

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Malignant Transformation

A condition where trophoblastic tissues have become malignant. The trophoblast is a layer of cells that usually forms the placenta. In this condition, the trophoblast cells grow uncontrollably causing a type of cancer.

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Miscarriage

A condition where a pregnancy ends before 20 weeks gestation, resulting in the loss of the fetus. It is characterized by signs like vaginal bleeding, abdominal pain, and the absence of fetal heart activity.

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HCG Pregnancy test

A pregnancy test that measures the levels of human chorionic gonadotropin (hCG) in the blood or urine. It is used to determine the presence or absence of pregnancy.

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Methotrexate

A type of medication used to treat certain types of cancer, including choriocarcinoma. It can also be used to terminate an ectopic pregnancy or a miscarriage.

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Choriocarcinoma

A rare type of cancer that can develop in the uterus after a miscarriage or molar pregnancy. It is characterized by high levels of hCG in the blood and can spread to other parts of the body.

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Study Notes

Risk Pregnancies

  • First Trimester Bleeding
    • Abortion: Vaginal bleeding before 20 weeks gestation. Can be medical (abortion pills) or spontaneous.
    • Complete Abortion: All products of conception expelled.
    • Incomplete Abortion: Some products of conception remain. Requires dilation and curettage (D&C) for management.
    • Threatened Abortion: Bleeding with closed cervix; may resolve. Requires monitoring, rest, and potentially progesterone treatment.
    • Missed Abortion: Fetus dies in utero but is not expelled.
    • Ectopic Pregnancy: Fertilized ovum implants outside uterus, usually fallopian tube.
    • Early Pregnancy Failure: Fetus dies before 20 weeks, not usually expelled.
    • Habitual Abortion: 3 or more consecutive spontaneous abortions.
  • Second Trimester Bleeding
    • Gestational Trophoblastic Disease (Hydatidiform Mole): Abnormal placental growth with vesicles, no viable fetus.
    • Abruptio Placenta: Premature separation of placenta from uterine wall. Painful vaginal bleeding.
    • Placenta Previa: Placenta implants low in uterus, partially or fully covering the cervical opening.
  • Third Trimester Bleeding
    • Placenta Previa: Low implantation of the placenta. Bleeding may or may not start till labor.
    • Marginal: Edge of placenta approaches cervical opening
    • Partial: Part of the cervical opening is covered.
    • Total: Entire cervical opening is covered.
    • Abruptio Placenta: Premature separation of the placenta from uterine wall.

Management

  • Treatment: Varies by condition. Medical management or surgical intervention may be required.
  • Nursing Responsibilities: Assess bleeding, vital signs, and observe for complications.

Pregnancy Induced Hypertension (PIH)/Preeclampsia/Eclampsia

  • Classification:
    • Mild Pre-eclampsia: BP ≥ 140/90 mmHg, proteinuria.
    • Severe Pre-eclampsia: BP ≥ 160/110 mmHg, proteinuria, symptoms.
    • Eclampsia: Seizures.
  • Contributing Factors: Diet, genetics, multiple pregnancies
  • Signs and Symptoms: High blood pressure, protein in urine, edema, headaches, visual disturbances, abdominal pain
  • Management: Bed rest, medication (e.g., magnesium sulfate) to prevent seizures, monitoring fetal and maternal well-being.
  • Complications: Maternal and fetal morbidity and mortality.

Birth

  • Indicators:
  • 24 weeks: Management focused on stabilization for survival
  • Vaginal delivery: Preferred method where feasible.
  • Cesarian Section (C-Section): If vaginal delivery is not possible or for fetal risks. More complications overall compared to vaginal delivery.
  • Post-partum Conditions: Post-partum hypertension can occur.

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Description

Explore key concepts related to risk pregnancies focusing on bleeding complications in the first and second trimesters. This quiz reviews medical terms and conditions such as abortion types, ectopic pregnancy, and gestational trophoblastic disease. Perfect for students and professionals in obstetrics and gynecology.

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