OB EXAM 3
L E X I O L E N I C Z A K Spontaneous Abortion •Loss of birth naturally before 20 weeks gestation •TERM: 37 -42 weeks
•PRETERM: 20 -37 weeks Ectopic Pregnancy •Fertilized ovum (egg) implants outside the uterine cavity
•Treatment –remove the fetus •Remove tube if embryo is in tube (fallopian tubes 96% implant here, most common site)
•Risk Factors
•Pelvic inflammatory disease (PID) d/t tubal scarring •STIS (gonorrhea, chlamydia) (2x increased risk, silent infections) d/t tubal damage
•Family HX Gestational Trophoblastic Disease •Abnormal trophoblast cells grow inside the uterus after conception and a tumor develops inside the uterus •1:1000 pregnancies •Assessment Findings •Extremely high HCG levels, brown vaginal spotting, inability to detect fetal HR, N/V, swelling, preeclampsia
•Treatment •Immediate evacuation of uterine contents; D&C used to empty uterus, tissue sent to lab for analysis of cancer •Baseline HCG level obtained, quantitative HCG level every week until undetectable for 3 weeks, then HCG levels drawn every month for 1 year
•Pregnancy testing, avoid pregnancy for 1 year, messes with HCG levels, use contraception
L E X I O L E N I C Z A K Spontaneous Abortion •Loss of birth naturally before 20 weeks gestation •TERM: 37 -42 weeks
•PRETERM: 20 -37 weeks Ectopic Pregnancy •Fertilized ovum (egg) implants outside the uterine cavity
•Treatment –remove the fetus •Remove tube if embryo is in tube (fallopian tubes 96% implant here, most common site)
•Risk Factors
•Pelvic inflammatory disease (PID) d/t tubal scarring •STIS (gonorrhea, chlamydia) (2x increased risk, silent infections) d/t tubal damage
•Family HX Gestational Trophoblastic Disease •Abnormal trophoblast cells grow inside the uterus after conception and a tumor develops inside the uterus •1:1000 pregnancies •Assessment Findings •Extremely high HCG levels, brown vaginal spotting, inability to detect fetal HR, N/V, swelling, preeclampsia
•Treatment •Immediate evacuation of uterine contents; D&C used to empty uterus, tissue sent to lab for analysis of cancer •Baseline HCG level obtained, quantitative HCG level every week until undetectable for 3 weeks, then HCG levels drawn every month for 1 year
•Pregnancy testing, avoid pregnancy for 1 year, messes with HCG levels, use contraception
