Bleeding causes in the first trimester pregnancy
Download
1 / 32

Bleeding causes in the first trimester pregnancy - PowerPoint PPT Presentation


  • 206 Views
  • Uploaded on

Bleeding causes in the first trimester pregnancy. Threatened abortion Ectopic pregnancy Cervical polyps Hydatidiform mole Cervicitis. Abortion. Threatened abortion Inevitable abortion Complete abortion Incomplete abortion Missed abortion. Threatened abortion.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Bleeding causes in the first trimester pregnancy' - truong


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Bleeding causes in the first trimester pregnancy
Bleeding causes in the first trimester pregnancy

  • Threatened abortion

  • Ectopic pregnancy

  • Cervical polyps

  • Hydatidiform mole

  • Cervicitis


Abortion
Abortion

  • Threatened abortion

  • Inevitable abortion

  • Complete abortion

  • Incomplete abortion

  • Missed abortion


Threatened abortion
Threatened abortion

Bleeding and uterine cramping without cervical dilation


Inevitable abortion
Inevitable abortion

  • Profuse haemorrhaging, rupture of the membranes, cramping with a dilated cervical os


Incomplete abortion
Incomplete abortion

  • When some products of conception are expelled but some tissue remains in the uterine cavity.


Recurrent pregnancy loss rpl
RECURRENT PREGNANCY LOSS (RPL)

  • The loss of tree or more spontaneous and consecutive pregnancies, occuring before the period of viabity

    PRIMARY RPL

    SECONDARY RPL


Causes of rpl
Causes of RPL

  • Chromosomal 1,8- 4,6%

  • Anatomic 1-28%

  • Immunologic 6-65%

  • Hormonal 5- 29%

  • Infectious

  • Unexpained 15-50%


Genetic causes
Genetic causes

  • Trisomy 40-50%

  • Monosomy 15-25%

  • Triploidy 15%

  • tetraploidy 5%


Anatomic abnormalities
Anatomic abnormalities

  • Uterine congenital abnormalieties ( septate uterus, bicornuate or unicornuate uterus)

  • Intrauterine adhaesiones

  • Leiomyomata

  • Cervical incompetence


Endokrinologic causes
Endokrinologic causes

  • The luteal phase deficiency

  • Thyroid disease

  • diabetes


Infections
Infections

  • Listeria monocytogenes

  • Mycoplasma hominis

  • Ureaplasma urealiticum

  • Toxoplasmosis

  • Cytomegalia

  • Rubella


Enviromental factors
Enviromental factors

  • Smoking

  • Alkohol

  • Ansthetic gases

  • Toxins

  • Radiations


Missed abortion
Missed abortion

Death of the fetus or embryo without the onset of labour or the passage of tissue


Diagnosis of abortion
Diagnosis of abortion

  • Clinical examination ( bleeding, abdominal pain, cramping)

  • Ultrasonography


Medical conditions associated with pregnancy loss
Medical conditions associated with pregnancy loss

  • Collagen vascular diseases

  • Thyroid disease

  • Diabetes mellitus

  • Chronic active hepatitis

  • Infections

  • Endometriosis

  • Thrombo-embolic disease

  • Chronic renal disease

  • Chronic cardiovascular disease


Immune theories of rpl
Immune theories of RPL

  • In the alloimmune theory state, the maintenance of normal pregnancy requires the immune system to recognize the implanting embryo as foreign

  • the autoimmune theory state, in whichwomen’s immune system may produce antiphospholipid antibodies



Criteria for anti phospholipid antibody syndrome

Laboratory findings

Persistently elevated anti-phospholipid antibodies (ACA)

Lupus anticoagulant (LA)

Clinical findnings

Thrombosis (venous or arterial)

Recurrent pregnancy loss

Thrombocytopenia

Criteria for anti-phospholipid antibody syndrome


The target cells for antiphospholipid antibodies
The target cells for antiphospholipid antibodies

  • Endothelial cells

  • Throphoblastic cells

  • Blood platelets

  • Embyonic tissue cells

  • Coagulation factors

  • Proteins involved in the coagulation cascade or in antibodies bindings



Molar pregnancy microscopic features1

Complete mole

Marked oedema and enlargement of the villi

Dissappearance of the villous blood vassels

Proliferation of lining trophoblast of the villi

Absence of the fetus, cord ar amniotic membrane

A normal kariotype

Partial mole

Marked swelling of the villi with atrophic throphoblastic cells

Presence of normal villi

Presence of fetus, cord and amniotic membrane

An abnormal karyotype

Molar pregnancy (microscopic features)


Symptoms
Symptoms:

  • Bleeding

  • The uterus is often larger than expected

  • Nausea and vomiting

  • Preeclampsia

  • Clinical hyperthyroidism

  • Abdominal pain secondary to theca lutean cysts


Diagnosis
Diagnosis

  • Passage of vesicular tissue

  • A quantitative HCG > 100 000 uIU/ml

  • Ultrasonography ( snow storm)


Clinical classification of gestational thropfoblastic disease
Clinical classification of gestational thropfoblastic disease

Molar pregnancy (hydatidiform mole)

  • Compete mole

  • Partial mole

    Gestational throphoblastic neoplasia


Persistent gestational throphoblastic neoplasia
Persistent gestational throphoblastic neoplasia disease

  • Histologically benign

  • Persistent histologically benign

  • Persistent histologically malignant


Benign gtd
Benign GTD disease

  • Low socioeconomic status

  • Older women

  • Spontaneous remission in 80-85% after dilatation and evacuation

  • Choriocarcinoma develops in 3- 5% of moles


Malignant gtd
Malignant GTD disease

  • 1 : 20 000 pregnancies

    A/ molar pregnancy (50%)

    B/ normal pregnancy (25%)

    C/ abortion and ectopic pregnancy (25%)


Management
Management disease

  • Suction curetage

  • Primary hysterectomy

  • Prophylactic chemiotherapy


Follow up examination include
Follow–up examination include disease

  • HCG determinations every 1-2 weeks until they are negative twice, then montly for 1 year

  • Contraception for 1year

  • Physical examination every 2 weeks until remission, then every 3 months for 1 year

  • Chest film initially and repeated if the HCG plateau or rises

  • Chemiotherapy should be started if the HCG titer rises or is stable if metastases are detected at any time


Abortion1
Abortion disease

  • Spontaneous

  • Induced

  • Early ( before 12 weeks)

  • Late (after 12 weeks)


Abortion2
Abortion disease

The termination of pregnancy before viability,

(22 weeks from the first day of the last normal menstrual bleeding).


ad