BIOL30001 Lecture Notes - Lecture 29: Gestational Sac, Vaginal Bleeding, Fallopian Tube
16 Oct 2018
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Lecture 29 diseases and disorders of pregnancy. Early pregnancy: up to 12-16 weeks placenta invades the inner 1/3 of the uterine myometrium, remodels the maternal spiral arterioles: Converts to high capacitance (ie accommodates large volumes) and low resistance system. Miscarriage (spontaneous abortion) = early pregnancy: occurs in 10-15% of clinically recognised pregnancies, 50% have chromosomal errors 50% due to genetic errors, 50% due to implantation errors, risk increases with maternal age. Management: surgical suction curettage (local anaesthetic, canulla and remove contents of womb, medical expectant management misoprostol (prostaglandins) to induce uterine contractions. Clinical presentation and diagnosis: vaginal bleeding and abdominal pains/cramping thus, can masquerade as miscarriage. If not, there should be a high index of suspicion it is an ectopic pregnancy. Salpingostomy = cut along the top of the ectopic, pull out the sac, leave rest of tube. Salpingectomy = take out the entire tube, including the ectopic. Note: laparoscopic salpingectomy is the most common surgical treatment approach: medical approach.
