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Ob/gyn🤰👩🏼‍🍼 > Miscariage > Flashcards

Miscariage Flashcards

1
Q

What is miscarriage ?

A

Spontaneous expulsion of the pregnancy content before the fetus reach the age of viability

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2
Q

According to the who the weight of the fetus that is considered as a miscarriage should be less than

A

500 mg and less than 24 weeks

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3
Q

The most common complication of early pregnancy is

A

Miscarriage

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4
Q

What is the relationship between miscarriage risk and gestation age

A

The risk of miscarriage decrease as long as the increasing in age of gestation

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5
Q

The most common gestation period for miscarriage is ?

A

12 weeks
80% of the miscarriage happened during this period

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6
Q

The overall risk for miscarriage is

A

20%

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7
Q

The most important risk factor for miscarriage is

A

Advanced maternal age

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8
Q

The risk factor or miscarriage are ?

A

Chromosomal anomalies
Acute maternal Infection
Endocrinopathies
Anatomical abnormalities
Trauma
Hypercoagulable state
Congenital anomalies in the fetus

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9
Q

the most common etiology factor for miscarriage is

A

Chromosomal anomalies specially when the miscarriage happened in an early age of gestation

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10
Q

Types of miscarriage

A

Missed miscarriage
Threatened miscarriage
Complete miscarriage
Incomplete miscarriage
Inevitable miscarriage

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11
Q

Threatened miscarriage is

A

Bleeding through a closed cervix on the first half of pregnancy

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12
Q

Main features for the threatened miscarriage ?

A

Pain -painless
Uterus size -normal
Cervix -closed
Fetal cardiac activity - detectable

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13
Q

Prognosis for threatened miscarriage is

A

G00d prognosis 90-96% survival rate

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14
Q

Management for threatened miscarriage

A

Bed rest
Progesterone

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15
Q

Inevitable miscarriage features

A

Bleeding-increase
Cramps - increase
Cervix -dilated

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16
Q

Inevitable miscarriage is

A

When the gestational tissue can be felt or seen through the internal cervical os

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17
Q

Complete miscarriage features

A

Pain -mild
Uterus size -small
Cervix - closed
Bleeding -scant

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18
Q

Incomplete miscarriage features

A

Cervix-opened
Uterus size - smaller than expected
Bleeding - sever and could cause hypovolmic shock
Cramps -severe

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19
Q

What is the incomplete miscarriage

A

It’s a miscarriage with reminanteproducts in the cervix and vagina

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20
Q

The type of miscarriage that’s associated with risk of hypovolemic shock

A

Incomplete miscarriage

21
Q

The type of miscarriage that’s is associated with the most severe form of cramps

A

Inevitable miscarriage

22
Q

What is missed miscarriage

A

In utero death of the embryo prior to the age of viability ,with retention of he pregnancy for a prolonged period of time

23
Q

Features for missing miscarriage ?

A

The symptoms of pregnancy will decrease

The cervix is usually closed

24
Q

The criteria for missed miscarriage diagnosis ?

A

-Absence of cardiac activity when the embryo crown rump is more than 5 mm
-absence of yolk sac when the mean sac diameter is 13
-absence of embryonic pole when the mean sac is more than 18 trans vaginal

25
Q

Surgical treatment for miscarriage cases during the early weeks of gestation is
(Before week 12)

A

Dilatation and curettage
Dilatation and evacuation
To prevent the risk of hemorrhage and infection due to the gestation remnants

26
Q

D and c possible complication

A

Risk of general anesthesia
Risk of adhesions
Risk of future ectopic pregnancy

27
Q

Miscarriage medical treatment

A

Prostaglandin E 1analog
(Misoprostol)

28
Q

What is the advantage of using misoprostol in the cases of miscarriage

A

Low cost
Low insidence of side effects
Stability at a room temperature

29
Q

Main features for septic miscarriage are

A

Fever
Chills
Malaise
Abdominal pain
Discharge
Bleeding

30
Q

Physical examination findings for septic miscarriage reveal

A

Tachycardia
Tachypnea
Lower abdominal tenderness
Dilated cervix
Tender uterus

31
Q

The organism that’s responsible for the septic miscarriage is

A

Staphylococcus aureus-gram negative bacilli

32
Q

How the septic miscarriage should be managed ?

A

1- stabilize the patient
2- take a-blood and endometrial culture
3- board spectrum antibodies
4- surgical evacuation for the uterine contents

33
Q

Recurrent miscarriage definition

A

Occurrence of three or more losses of clinically recognized pregnancies before the age of viability .

34
Q

What are the types of abnormal pregnancies that aren’t included in the recurrent miscarriage

A

Ectopic
Molar
Biochemical

35
Q

The incidence of recurrent miscarriage is?

A

0.4

36
Q

The main factors that lead to recurrent miscarriage

A

Immunologic
Anatomical cause
Genetic case
Endocrine cause
Microbiological

37
Q

The only immune condition in which pregnancy loss is diagnostic criteria for the disease is

A

Anti phospholipid syndrome

38
Q

The incidence of anti phospholipid in the recurrent miscarriage cases is

A

15%

39
Q

Adverse pregnancy out comes in the case of antiphospholipid syndrome include

A

-One or more preterm births before 34 weeks
-one or more morphologically normal fetal losses after 10th week of gestation
Three or more fetal loss
Before 10th week of gestation

40
Q

Inherited thrombophilic diseases that could lead to recurrent miscarriage

A

-Protein c deficiency
-Anti thrombin 3
-Prothrombin gene mutation
-Factor 5 Leiden deficiency

41
Q

Anatomical conditions that lead to recurrent miscarriage ?

A

Septate Uterus
Leiomyoma
Endometrial polyp
Intrauterine adhesion

42
Q

The most common anatomical condition that is associated with recurrent miscarriage ?

A

Septate uterus

43
Q

Endocrine factors that are associated with recurrent miscarriage ?

A

DM
Pcos
Thyroid disease

44
Q

Investigation that needs to be done in the cases of recurrent miscarriage ?

A

1- anti phospholipid antibody
2- karyotying cytogenetic
3-pelvic us to confirm the anatomical anomalies
4- clotting factors

45
Q

Genetic factors that lead to recurrent miscarriage ?

A

Major chromosomal rearrangement
-usually translocation
-inversion

46
Q

How does the translocation mutation or inversion mutation leads to miscarriage

A

When both parents have Lethal genes that are inherited in a homogeneous or unbalanced state

47
Q

Anti phospholipid antibodies test should be done for women’s who ?

A

Recurrent First term miscarriage
oner more second rimester miscarriage

48
Q

Anti Phospholipid syndrome screening test is considered positive when ?

A
  1. Positive test 12 weeks apart
49
Q

Karyotyping cytogenetic analysis should be performed on what

A

Products of third miscarriage

Ob/gyn🤰👩🏼‍🍼 (9 decks)

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