miscarriages

Question 1

missed vs incomplete vs inevitable

Answer 1

Missed miscarriage: the foetus is dead but is retained in utero.

Incomplete miscarriage: some tissue is expelled, yet some is main-
tained in utero.

Inevitable miscarriage: the cervix is dilated, but the products of con-
ception have not been expelled yet.

Question 2

blood investigations

Answer 2

Full blood count, group and save, serum ßhCG.

Question 3

management of incomplete miscarriage

Answer 3

Surgical evacuation with dilatation and curettage or suction
curette, medical treatment with misoprostol and mifepristone,
expectant management.

Question 4

what investigation can occur with foetal products

Answer 4

Histology, karyotyping.

Question 5

2 complications of surgical evacuation of uterus

Answer 5

Injury to the cervix, p erforation o f the uterus, scarring o f the
in trau terin e lining (A sherm an’s syndrom e), standard operative
risks, e.g. anaesthetic risks, bleeding, infection, etc.

Question 6

causes of recurrent spontaneous miscarriages

Answer 6

Infection, cervical incom petence, parental chrom osom al
abnorm ality, u terin e abnorm alities, e.g. b ico m u ate u terus o r large
fibroids, antiphospholipid antibodies.