Abortion Flashcards by Frankie Aguinot

Question

Answer

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Define abortion

a. less than 15 weeks
b. less than 20 weeks
c. less than 500g
d. less than 250g

b. or c.

Loss of a fetus less than 20 weeks age of gestation or a birthweight less than 500g

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When do more than 80% of spontaneous abortion occur?

First 12 weeks

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Fetal factors of abortion and which is more likely?

. Anembryonic
. Embryonic

Both are 50%

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What is/are the anembryonic defect?

Blighted ovum; fertilized egg attaches to the uterine wall but does not develop

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What is/are the embryonic defect?

. Aneuploid

. Euploid

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Which embryonic defect has normal chromosomes?

Euploid

Aneuploid has chromosomal anomalies

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Which trimester is aneuploid abortion most likely?

First trimester - 55%

2nd - 35%, 3rd 5%

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Which parent is most likely to contribute to aneuploid abortion?

Maternal gametogenesis errors 95%

Paternal - 5%

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What are the 5 types of aneuploid abortion? Which are the first most common and second most common?

. Autosomal trisomy - 1st mc
. Monosomy X (45, X) aka Turner Syndrome - 2nd mc

. Triploidy
. Tetraploid aboruses
. Chromosomal structural abnormalities

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Which is the most likely cause of trisomy?

Isolated nondisjunction

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Most common trisomy autosomes are?

13, 16, 18, 21, 22

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When do most aneuploid abortions occur?

By 8 weeks - 75%

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Which of the following is aborted later and when does it peak?

. Aneuploid
. Euploid

Euploid; peaks are 13 weeks

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Which infections increases abortion?

. Chlamydia trachomatis
. Polymicrobial infection fromperiodental disease
. Mycoplasma
. Ureaplasma
. HIV

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When does bacterial vaginosis cause abortion?

2nd trimester

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When is the best time for operation for benign ovarian cyst? Why?

2nd trimester (14-16 weeks); placenta is already established

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When is abdominal trauma most likely to cause miscariage? Earlier or later gestation

Advanced AOG

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What are the the pathophysiological models of the immunoligical factors of abortion? Which is most potent?

. Autoimmune; antiphospholipid antibodies directed against binding proteins in plasma

. Alloimmunity; against another person

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MOA of Mifepristone

a. acts on trophoblast and halts implantation
b. increases uterine contractility by reversing the progesterone-induced inhibition of contraction
c. increasing uterine contractility by stimulating the myometrium directly

b. increases uterine contractility by reversing the progesterone-induced inhibition of contraction

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MOA of Misoprostol

c. increasing uterine contractility by stimulating the myometrium directly

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MOA of Methotrexate

a. acts on trophoblast and halts implantation

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What thyroid related lab result is a marker for increase of miscarriage?

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high serum to level of Ab to thyroid peroxidase

This level of caffeine consumption is associatd with increased risk of miscarriage

a. 200 mg
b. 300 mg
c. 400 mg
d. 500 mg

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d. 500 mg

200 mg is moderate

What environmental toxins are linked to miscarriage

. Bisphenol A . Phthalates . Polychlorinated byphenyls . DDT

What serum progestorone concentrations suggest a dying pregnancy? A. <5 ng/ml b. <10 ng/ml c. >15 ng/ml d. > 20ng/ml

A. <5 ng/ml

What serum progestorone concentrations suggest a healthy pregnancy? A. <5 ng/ml b. <10 ng/ml c. >15 ng/ml d. > 20ng/ml

d. > 20ng/ml

What is the bhCG levels discriminatry for transvaginal sonography? A. 1500 b. 3000 c. 4500 d. 6000

A. 1500

What is the bhCG levels discriminatry for transabdominal sonography? A. 1500 b. 3000 c. 4500 d. 6000

d. 6000

What is yolk sac visible and diameter?

5.5 weeks w/ 10 mm

What is the management for incomplete abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. Curettage . Misoprostol (oral) . Expectant management

What is the management for threatened abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. Observation . acetaminophen-based analgesia . bed rest

What is the management for complete abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. observation

What is the management for missed abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. surgical or medical evactuation . Misoprostol (vaginal) . Observation

What is the management for inevitable abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. Curettage

What is the management for septic abortion? ``` . acetaminophen-based analgesia . administration of broad spectrum . antibiotics . bed rest . curettage . expectant management . medical evacuation . misoprostol . observation . suction curretage . surgical or medical evactuation ```

. suction curretage | . administration of broad spectrum antibiotic

What type of medicine id misoprostol? (letters)

Prostaglandin E1

What is the characteristic findings of complete abortion?

minimally thickened endometrium without a gestational sac

Complete gestation in complete abortion should be discerned from what 2?

Blood clots Decidual cast

What is a decidual cast?

a layer of endometrium in the shape of the uterine cavity can appear as collapsed sac

When can fetal cardiac activity be detected?

6 to 6.5 weeks

What value difference of <5mm raises concern in missed abortion?

MSD (mean sac diameter) and CRL

In cases of suspected inevitable abortion what is the laboratory finding?

amnionic fluid will fern on a microscope slide or will have a pH of >7

What sonographic finding in suspected inevitable abortion?

oligohydramnios

What are biological causes of septic abortion?

. Group a streptococcus-S pyogenes | . Clostridium perigens

In recurrent miscarriagees are what the two most common chromosomal abnormalities?

1. reciprocal translocation | 2. robertsonian translocation

What are anatomical factors in recurrent miscarriage?

. Ascherman syndrom - uterine synechiae . Uterine leiomyomas . Congenital genital tract anamolies

What is the treatment for ascherman syndrome?

hysteroscopic adhesiolysis

What is antiphospholipid antibody syndrome?

defined by antiphospholipid antibodies in combination with barious forms of reprodutive loss and increased risks for venous thromboembolism

Cervical clerage is offered to women whose cervical length is a. <15mm b. <20mm c. <25mm d. <30mm

c. < 25mm

When is cervical cerclage often performed? A. 8 - 12 weeks b. 12 - 14 weeks c. 15 - 18 weeks d. 18 - 21 weeks

b. 12 - 14 weeks

When is vagical cerclage often performed? A. 8 - 12 weeks b. 12 - 14 weeks c. 15 - 18 weeks d. 18 - 21 weeks

c. 15 - 18 weeks

In surgical abortion, what is often used for cervical ripening? A. antiprogestin mifepristone b. hygroscopic dilators c. dilapan-S d. Misoprostol

d. Misoprostol

In suction curettage, what is swabbed on cervix?

Povidoneiodine

For pregnancies beyond 16 weeks what instrument is used?

sopher forceps

What drugs are used for medical abortion?

. Mifepristone + Misoprostol or . Misoprostol

Abortion Flashcards

(56 cards)