ABORTION

Question 1

Abortion

Answer 1

Spontaneous or induced termination of pregnancy before fetal viability

Question 2

Abortion

Answer 2

pregnancy termination before 20 weeks’ gestation

OR

fetus born weighing < 500 g

Question 3

Spontaneous Abortion

Answer 3

threatened
inevitable
incomplete
complete
missed abortion

Question 4

> 80 % of spontaneous abortions occur within the

Answer 4

first 12 weeks

Question 5

No identifiable embryonic elements

Answer 5

anembryonic miscarriage

Question 6

Often display a developmental abnormality of the embryo, fetus, yolk sac, and, at times, the placenta

Answer 6

embryonic miscarriages

Question 7

75 % of chromosomally abnormal abortions occurred by

Answer 7

8 weeks’ gestation

Question 8

Most frequently identified chromosomal anomaly in the 1st trimester

Answer 8

Autosomal Trisomy

trisomies of chromosomes 13, 16, 18, 21 , and 22 - most common

Question 9

Single most frequent specific chromosomal abnormality

Answer 9

Monosomy X (45,X) (Turner Syndrome)

Question 10

Associated with hydropic or molar pregnancy

Answer 10

Triploidy

Question 11

Presumed when bloody vaginal discharge or bleeding appears through a closed cervical os during the first 20 weeks

Answer 11

Threatened Abortion

Question 12

The most predictive risk factor for pregnancy loss

Answer 12

Bleeding

Question 13

serum progesterone concentrations that suggest a dying pregnancy

Answer 13

< 5 ng/mL

Question 14

Used to locate the pregnancy and determine viability

Answer 14

Transvaginal sonography

Question 15

Bleeding that follows partial or complete placental separation and dilation of the cervical os

Answer 15

Incomplete Abortion

Question 16

History of heavy bleeding, cramping, and passage of tissue or a fetus

During examination – closed cervical os

Answer 16

Complete Abortion

Question 17

Describes dead products of conception that were retained for days, weeks, or even months in the uterus with a closed cervical os

Answer 17

Missed Abortion

Question 18

Nonviable pregnancy without vaginal bleeding, uterine cramping or cervical dilation

Answer 18

Missed Abortion

Question 19

Recurrent Abortion

Answer 19

≥ 3 losses at < 20 weeks OR with a fetal weight < 500 grams

American Society for Reproductive Medicine (2008)
≥ 2 failed clinical pregnancies confirmed by either sonographic or histopathological examination

Question 20

Refers to multiple losses in a woman who has never delivered a live born

Answer 20

Primary RPL

Question 21

Refers to multiple pregnancy losses in a patient with a prior live birth

Answer 21

Secondary RPL

Question 22

Midtrimester Abortion

Answer 22

Extends from the end of the 1st trimester until the fetus weighs ≥ 500 g or gestational age reaches 20 wks

Question 23

Risk Factors For Second-Trimester Abortion

Answer 23

race
ethnicity
prior poor obstetrical outcomes
extremes of maternal age

Question 24

Recommended for women with prior preterm birth

Answer 24

Cervical length screening

Question 25

Funneling

Answer 25

Ballooning of the membranes into a dilated internal os but with a closed external os

Question 26

Contraindications to Cerclage

Answer 26

bleeding contractions ruptured membranes

Question 27

Simpler procedure and most commonly used vaginal cerclage

Answer 27

McDonald

Question 28

Complications of Cerclage

Answer 28

membrane rupture preterm labor hemorrhage infection

Question 29

Medical or surgical termination of pregnancy before the time of fetal viability

Answer 29

Induced Abortion

Question 30

number of abortions per 1000 live births

Answer 30

abortion ratio

Question 31

number of abortions per 1000 women aged 15 to 44 years

Answer 31

abortion rate

Question 32

Medical And Surgical Disorders That Are Indication For Termination Of Pregnancy

Answer 32

persistent cardiac decompensation (with field pulmonary hypertension) advanced hypertensive vascular disease or diabetes malignancy to prevent birth of a fetus with a significant anatomical, metabolic, or mental deformity - THE MOST FREQUENT INDICATION CURRENTLY

Question 33

hygroscopic dilators (osmotic dilators)

Answer 33

Devices that draw water from surrounding tissues and expand to gradually dilate the endocervical canal For ripening

Question 34

Side effects of Misoprostol

Answer 34

fever bleeding gastrointestinal side effects

Question 35

Antiprogestin; effective cervical-ripening agent

Answer 35

Mifepristone

Question 36

Prevent postabortal infection after a first- or second-trimester surgical evacuation

Answer 36

prophylactic Doxycycline

Question 37

Transcervical approach to surgical abortion cervix is first dilated and then products of conception are evacuated

Answer 37

Vacuum Aspiration

Question 38

sharp dilation and curettage (DC)

Answer 38

Contents are mechanically scraped out solely by a sharp curette currently NOT recommended for pregnancy evacuation due to greater blood loss, pain, and procedural time

Question 39

Lies within connective tissue lateral to the uterosacral and cardinal ligaments and supply cervix, vagina, and uterus

Answer 39

Frankenhauser plexus

Question 40

Risk factors for abortion complication

Answer 40

``` operator inexperience prior cervical surgery or anomaly adolescence multiparity advanced gestational age ```

Question 41

3 Medications Used Alone Or In Combination in Medical Abortion

Answer 41

Mifepristone – augments uterine contractility by reversing progesterone-induced myometrial quiescence Methotrexate - acts on trophoblast and halts implantation Misoprostol - directly stimulates the myometrium

Question 42

Symptoms following Misoprostol (common w/n 3 hrs)

Answer 42

vomiting diarrhea fever chill bleeding and cramping

Question 43

Indications for uterine evacuation in the 2nd trimester

Answer 43

fetal anomaly or death maternal health complications inevitable abortion desired termination