ABORTIONS/MISCARRIAGES

Question 1

what is an abx?

Question 2

outline the incidence of abx

Question 3

outline the etiology of abx

Question 4

what is polyploidy?

Answer 4

Polyploidy is a genetic condition where a person has more than two sets of chromosomes. It can occur in humans in the form of triploidy (69 chromosomes) or tetraploidy (92 chromosomes).

Question 5

what is a blighted ovum?

Answer 5

A blighted ovum, or anembryonic pregnancy, is when a fertilized egg implants in your uterine lining but doesn’t grow into an embryo. The gestational sac and placenta will grow, but an embryo doesn’t grow so the gestational sac stays empty. It causes a miscarriage in the first trimester of pregnancy.

Question 6

what is hydropic degeneration of villi?

Answer 6

“Hydropic degeneration of villi” refers to a condition where the chorionic villi of the placenta become swollen and fluid-filled, often seen in cases of abnormal pregnancies like molar pregnancies or fetal demise, characterized by the accumulation of fluid within the villous stroma, leading to a distended and edematous appearance of the villi; essentially, it means the placental villi are degenerating by becoming excessively filled with fluid.
seen in failed or failing preg

Question 7

explain how endocrine and metabolic factors cause abx

Answer 7

 Luteal Phase Defect (LPD) results in early miscarriage as implantation and placentation are not
supported adequately. Deficient progesterone secretion from corpus luteum or poor endometrial response
to progesterone is the cause.
 Thyroid abnormalities: Overt hypothyroidism or hyperthyroidism are associated with increased fetal
loss. Thyroid auto antibodies are often increased.
 Diabetes mellitus when poorly controlled causes increased miscarriages

Question 8

explain how immunological disorders cause abx

Answer 8

 Autoimmune disease- can cause miscarriage usually in 2nd trimester.
* These pts form Abs against their own tissue & placenta, which ultimately cause rejection of early preg.
* Abs responsible are: (i) Antinuclear antibodies (ANAs); (ii) ds Anti-DNA Abs; (iii)
Antiphospholipid Abs includes lupus anticoagulant (LAC) & anticardiolipin Abs (aCL).
* Spiral artery & placental intervillous thrombosis, placental infarction and fetal hypoxia is the
ultimate pathology
 Alloimmunity- failure of maternal recognition of trophoblast lymphocyte cross-reactive antigen (TLX).
 Lead to lack of production of blocking Abs by the mother, due to sharing of Human Leucocyte Antigen
(HLA) between partners

Question 9

explain how inherited thrombophilia cause abx

Answer 9

 Causes both early and late miscarriages due to intravascular coagulation.
 Protein C resistance (factor V Leiden mutation) is the most common cause. Other
conditions are: Protein C deficiency and hyperhomocysteinemia

Question 10

explain how anatomical abn cause abx

Answer 10

 Cervical incompetence- Either congenital or acquired is one of commonest cause
of midtrimester & recurrent abortion
 Congenital malformation of uterus
 in form of bicornuate or septate uterus may be responsible for
midtrimester recurrent abortion
 Uterine fibroids
 Esp of submucous variety might be responsible not only for infertility
but also for abortion, due to distortion or partial obliteration of uterine
cavity.
 Other causes are: decreased vascularity at the implantation site, red
degeneration of fibroid and
increased uterine irritability.
 Intrauterine adhesionso Synechiae interfere with
implantation, placentation and fetal
growth. Depending on the severity
of adhesions, e.g. total (Asherman’s syndrome), corporal or cervicoisthmic, pt suffers from amenorrhea, hypomenorrhea, infertility or
recurrent abortion

Question 11

classify abx

Question 12

what are the risk factors of abx?

Question 13

outline the mechanism of abx

Question 14

what is a threatened abx?

Question 15

list the clinical featues of threatened abx

Question 16

investigations of threatened abx

Question 17

DDx of threatened abx

Question 18

outline the management of threatened abx

Question 19

what is the prognosis of threatened abx

Question 20

what is cervical ectopy?

Answer 20

A cervical ectopy is a red, velvet like and often raw looking area with a graze type appearance on the outer surface of the cervix. This is a benign (non-cancerous) condition and does not lead to cervical cancer.
Cervical ectropion is a condition in which the cells from the ‘inside’ of the cervical canal, known as glandular cells, are present on the ‘outside’ of the vaginal portion of the cervix. The cells on the ‘outside’ of the cervix are typically squamous epithelial cells.

Question 21

what is an inevitable abx?

Question 22

what are the clinical features of inevitable abx

Question 23

how do you manage inevitable abx

Question 24

what is a complete abx?

Question 25

what are the clinical features of complete abx?

Question 26

how do you investigate a complete abx?

Question 27

what is the management for complete abx?

Question 28

what is a uterine curettage?

Answer 28

aka A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues

Question 29

what is incomplete abx?

Question 30

c/f of incomplete abx?

Question 31

complications of incomplete abx?

Question 32

management of incomplete abx?

Question 33

describe a patulous cervical os

Answer 33

A "patulous cervical os" refers to a cervix (the opening of the uterus into the vagina) that dilates or opens abnormally, particularly during the second or early third trimester of pregnancy, which is a symptom of an "incompetent cervix" or cervical insufficiency, potentially leading to complications like preterm birth

Question 34

what is a missed abx?

Question 35

outline the pathology of missed abx

Question 36

c/f of missed abx

Question 37

complications of missed abx

Question 38

management of missed abx

Question 39

what is a laminaria tent?

Answer 39

A laminaria tent is a small, thin, stick-like rod made from dried seaweed stems (specifically Laminaria digitata or Laminaria japonica) that is used to slowly dilate the cervix, often before procedures like medical abortion or childbirth. It absorbs fluid from the cervical tissues and swells, gently opening the cervix.

Question 40

what is a septic abx?

Question 41

what are the criteria for a septic abx

Question 42

what are the modes of infection for septic abx

Question 43

c/f of septic abx

Question 44

how do you grade septic abx

Question 45

investigations for septic abx

Question 46

complications of septic abx

Question 47

management of septic abx

Question 48

what is physometra?

Answer 48

"Physometra" refers to the distention of the uterine cavity with air or gas. It's a condition where the uterus is inflated by air, rather than fluid, like in pyometra (pus in the uterus) or hydrometra (fluid in the uterus)

Question 49

what is recurrent abx?

Question 50

aetiology of recurrent abx

Question 51

investigations for recurrent abx

Question 52

what are the qualifications for performing a medical termination of pregnancy (MTP)?

Question 53

outline the methods of MTP

Question 54

List the post abortion care (PAC) services

Question 55

how can unsafe abx be prevented