C6.1: Abortion Classifications Flashcards
define abortion
termination of preg prior to 20 weeks, either SA or TA
whats the rate of preg loss?
25%
jumps to 50% at age 45
what are the characteristics of a threatened abortion what commonly causes it?
vaginal bleeding
normal and viable IUP (heart beat seen)
cervix closed
might have cramps
often due to implantation bleed
what is an embryonic demise?
embryo present but not heartbeat
OR
no fetus seen within retained membranes, on GS
how does a SA with no retained parts appear?
as a normal non gravid uterus
maternal factors causing SA
malformation of uterus toxic agents infection hormone failure implantation didnt occur (poor trophoblastic reaction) advanced maternal age
fetal factors causing SA
malformations
genetic (50-70%)
fatal and maternal factors causing SA
RH incompatibility
Rh is an antigen of the RBC
why does RH incompatibility cause SA if left untreated?
the mother is Rh- so will produce antibodies that attack the fetus which is Rh+
what are the clinical signs of SA
vagina bleeding
- can be light or heavy, heavy bleeding means she is 3 X more likely to miscarry than light bleeding
cramping
dilated cervix
uterine contractions
what % of preg will be lost if mom has vaginal bleeding?
for those that arent lost, what % have complications and what are those complications?
50%
17% will have complications such as PROM (premature rupture of membranes) and preterm labour
treatments for SA are:
nothing
dilation and curettage
what is a D&C
dilate the Cx and clean the uterine cavity
curettage means cleansing of a diseased area
how much of the uterine cavity should the GS occupy at 6, 8, and 10 wks?
6: < 1/2
8: 1/2
10: entire cavity
when does midgut herniation occur and what is the medical term for it?
~10 weeks
called physiological midgut herniation (gut herniates out of abdomen, twists, and then goes back in by 12 wks at latest)
how do you measure the yolk sac?
inner to inner
an normal IUP at 12 6/7 wks reduces that risk of preg loss to what %?
1-2%
a normal IUP of 6 wks often yields what type of result for the preg?
favourable
whats a subchorionic hemorrhage?
collection of blood near the gestation sac, could be a vanishing twin
what are the characteristics of an anembryonic pregnancy?
whats another term for it?
GS develops but no embryo
no yolk sac (usually)
bleeding with + preg test
blighted ovum
how will an anembryonic pregnancy appear on US?
uterus sm for dates
GS w/o fetus
MSD >20mm and no embryo (important, indicates preg isnt viable)
why do we do follow ups for anembryonic pregnancies?
GS may continue to gros due to hormones
what are the characteristics of an embryonic demise?
whats another term for it?
fetus dies but stays in uterus
bleeding
small for dates
5mm or greater embryo w/o HB
missed abortion
what do embryonic demises often occur?
between 10-14 weeks (often embryo has died earlier but patient had no symptoms
