Clincal:Abortions Flashcards Preview

Reproductive Exam 1 > Clincal:Abortions > Flashcards

Flashcards in Clincal:Abortions Deck (56):
1

Define abortion

unexpected, unplanned, sponatneous loss of pregnancy BEFORE fetus is sufficiently developed to survive extrautreo

2

up to how many weeks gestation defines it to be an abortion

Occur up to 20 weeks gestation

3

if the abortion is spontaneous and occurs AFTER 20 week but BEFORE 37 it is a ...

Preterm birth

4

spontaneous abortion is aka

miscarriage

5

how many weeks gestation defines it to be intrauterine fetal demise (IUFD)

Fetal death after 20 weeks but BEFORE the onset of labor

6

IUFD is considered what type of abortion BEFORE 20 weeks

missed abortion

7

AFTER 20 weeks gestation, fetal death is considered ... and no longer a missed abortion

IUFD

1% of pregnancies

8

abortion incidence of all preganancies

50%

9

abortion incidence of clinically recognizable pregnancies

10-15%

10

if the fetus makes it to ... weeks gestation, the loss rate is reduced to (blank)% over the next 20 weeks

8 weeks gestation
3%

11

what is the loss rate over the next 20 weeks if mom is < 30 yrs old

2%

12

what is the loss rate over the next 20 weeks if mom is >40 yrs old

5-10%

13

at what age does the mom start going downhill in creating healthy babies

35 yrs old

worse if she's 35 and smokes

14

define threatened abortion

vaginal bleeding BEFORE 20 weeks and the cervical os is CLOSED

15

what % of pregnant pt have some degree of bleeding in the 1st trimester

25%

16

of the 25% that have some degree of bleeding in the 1 trimester, how many result in loss of the pregnancy

25-50%

17

define inevitable abortion

vaginal bleeding with the cervix open to some degree

18

what symptom is frequently seen with inevitable abortion

cramping

19

define incomplete abortion

bleeding, Os OPEN, and passage of some products of conception

20

define complete abortion

bleed, Os CLOSED, and passage of ALL the productions of conception

21

define missed abortion

fetus died and is retained in the uterus
there's usually no bleeding and usually no symptoms
-basically the body "missed" the fact that the fetus is dead and hasn't elicited any symptoms

22

therapeutic or elective abortions

Elective termination of the pregnancy

23

define septic abortion

any spontaneous or therapeutic abortion with intrauterine infection

24

define recurrent abortion

3 successive abortions
-a work up should be done usually after the 2nd abortion

25

what could be causing recurrent abortions

usually bacteria/ infections/ viruses

26

***what is the MOST common cause of spontaneous abortion***

significant genetic abnormality of the conceptus --> im assuming another word for the fetus

27

what are some other etiologies

Infections
Environmental Exposure
Systemic disorders
Increased maternal age
Uterine abnormalities
Fetal/Genetic abnormalites
Immunologic

28

what are some examples of infections that can cause an abortion

Rubella, Listeria, Mycoplasma, Toxoplasma (cat feces)

29

what are examples of environmental exposures that can cause an abortion

smoking, alcohol, chemicals

30

what are examples of systemic disorders that can cause an abortion

Diabetes, hypothyroidism, SLE

31

How can increased maternal age affect abortions

the chromosomal factors

32

what are examples of uterine abnormalities

cervical incompetence
fibroids
septums
Asherman's syndrome - endometrial lining adhering to each other

33

what can cause Asherman's syndrome

scraping of the endometrial lining, D&E

34

Abortions effected by serum Ab, Rh, Kell & Duffy, etc... is what etiology

immunologic

35

Fetal/Genetic abnormalities:
what ratio of spontaneous 1st trimester abortions have significant CHROMOSOMAL abnormalities

2/3

36

of the 2/3 with chromosomal abnormalities, 1/2 is associated with what type of chromo abnl

Trisomies

37

What do you do for a threatened abortion

ultrasound
rest and reassurance

38

What do you do for an inevitable abortion

hospital admission
analgesia
possible D&C
prostaglandins,
cytotec

39

What do you do for a incomplete abortion

same as inevitable:
hospital admission
analgesia
possible D&C
prostaglandins,
cytotec

40

D&C, Cytotec, prostaglandins, Laminaria manages which abortion type

Missed abortion

41

**if pt is Rh - , what must be given ***

Rhogram injection

42

what do you do for a complete abortion

supportive measures

43

I.V, antibiotics and evacuation

septic abortion

44

What do you need to do for recurrent abortions

workup with cultures, labs for Ab, and possibly chromosomal studies

45

What do you do for an elective abortion

counselling, D&C, D&E (done in the 2nd trimester), prostglandins or laminaria

46

**what are the causes and their respective % for fetal death***

placental and cord - 10-20%
HTN - 5-20&
Med complications - 5-10%
Infections - 5-10%
Congential anomalies - 5-10%
unknown - >50%

47

How do you diagnose IUFD

US
spalding's sign
gas in the CV system

48

What does an ultrasound do for IUFD

it confirms lack of movement and absence of fetal heart tones

49

what is Spalding's sign

the overlapping of the fetal skull bones on x-ray
- mostly due to liquefaction of the fetal brain

50

What is important to monitor for IUFD

coagulopathies

51

fibrinogen, fibrin split products, PT and PTT, CBC with Platelets

DIC

52

what needs to be done as a follow up for abortions

-work up pts for infections especially TORCH
-immune diseases
-uterine anomalies
-chromosome defects

53

What does TORCH stand for

T – Toxoplasmosis / Toxoplasma gondii
O – Other infections
R – Rubella
C – Cytomegalovirus
H – Herpes simplex virus-2 or neonatal herpes simplex

54

Dont need to know, but who knows:
how do you manage IUFD

13 to 28 weeks- either watchful expectancy or induction of labor.
80%- spontaneous labor in 2-3 weeks.
Induction with prostaglandins 12-28 weeks.
D&E.

55

Dont need to know, but who knows:
when does pitocin induction begin

after 28 weeks

56

Dont need to know, but who knows:
what is pitocin induction

high rate of uterine rupture with prostoglandins at the age