Early Obstetric Hemorrhage

Question 1

Abortion is defined by WHO as pregnancy termination prior to ____ weeks of gestation or with fetus born weighing ______

Answer 1

20 weeks
<500 g

Question 2

This pertains to a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 6/7 weeks AOG.

Answer 2

Early pregnancy loss

Question 3

Pregnancy of Unknown Location is identified with ________ testing but without a confirmed sonographic location

Answer 3

serum Beta-hCG

Question 4

Of embryonic miscarriages, how many percent of all abortuses have chromosomal abnormalities?

Answer 4

25%

Question 5

This pertains to a miscarriage that contains no identifiable embryonic elements

Answer 5

Anembryonic Miscarriage
Pre-embryonic loss

Question 6

The frequency of chromosomal anomalies in abortuses and stillbirths is highest in which trimester?

Answer 6

First trimester (55%)

Second trimester is 35%
Third trimester is 5%

Question 7

Which embryonic abortion tend to abort later in gestation?

Answer 7

Euploid/Normal Abortion

Question 8

The incidence of euploid abortions increases dramatically after maternal age exceeds:

Answer 8

35 years

Question 9

Between maternal and paternal gametogenesis errors, which one causes 95% of chromosonal abnormalities in aneuploid/abnormal abortions?

Answer 9

maternal

Question 10

75% of aneuplod abortions abort before ____ weeks of gestation

Answer 10

8 weeks

Question 11

This is the most frequently identified chromosomal anomaly in aneuploid abortions

Answer 11

Autosomal trisomy

Question 12

This is the single most frequent specific chromosomal abnormality in aneuploid abortions

Answer 12

Monosomy X (45 X)

Question 13

True or False:
Autosomal monosomy is incompatible with life

Answer 13

True

Question 14

This chromosomal abnormalities is associated with hydropic placental (molar) degeneration

Answer 14

Triploidy

Question 15

True or False:
Advanced maternal and paternal age DO NOT increase the incidence

Answer 15

TRUE

Question 16

What are the maternal factors that can cause abortion?

Answer 16

Infections
Medical disorders
Cancer
Surgical Procedures
Nutrition
Social and Behavioral
Occupational and Environmental factors

Question 17

Which paternal factor is associated with increased abortion?

Answer 17

Age

Question 18

At what paternal age is the risk for abortion lowest?

Answer 18

before age 25

Question 19

In increasing paternal age, chromosomal abnormalities in the __________ likely play a role in abortions

Answer 19

spermatozoa

Question 20

Which Maternal Medical Disorders have prominent risks associated to abortions:

Answer 20

1. Poorly controlled DM
2. Obesity
3. Thyroid disease
4. Systemic disease

Question 21

True or False:
Exposure to <5 rads does not increase risk of abortion

Answer 21

TRUE

Question 22

Which chemotheraputic drug is particularly worrisome in women with ongoing pregnancy due to its association with abortion?

Answer 22

Methotrexate

Question 23

Surgical removal of which structure before 10 weeks of gestation may cause abortion?

Answer 23

Corpus luteum

Question 24

True or False:
Trauma seldom causes first trimester miscarriage

Answer 24

True
→ Major trauma (especially abdominal) can cause fetal loss, but is more likely as pregnancy advances

Question 25

True or False: Underweight is not associated with a greater miscarriage risk

Answer 25

True Note: Obesity does raise pregnancy loss rates.

Question 26

Regular or heavy use of alcohol about ____ or more drinks per week increases miscarriage risk

Answer 26

4 or more

Question 27

Alcohol intake during pregnancy is strongest for miscarriage occurring prior to ______ weeks of gestation

Answer 27

10 weeks

Question 28

Secondhand smoke exposure during pregnancy increased the risk of miscarriage by ___%

Answer 28

11%

Question 29

Reports link heavy intake of approximately _____ cups of coffee per day (about _____ mg of caffeine) with slightly greater abortion risk

Answer 29

5 cups (500 mg)

Question 30

True or False: Studies of moderate intake (less than 200 mg daily) did not indicate increased risk

Answer 30

True

Question 31

Give 4 environmental toxins have a possible link to miscarriage:

Answer 31

Bisphenol A Phthalates Polychlorinates Biphenyls Dischlorodiphenyltrichloroethane DDT

Question 32

This is the most predictive risk factor for pregnancy loss in threatened miscarrage

Answer 32

Bleeding

Question 33

What is the normal serum progesterone?

Answer 33

> 20 ng/mL

Question 34

What is the serum progesterone level associated with threatened abortion?

Answer 34

< 5 ng/mL

Question 35

What diagnostic procedure establishes viability of the fetus?

Answer 35

Serial quantitative serum beta-hCG

Question 36

Identify type of abortion in patient with vaginal bleeding. Physical and Internal Examination: → Abdomen is soft, non-tender → Cervix is closed → Intact Bag of water → Size of uterus is compatible with AOG

Answer 36

Threatened miscarriage

Question 37

Identify type of abortion in a patient in <20 wk AOG with PPROM only ● Internal Examination: → Ruptured bag of water → Passage of amniotic fluid → Cervix is open

Answer 37

Inevitable abortion

Question 38

Identify type of abortion in patient with history of heavy bleeding, cramping, and passage of tissue or fetus. IE: closed cervical os UTZ: empty cavity

Answer 38

Complete Abortion

Question 38

Identify type of abortion in patient with vaginal bleeding and small uterus IE: open cervic and tissues plugging the os

Answer 38

Incomplete abortion

Question 39

Identify type of abortion. Dead products of conception were retained for days, weeks, or even months in the uterus with a closed cervical os

Answer 39

Missed abortion