Flashcards in Early Pregnancy Complications Deck (88)
Miscarriage is defined as the spontaneous end of a pregnancy before the foetus has reached the age of viability- what is this age?
Sporadic miscarriages occur in what percentage of all pregnancies?
What is the most common cause of a miscarriage?
Underlying genetic abnormality
What are some risk factors for miscarriage?
Increased maternal age, smoking/alcohol/drugs, excessive caffeine
What defines recurrent miscarriage?
The loss of three consecutive pregnancies
In women with APS, what interventions may improve the live birth rate for future pregnancies?
Low-dose aspirin and LMWH
What are some risk factors for recurrent miscarriage?
Increasing age and previous miscarriages
How is a miscarriage most likely to present?
PV bleeding and crampy abdominal pain
What two types of miscarriage will be associated with a viable intra-uterine pregnancy on ultrasound?
Threatened and inevitable
Which type of miscarriage is this describing: vaginal bleeding and/or abdominal pain with a closed cervical os?
Which type of miscarriage is this describing: vaginal bleeding and abdominal pain with an open cervical os?
Which type of miscarriage is this describing: vaginal bleeding and abdominal pain with an open cervical os and/or products of conception in the cervical os?
Which type of miscarriage is this describing: settling vaginal bleeding and abdominal pain with a closed cervical os?
Which type of miscarriage is this describing: often completely asymptomatic, but no foetal heartbeat and/or an empty gestational sac is found on ultrasound?
Why should products of conception be removed from the cervix in women having a miscarriage?
To reduce blood loss and pain, and reduce the risk of cervical shock
If a woman with a miscarriage experiences cramps, N+V, sweating and fainting, what complication should you consider?
What are the 4 main investigations for women with a miscarriage?
Urinary pregnancy test, serial HCG testing, TVUS, bloods for G&S
Transvaginal ultrasound is the most sensitive investigation for pregnancies less than what gestation?
The foetal heartbeat should be auscultated by hand held Doppler from what gestation?
What pattern seen on serial HCG testing is most indicative of miscarriage?
Decreasing concentrations over time
In a woman with recurrent miscarriage, what investigation is used to screen for anti-phospholipid syndrome?
In a woman with recurrent miscarriage, what investigation is used to look for balanced translocations?
In a woman with recurrent miscarriage, what investigation is used to look for thrombophilic defects?
In a woman with recurrent miscarriage, what investigation is used to look for uterine abnormalities?
TVUS and/or hysteroscopy
What management is required for women with excessive, life-threatening blood loss from a miscarriage?
What is usually the first line management plan for miscarriage?
What are the 3 situations in which expectant management is not possible for miscarriage?
High risk of bleeding, evidence of infection, previous adverse/traumatic event associated with pregnancy
What follow up is required for women who undergo expectant management of a miscarriage?
Ultrasound scan in 2-3 weeks
What medicine is used in the medical management of a miscarriage?
PO or PV misoprostol (PV is recommended)