Early Pregnancy Loss

Question 1

Medical term for pregnancy loss before 20 weeks is

Answer 1

abortion

Question 2

Vaginal spotting early in gestation. No passage o embryonic or fetal tissue. Abdominal cramping. Cervix is closed.

Answer 2

Threatened Abortion

Question 3

Management/Treatment of threatened abortion

Answer 3

Possible mild activity restriction with bedrest 24-48 hours, sedation. Instructed to avoid stimulation of sexual intercourse and orgasm for 2 weeks.

Question 4

Pregnancy loss that cannot be prevented. Bleeding may be moderate/heavy.Cervix is dilated with tissue in cervix.

Answer 4

Inevitable abortion

Question 5

Management of inevitable abortion:

Answer 5

If products of conception are not passed spontaneously, vacuum curettage or administration of prostaglandin analog to evacuate the uterus. A D&C may be performed.

Question 6

Passage of some of the products of conception. Ultrasound reveals retained material in the uterus. Cervix is open

Answer 6

Incomplete abortion

Question 7

Management of incomplete abortion

Answer 7

Cervix is open but may require additional dilation before curettage.

Question 8

All fetal tissue and products of conception passed in bleeding. Ultrasound reveals an empty uterus.

Answer 8

Complete abortion

Question 9

If a pregnancy ends before 20 weeks it is an:

Answer 9

Abortion

Question 10

Management of complete abortion

Answer 10

No further intervention may be needed if uterine contractions adequate to prevent hemorrhage and there is no infection. No need for treatment but follow up care to discuss related issues.

Question 11

Fever, abdominal pain and tenderness. Bleeding from scant to heavy, usually malodorous. Cervix usually dilated.

Answer 11

Septic abortion

Question 12

Management of septic abortion

Answer 12

Care includes termination of pregnancy; culture and sensitivity studies to initiate appropriate antibiotic therapy.

Question 13

Retained nonviable embryo or fetus for 6 weeks or more. Fetus has died and placenta atrophied but products of conception retained. Cervix is closed.

Answer 13

Missed abortion

Question 14

Management of missed abortion

Answer 14

If spontaneous evacuation of the uterus does not occur within one month, uterus is evacuated by method appropriate to duration of the pregnancy. Blood clotting factors are monitored. DIC with uncontrolled hemorrhage may develop in cases of fetal death after week 12.

Question 15

Three or more consecutive losses before 20 weeks of gestation. Cervix open.

Answer 15

Habitual or recurrent abortion

Question 16

Management of habitual or recurrent abortion

Answer 16

Identification and treatment of underlying cause if possible. Prophylactic cerclage if r/t cervical insufficiency.

Question 17

Cervical Internal OS opening or prolapsed fetal membranes

Answer 17

cervical insufficiency

Question 18

Abdominal pain, spotting, positive pregnancy test, verified by US, signs of shoulder pain (Ruptured tube) signs of shock

Answer 18

ectopic pregnancy

Question 19

Painless bright red bleeding after 20 weeks

Answer 19

placenta previa

Question 20

Painful abdominal pain with or without bleeding, uterine tenderness, confirmed after delivery

Answer 20

abruptio placentae