Pregnancy Loss

Question 1

Intrauterine fetal demise (stillbirth) is defined as fetal death after 20 weeks, no fetal cardiac activity on ultrasound Management:
- 20-23 weeks:
- ≥ 24 weeks:

Answer 1

• Dilation and evacuation OR vaginal delivery
• Induced vaginal delivery

Question 2

-Unstable spontaneous abortion is managed with:
- Stable spontaneous abortion is managed with:

Answer 2

• Dilation and curettage
• Expectant / medical management

Question 3

What is the potential complication of intrauterine fetal demise that is retained in utero for several weeks?

Answer 3

Coagulopathy (e.g. disseminated intravascular coagulation (DIC)) due to systemic absorption of thromboplastin

Question 4

What type of miscarriage is characterized by no vaginal bleeding and a closed cervical os with no fetal cardiac activity?

Answer 4

Missed abortion

Question 5

What type of miscarriage is characterized by vaginal bleeding and a closed cervical os with normal fetal cardiac activity?

Answer 5

Threatened abortion

Question 6

What is the recommended treatment for patients with septic abortion?

Answer 6

Broad-spectrum antibiotics(clindamincin+gentamicin) + dilation and curettage

Question 7

What is the treatment for threatened abortion?

Answer 7

Reassurance and follow-up ultrasonography

Question 8

After delivery, what is the next best step in management of a stillbirth?

Answer 8

Recommend fetal autopsy & placental evaluation

Question 9

What type of miscarriage is characterized by vaginal bleeding and a dilated cervical os without expulsion of products of conception?

Answer 9

Inevitable abortion

Question 10

Vaginal bleeding, closed cervical os and no parts on ultrasound is suggestive of:

Answer 10

Complete abortion