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Obstetrics and Gynaecology > Pregnancy loss > Flashcards

Flashcards in Pregnancy loss Deck (12)
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1
Q

What is spontaneous abortion/miscarriage?

A

Loss of pregnancy before 20 weeks’ gestation

2
Q

What is stillbirth/intrauterine fetal demise?

A

Loss of pregnancy after 20 weeks’ gestation

3
Q

What is recurrent pregnancy loss?

A

Two or more miscarriages occurring before 20 weeks’ gestation

4
Q

What are the risk factors of spontaneous abortion?

A

(Maternal) Reproductive organ abnormalities (i.e. cervical incompetence, uterine adhesions)
Systemic diseases (i.e. diabetes mellitus, hyper/hypothyroidism, genetic disorders, hypercoagulability)
(Fetoplacental) Chromosomal/congenital abnormalities
Trauma
Drugs
Toxins

5
Q

What are the risk factors of stillbirths?

A

(Maternal) Fetal-maternal hemorrhage, Diabetes mellitus, Hypertensive pregnancy disorders, Uterine rupture, advanced age
(Fetoplacental) Intrauterine growth restriction, placental abnormalities (i.e. abruption, previa), infection, congenital
Unknown
Toxin / Drugs

6
Q

What are the types of abortions and the clinical findings?

A

Threatened abortion: Vaginal bleeding, no foetal activity, closed cervical os
Inevitable abortion: Vaginal bleeding +/- products of conception, open os
Missed abortion: No bleeding, no products of conception, no foetal activity, closed os
Incomplete abortion: Vaginal bleeding, products of conception, open os, usually > 12weeks
Complete abortion: Vaginal bleeding, products of abortion, closed os, usually < 12 weeks
Stillbirth: No foetal movement, no cardiac activity, open/closed os, > 20 weeks

7
Q

How is pregnancy loss diagnosed?

A
(<20 weeks) Doppler ultrasound for foetal activity 
Pelvic examination 
Transvaginal ultrasound 
Downtrend beta-hCG 
(>20 weeks) US
Foetal autopsy to determine cause
8
Q

What is the treatment for threatened abortion?

A

Expectant management
Weakly US
Treat underlying conditions
Rh(D)-negative women should receive Rh(D)-immune globulin

9
Q

What is the treatment for inevitable/missed/incomplete/abortions?

A

Expectant management
Misoprostol (induce expulsion of products of conception)
Pretreatment with mifepristone 24 hours prior is recommended (improves efficacy than just misoprostol)
Surgical evacuation

10
Q

What is the treatment for complete abortions?

A

No treatment

11
Q

What is the treatment for stillbirths?

A

Do not rush delivery unless other risk factors present (i.e. preeclampsia, infection)
Spontaneous labor usually begins within 2 weeks of stillbirth
Emotional support

12
Q

What are the complications of pregnancy loss?

A

(Septic abortion) Complication of a missed, inevitable, or incomplete abortion in which retained products of conception become infected
(Retained products of conception (RPOC)) → release of thromboplastin into systemic circulation → disseminated intravascular coagulation
(Endometritis)