Recurrent pregnancy loss

Question 1

What is the definition of spontaneous abortion?

Answer 1

Loss prior to 20 weeks or below 500 g

Question 2

What is the definition of recurrent pregnancy loss?

Answer 2

Two or more consecutive spontaneous miscarriages

Question 3

What is the definition of anembryonic pregnancy?

Answer 3

empty gestational sac at 4-5 weeks of pregnancy

Question 4

What is the definition of yolk sac misscariage?

Answer 4

Yolk sac present by no embryo by 5-6 weeks

Question 5

What is the definition of fetal demise?

Answer 5

fetus with cessation of cardiac activity after 10 weeks

Question 6

What is the definition of early pregnancy loss?

Answer 6

nonviable, intrauterine pregnancy prior to 13 weeks gestation

Question 7

Crown rump length of ____mm or greater and no heart beat is diagnostic of early pregnancy failure.

Answer 7

7

Question 8

Mean Sac diameter of ___mm or greater and no embryo present is diagnostic of early pregnancy failure.

Answer 8

25

Question 9

Absence of embryo with heartbeat ____ days or more after scan showed gestational sac WITHOUT yolk sac is diagnostic of early pregnancy failure.

Answer 9

14

Question 10

Absence of embryo with heartbeat _____ days or more after scan showed gestational sac WITH yolk sac is diagnostic of early pregnancy failure.

Answer 10

11

Question 11

What medications should be given preop for a D&C for missed SAB?

Answer 11

Doxycyline 200 mg

Question 12

What is the recommended regimen for medical management of missed SAB?

Answer 12

Misoprostal 800 mcg vaginally

Question 13

What medication and dose can be added to misoprostal to improve the efficacy for missed SAB?

Answer 13

Mifepristone 200 mg 24 hrs prior to Misoprostal

Question 14

Misscariage affects what percentage of pregnancies?

Answer 14

12-15%

Question 15

What is the rate of recurrent pregnancy loss?

Answer 15

1-2%

Question 16

What is the most common cause of recurrent pregnancy loss?

Answer 16

Chromosomal abnormalities

Question 17

What is the rate of miscarriage in women < 30 years?

Answer 17

25%

Question 18

What is the rate of miscarriage in women 31 - 35 yrs?

Answer 18

28%

Question 19

What is the rate of miscarriage in women 36 - 39 yrs?

Answer 19

33%

Question 20

What is the rate of miscarriage in women > 40yrs

Answer 20

52%

Question 21

What percentage of 1st trimester pregnancy loss is attributed to chromosomal abnormalities?

Answer 21

> 75%

Question 22

What is the most common Trisomy associated with SAB?

Answer 22

Trisomy 16

Question 23

What is the most common chromosomal abnormality resulting in SAB?

Answer 23

Trisomies

Question 24

What is the second most common chromosomal abnormality resulting in SAB?

Answer 24

Monosomy X, Turners

Question 25

What is the most common type of genetic mutation associated with parental chromosomal abnormalities?

Answer 25

balanced translocation

Question 26

What is the most common congenital uterine anomaly associated with recurrent pregnancy loss?

Answer 26

Septate Uterus

Question 27

What is the best treatment for recurrent pregnancy loss associated with a septate uterus?

Answer 27

Hysteroscopic septoplasty

Question 28

Which type of fibroids carry risk of miscarriage?

Answer 28

Submucosal and intramural

Question 29

In a patient with previous curretage for septic SAB who has recurrent pregnancy loss, what would you anticipate the cause?

Answer 29

Asherman's syndrome

Question 30

What percentage of women with recurrent pregnancy loss have positive antiphospholipid antibodies?

Answer 30

5 - 20%

Question 31

What three antiphospholipid antibodies can cause recurrent pregnancy loss?

Answer 31

Lupus anticoagulant, Anticardiolipin antibody, Anti-B2 Glycoprotein I antibody

Question 32

True/False: subclinical hypothyroidism cause recurrent pregnancy loss

Answer 32

True

Question 33

What two infectious organisms are associated with Recurrent pregnancy loss?

Answer 33

Ureaplasma and Mycoplasma

Question 34

Do obese women have a higher rate of SAB?

Answer 34

Yes