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Flashcards in Spontaneous Abortion Deck (11):
0

1. Threatened abortion
2. Inevitable abortion
3. Incomplete abortion
4. Completed abortion
5. Missed abortion

1. Less than 20 weeks gestation, vaginal bleeding, NO cervical dilation

2. Less than 20 weeks gestation, bleeding, dilation, no passage of tissue

3. Less than 20 weeks gestation, bleeding, passage of tissue per vagina but with RETAINED tissue in utero, Open cervix, continuing contractions

4. Less than 20 weeks gestation, all products of conception past, closed cervix

5. Less than 20 weeks gestation, asymptomatic fetal demise

2

Treatment of incompetent cervix?

cerclage – Surgical ligation at level of internal cervical os

3

Treatment of incomplete abortion?

D&C of the uterus

4

Threatened abortion: history? Passage of tissue? Cervical os? Viability of pregnancy? Treatment?

Vaginal bleeding; no passage of tissue; closed; 50% miscarry; transvaginal ultrasound and hCG level

5

Inevitable abortion: history? Passage of tissue? Cervical os? Viability of pregnancy? Treatment?

Cramping/bleeding; no passage of tissue; open; inevitable abortion; suction D&C

6

Incomplete abortion: history? Passage of tissue? Cervical os? Viability of pregnancy? Treatment?

Current cramping/bleeding; some passage of tissue; open; nonviable; D&C

7

Complete abortion: history? Passage of tissue? Cervical os? Viability of pregnancy? Treatment?

Subsided cramping/cleaning; all tissues passed; closed; nonviable; follow hCG until negative

8

Missed abortion: history? Passage of tissue? Cervical os? Viability of pregnancy? Treatment?

No symptoms; no passage of tissues; clothes; nonviable; D&C

9

Clinical presentation of molar pregnancy?

1. Vaginal spotting
2. Absence of fetal heart tones
3. Size greater than dates
4. Elevated hCG

10

Diagnosis of molar pregnancy? Treatment? If trophoblastic disease persists after evacuation?

Ultrasound showing "snowstorm" pattern

Suction curettage followed by weekly hCG levels

Chemotherapy

11

Inevitable abortion versus incompetent cervix?

Uterine contractions lead to cervical dilation

versus

cervical opening (without uterine contractions) resulting in painless dilation