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Flashcards in spontaneous abortion Deck (17)
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1

abortion

termination of prego by any means before 20 wks gestation

2

spontaneous abortion

premature expulsion of the products of conception, it occurs in up to 15-20% of clinically recognized preg

3

what is the most common cause of spontaneous abortion

chromosomal abnormalities

4

what are maternal facotrs that may increase the risk of spontaneous aborion?

smoking, infxn, maternal systemic dz, immunologic parameters, drug use, high BMI, heavy caffeine use, submusocal fibroids, uterine abnormalitly,

Ashermans, hx of prior SAB

5

when do most spontaneous abortions occur? (aka miscarries)

first trimester

6

threatened SA

+ vag bleed
-cevix opening
-no product of conception passes

7

inevitable SA

+ vag bleed
+ cervix opening
- not product of conception yet, but no way to maintiain prego

8

incomplete aSA

+ vag bleed
+ cervix opening
partial products

9

complete SA

+vag bleed
+cervix opeing
+product

10

missed SA

- vag bleed
-cervix
-no (fetal demise w/o sx)

11

tx of SA

o If the pregnancy has been definitively determined to be no longer viable, the uterus must be emptied
o If the pregnancy is early and the patient is managed expectantly (allow the products of conception to pass naturally), careful follow-up with pelvic examinations, serial hCG titers, and transvaginal ultrasonography can be used to determine whether the abortion is complete
o Dilation and curettage also may be necessary to ensure complete emptying of the uterus or as one form of induced abortion. Morbidity is caused by uterine perforation or cervical laceration

12

tx of complete SA

RhoGam

13

tx of Threatened SA

avoid heavy activity, pelvic rest (no tampons, sex)

14

tx of missed

D&C; expectant management; RhoGAM if appropriate

15

INcomplete tx

D&C; expectant management; RhoGAM if appropriate

16

inevitable tx

D&C or uterotonics to complete SAB; RhoGAM if appropriate. Maternal mortality is 10-50% if in septic shock

17

septic SA tx

Complete uterine evacuation, D&C, IV antibiotics, RhoGAM if appropriate.
Maternal mortality is 10-50% if in septic shock.