UW abortions 02-19 (2)

Question 1

UW table. Spontaneous. Definition?

Answer 1

pregnancy loss < 20 weeks

Question 2

UW table. Spontaneous. Risk factors? 3

Answer 2

Advanced maternal age;
Previous spontaneous abortion;
Substance abuse

Question 3

UW table. Spontaneous. Tx options?3

Answer 3

Expectant
Medical induction (misoprostol)
Suction curettage if infection or HD instability

Question 4

UW table. Spontaneous. Additional management? 2

Answer 4

Rho (D) immune globulin
Pathology examination

Question 5

UW table. Spontaneous. Complications? 5

Answer 5

Hemorrhage
Retained products of conception
Septic abortion
Uterine perforation
Intrauterine adhesions

Question 6

Common cause of 1st/2nd trim bleeding?

Answer 6

Spontaneous abortion

Question 7

UW additional text. Spontaneous. Presentation? 4

Answer 7

Heavy vaginal bleeding
Cramping
Dilated cervix
Nonviable intrauterine gestation in the lower segment of uterus

Question 8

UW additional text. Spontaneous. Tx if HD stable?

Answer 8

Expectant management
Misoprostol

Question 9

UW additional text. Spontaneous. Tx if HD unstable?

Answer 9

Suction curettage

Question 10

UW abortu fotkes. Inevitable (spontaneous) CP?

Answer 10

vaginal bleeding
dilated cervical os
products of conception may be seen or felt at or above cervical os

Question 11

UW additional text. Missed abortion. onset?

Answer 11

intrauterine pregnancy demise at < 20 weeks gestation

Question 12

UW additional text. Missed abortion. risk factors?

Answer 12

advanced maternal age (due to incr. of fetal chromosomal abnormalities)

Question 13

UW additional text. Missed abortion. presentation?

Answer 13

Asymptomatic
decreased pregnancy symptoms (nausea, breast tenderness)

Question 14

UW additional text. Missed abortion. physical examination? 2

Answer 14

Closed cervix
No bleeding

Question 15

UW additional text. Missed abortion. UG findings?

Answer 15

a) Embryo without cardiac activity
b) Empty gestational sac without fetal pole. (some early pregnancies can present without a fetal pole. Hence viability is determined by serial ultrasounds and serial b-hCG levels). Repeat b-hCG normally increase until the end of first trimester but in case of missed abortion, decreasing levels are seen

Question 16

UW abortu fotkes. Missed abortion. Cp3

Answer 16

No vaginal bleeding
Closed cervical os
NO FETAL CARDIAC ACTIVITY or empty sac

Question 17

UW additional text. Complete abortion. risk factors? 3

Answer 17

Cocaine, alcohol, tobacco

Question 18

UW additional text. Complete abortion. presentaton? 2

Answer 18

Lower abdominal pain
Heavy vaginal bleeding with passage of clots at < 20 weeks gestation

Question 19

UW additional text. Complete abortion. examination?

Answer 19

closed cervix

Question 20

UW additional text. Complete abortion. Diagnosis? 2

Answer 20

Ultrasonography (empty uterus; normal adnexa)
b-hCG positive because it can take up to 6 weeks for b-hCG to become undetectable

Question 21

UW abortu fotkes. Complete abortion. CP3?

Answer 21

vaginal bleeding
closed cervical os
products of conception COMPLETELY EXPELLED

Question 22

UW additional text. Threatened abortion. features? 4

Answer 22

Closed cervix
viable intrauterine gestation
vaginal bleeding
SUBCHORIONIC HEMATOMA

Question 23

UW abortu fotkes. Threatened abortion. cp3?

Answer 23

vaginal bleeding
closed cervical os
FETAL CARDIAC ACTIVITY

Question 24

UW abortu fotkes. Incomplete abortion. 3cp?

Answer 24

Vaginal bleeding
dilated cervical os
some products of conception expelled and some remain

Question 25

UW table. Septic abortion. risk factors? 3

Answer 25

Retained products of conception from: a) elective abortion with nonsterile technique b) Missed or incomplete abortion (rare)

Question 26

UW table. Septic abortion. CP? 4

Answer 26

Fever, chills, abdominal pain Sanguinopurulent vaginal discharge Boggy, tender uterus, dilated cervix Pelvic UG: retained POC, thick endometrial stripe

Question 27

UW table. Septic abortion. management? 3

Answer 27

IV fluids broad spectrum antibiotics suction curettage

Question 28

UW additional text. Septic abortion. Note about hysterectomy?

Answer 28

Not indicated. it is indicated in following case: a) Pelvic abscess; b) if the patient does not improve after suction curretage and 48h of broad spectrum abs

Question 29

UW additional text. Septic abortion. Note about misoprostol?

Answer 29

misoprostol causes uterine contractions and expels products of conception for spontaneous abortion. However, it is not used for septic abortion because of slow onset of action

Question 30

paveiksliukai.

Question 31

paveiksliukai.

Question 32

paveiksliukai. No vaginal bleeding Closed cervical os NO FETAL CARDIAC ACTIVITY or empty sac which one?

Answer 32

Missed abortion

Question 33

paveiksliukai. Vaginal bleeding Closed cervical os FETAL CARDIAC ACTIVITY which one?

Answer 33

Threatened abortion

Question 34

paveiksliukai. Vaginal bleeding Dilated cervical os Products of conception may be seen or felt at or above cervical os which one?

Answer 34

Inevitable abortion

Question 35

paveiksliukai. Vaginal bleeding Dilated cervical os Some products of conception expelled and some remain which one?

Answer 35

Incomplete abortion

Question 36

paveiksliukai. Vaginal bleeding Closed cervical os Products of conception COMPLETELY expelled which one?

Answer 36

Complete abortion

Question 37

(Choice D) Case - inevitable abortions. patient's uterine bleeding will likely stop after the uterus has been evacuated. A hysterectomy would be indicated for persistent bleeding after suction curettage only if all other treatments (eg, uterine tamponade, uterine artery embolization) have failed.

Answer 37

.

Question 38

A complete abortion, a type of spontaneous abortion.

Answer 38

.

Question 39

A complete abortion, a type of spontaneous abortion, typically presents as lower abdominal pain and heavy vaginal bleeding with the passage of clots at <20 weeks gestation. These symptoms worsen until the products of conception—often described as a solid or sac-like bloody purple to white mass—are expelled and the symptoms lessen and resolve.

Answer 39

.

Question 40

A complete abortion, a type of spontaneous abortion. Cervix? size of uterus?

Answer 40

Pelvic examination findings include a normal-sized uterus with a closed cervix. When finishes - the cervix closes, and the associated pain and bleeding subside.

Question 41

A complete abortion, a type of spontaneous abortion. hCG levels?

Answer 41

hCG yra positive. It can take up to 6 weeks for β-hCG levels to become undetectable while the levels clear and trophoblastic tissue resolves

Question 42

A complete abortion, a type of spontaneous abortion. Ug of uterus?

Answer 42

Empty uterus, but other findings, including a small simple (unilocular) ovarian cyst with fluid in the pelvis, are common. These findings are common in early pregnancy and represent the corpus luteum and retrograde bleeding from the spontaneous abortion, respectively.

Question 43

(Choice C) Although some pain and/or [Mehl – light bleeding can occur 1-2 weeks post ovulation when implantation begins] bleeding can occur with a normal pregnancy (ie, implantation site bleeding), ultrasound would reveal an intrauterine pregnancy (at 7 weeks gestation, ultrasound would show a fetal pole with a normal heartbeat).

Answer 43

.

Question 44

what would show UG in ectopic? bleeding?

Answer 44

common cause of first trimester bleeding. ectopic pregnancy typically presents with a complex adnexal mass with surrounding vascularity, and if ruptured, a large amount of complex fluid in the pelvis