1. Ch 2 - Failed Pregnancy Flashcards
vacuum curettage for abortion can b performed before __ weeks
13
drugs used for medical abortion
Mifepristone - (Mifiprex) a progesterone antagonist
Misoprostol - (Cytotec) Prostaglandin E1
in rare cases of medical abortion ___________ sepsis has been reported
clostridium sordellii
medical abortion can be used before ____ days
63
fetacidal agents
KCl
digoxin
when inducing labor for abortion which agents can be used to stimulate uterine contractions and cause cervical dilation
Hypertonic solution (intra-amniotic saline or urea)
Prostaglandins
- intra amniotic PGF2a
- vaginal PGE2 (dinoprostone)
- IM 15-methyl PGF2a (carboprost tromethamine)
- PGE1 (misoprostol)
bleeding that occurs before 12 weeks gestation.
spontaneous abortion
sono - nonviable pregnancy
no vaginal bleeding, uterine cramping, or cervical dilation
Missed abortion
management of missed abortion
suction D+C, conservative management, or misoprostol
sono - viable pregnancy
vaginal bleeding, no cervical dilation
Threatened abortion
management of threatened abortion
observation
vaginal bleeding, uterine cramping, cervical dilation
no POC passed
inevitable abortion
management of inevitable abortion
emergency suction D+C
vaginal bleeding, uterine cramping, cervical dilation
some POC passed
incomplete abortion
management of incomplete abortion
emergency suction D+C
sono - no intrauterine debris
vaginal bleeding, uterine cramping, cervical dilation
all POC passed
completed abortion
management of completed abortion
if previous uterine pregnancy confirmed - conservative
otherwise - weekly BhCG until negative (rule out ectopic)
in utero death of a fetus after 20 weeks gestation before birth
fetal demise
most serious complication of prolonged fetal demise (>2 weeks)
DIC from tissue thromboplastin release
threshold BhCG to detect pregnancy on ultrasound
vaginal sono - 1500 mIU (5 weeks)
abdominal sono - 6500 mIU (6 weeks)
management of unruptured tubal ectopic pregnancy
Methotrexate or
laparoscopic salpingostomy
follow up with BhCG titers and rhogam