198b baby killing

Question 1

rate of spontaneous pregnancy loss?

Answer 1

~15% (might be as high as 60%)

Question 2

abortion

Answer 2

loss of pregnancy prior to 20 weeks (or fetus less than 500 g)

1st and 2nd trimester can be medical or surgical

different types of spontaneous and induced

Question 3

spontaneous abortion and types

Answer 3

refer to 1st trimester loss

threatened - any bleeding related to preg

incomplete/complete - fetus is gone and cervix is closed (incop - still some material)

inevitable - cervix is dilated

missed - fetal demise in 1st trimester (old term before US); patients aren’t actually missed; fetus is still in woman

Question 4

types of abnormal preg?

Answer 4

ectopic

miscarriage (SAB)

Question 5

when do most abortions occur?

Answer 5

less than 8 weeks

Question 6

percent of abortions in 2nd trimester?

Answer 6

10-15%

Question 7

drugs and surgery in 1st trimester?

Answer 7

medication up to 10 weeks
mifepristone (antiprogesin)/misoprostol (prostaglandin analogue)
misoprostol alone

D and C (manual vacuum aspiration (mva) or electrical vacuum aspiration)

Question 8

second trimester abortions

Answer 8

D + C

induced abortion

Question 9

D + C

Answer 9

suction, not sharp

cervical dilation - misoprostol for ripening with rigid dilators

prostaglandin pre-treatment

Question 10

do you have to wait until 7 weeks to do an abortion?

Answer 10

no

Question 11

pain control

Answer 11

local, local + IV narcotics (not usually required)

paracervical block

Question 12

early preg loss rx

Answer 12

misoprostol w/ repeat dose in 3 days

surgical evacuation

Question 13

D and E procedure (dilation and evacuation)

Answer 13

cervical prep then uterine evacuation

cervical prep - osmotic dilators (laminaria, lamicel, dilapan)