2P - Early Pregnancy Complications Flashcards
It is the expulsion or extraction of an embryo or
fetus at less than 20 weeks gestation or weighing 500g or less?
Abortion
Abortion weight threshold?
500g
Most common AOG for spontaneous abortion?
before 16 weeks
50% of early miscarriage is due to
chromosomal abnormalities
What is the most predictive risk factor for pregnancy loss?
Bleeding during current pregnancy
What is a close differential diagnosis to a threatened abortion?
Implantation bleeding happening within 6 days post ovulation
A G1P0 woman experiences painless vaginal bleeding. IE shows closed soft cervix. What type of miscarriage?
Threatened
What risk are increased in patients with threatened miscarriage?
f preterm labor, placenta previa & IUGR
How many percent of patients with threatened miscarriages go into term?
80%
What is the management for threatened abortion?`
Bed rest
It is the clinical type of abortion where the changes
have progressed to a state from where
continuation of pregnancy is impossible
Inevitable abortion
A G1P0 woman 14 weeks AOG presents with abdominal pain and vaginal bleeding. IE reveals a dilated cervix and ruptured bag of water What is t he type of abortion?
Inevitable abortion
A G1P0 woman 14 weeks AOG presents with abdominal pain and vaginal bleeding. IE reveals a dilated cervix and ruptured bag of water. What is aim of management and treatment for pain?
To accelerate process of expulsion (by oxytocin); methergine 0.2 mg for pain
Process of abortion has already taken place, but
the entire products of conception are not expelled
& part of it is left inside the uterine cavity
incomplete abortion
A G1P0 woman presents with vaginal bleeding with a fleshy mass. IE reveals a smaller uterus than the start of amenorrhea and an open internal os. Mass found were incomplete.
incomplete abortion
What can anomalies can retained products of conception cause?
Bleeding, sepsis and placental polyp
What is the management for incomplete abortion?
ERCP
Early - dilatation and evacuation with anesthesia
Late - dilatation and evacuation with forceps
What drug used either vaginally or intracervically is to evacuate retained fetal parts?
Misoprostol
`A G1P0 woman presents with vaginal bleeding with a fleshy mass. IE reveals a smaller uterus than the start of amenorrhea and a closed internal os. TVS shows empty uterus.
Complete abortion
Fetus is dead and retained passively inside the
uterus for a variable period
Missed abortion
Retained products for a long time can lead
Sepsis
If gestation is <16 weeks, what is the possible complication of retained fetal parts?
DIC
Misoprostol management for missed abortion of <12 weeks
q24
Misoprostol management for missed abortion of >12 weeks
q6-12 hrs
most common cause of septic abortion?`
Aseptic attempted abortion
Grade of septic abortion if only localized at the uterus?
Grade 1
Grade of septic abortion if there is generalized peritonitis and or shock or jaundice or acute renal failure?
Grade 3
Grade of septic abortion if parametrium, tubes and pelvis peritoneum is infected??
Grade 2
What is an indication that septic abortion has spread beyond the uterus?
Rising pulse rate of more than 100-120/min
Recurrent miscarriage is defined as a sequence o
three or more consecutive spontaneous abortion
Most common cause of first trimester abortion?
Genetic Factors
Most common is balance translocation
Second trimester abortion congenital causes?
Mullerian duct defects
acquired are intrauterine adhesions, uterine
fibroids and endometriosis, cervical incompetence.
Intrauterine adhesions due
to previous curettage- can lead to early miscarriage.
Asherman syndrome
Management for uterine fibroids?
Myomectomy - bikini cut
Painless cervical dilatation with ballooning of
amniotic sac into vagina, followed by rupture of
membrane and expulsion of fetus
Cervical insufficiency
When does expulsion due to cervical insufficiency usually happen?
16-24 weeks
