2P - Recurrent Pregnancy Loss

Question 1

What is the definition of early pregnancy loss?

Answer 1

Loss of clinical pregnancy before 20 weeks of AOG

Question 2

increase in maternal age is directly or indirectly proportional to pregnancy loss?

Answer 2

Directly

Question 3

Incidence rate of early pregnancy loss among aged <35 yrs old and >40 yrs old?

Answer 3

9-12% - <35

>50% - >40

Question 4

Earliest time to ask for ultrasound after last menses to check for gestational sac?

Answer 4

5 weeks

Question 5

Recurrent pregnancy loss based on ASRM?

Answer 5

2 or more clinical pregnancy loss not necessarily consecutive

Question 6

Recurrent pregnancy loss based on ESRH and RCOG?

Answer 6

3 consecutive pregnancy losses including non visualized one

Question 7

What type of RPL refers to multiple pregnancy losses between normal pregnancies?

Answer 7

Tertiary RPL

Question 8

What type of RPL refers to multiple losses in a woman who
has already had a pregnancy beyond 20 gestational
weeks

Answer 8

Secondary RPL

Question 9

What type of pregnancy refers to multiple losses in a woman with no
previous viable infants

Answer 9

Primary RPL

Question 10

50-60% of early pregnancy losses are caused by?

Answer 10

Chromosomal abnormalities

Question 11

Pregnancies with unbalanced translocations usually end up with?

Answer 11

Miscarriage

Question 12

Most common type of chromosomal abnormalities?

Answer 12

Aneuploidy

Question 13

Most common cause of early pregnancy loss <10 weeks?

Answer 13

Aneuploidy

Question 14

Increase in RPL is caused by chromosomal abnormalities T or F?

Answer 14

False. Repeated RPL is caused by other factors than chromosomal abnormalities

Question 15

estimated success rate of live birth after 1 miscarriage?

Answer 15

85%

75% after 2 miscarriages

Question 16

Uterus is formed after separation of mullerian ducts? T or F?

Answer 16

False. Should be after joining of mullerian ducts

Question 17

This condition is characterized by having completely non existent uterus?

Answer 17

Mayer Rokitansky Kuster Hauser Syndrome

Question 18

Best diagnostic for uterine anomalies?

Answer 18

3D ultrasound

Question 19

Most common type of uterine anomaly?

Answer 19

Septate uterus - Class V

Question 20

type of uterine myoma causing RPL?

Answer 20

Submucous myoma

Question 21

Another name for intrauterine adhesions?

Answer 21

Asherman Syndrome

Question 22

intrauterine adhesions usually occur after what conditions?

Answer 22

curettage, uterine surgery, infection or complicated birth

Question 23

What is the gold standard diagnosis of chronic endometritis?

Answer 23

Immunohistochemistry stains for syndecan 1

Question 24

Treatment for endometritis caused by infection?

Answer 24

doxycycline

Question 25

Appearance of uterine cavity in chronic endometritis?

Answer 25

Strawberry

Question 26

This autoimmune disorder is characterized by recurrent thrombosis and obstetric morbidity?

Answer 26

Antiphospholipid syndrome

Question 27

Obstetric complications associated with APAS?

Answer 27

IUGR, prematurity and preeclampsia

Question 28

Diagnostic test for APAS?

Answer 28

anti cardiolipin, lupus anticoagulant and anti B2 glycoprotein 1

Question 29

50% of patients with APAS have SLE? T or F?

Answer 29

False. 50% of those with SLE have APAS

Question 30

What blood coagulation laboratory test is increased in SLE?

Answer 30

aPTT

Question 31

Current treatment standard of APAS?

Answer 31

Heparin and low dose aspirin

Question 32

What is the TSH threshold in diagnosing subclinical hypothyroidism in pregnancy?

Answer 32

>2.5 mIU/L

Question 33

What are the metabolic manifestations of PCOS?

Answer 33

insulin resistance and hyperinsulinemia, hyperandrogenaemia, or increased plasminogen activator inhibitor-1 activity.

Question 34

Treatment for the insulin effects of PCOS?

Answer 34

Metformin

Question 35

treatment for luteal phase deficiency?

Answer 35

Progesterone supplementation

Question 36

Amount of caffeine per day allowed during pregnancy to prevent RPL?

Answer 36

300 mg

Question 37

What is the estimated chance of live birth among women aged <30 years after 2 years of early pregnancy loss?

Answer 37

75% 40% for women aged >40 yrs

Question 38

For women with 3 miscarriages, what is the chance of a future live birth within 2 years?

Answer 38

70% 45% - 6 miscarriages