2P - Recurrent Pregnancy Loss Flashcards
What is the definition of early pregnancy loss?
Loss of clinical pregnancy before 20 weeks of AOG
increase in maternal age is directly or indirectly proportional to pregnancy loss?
Directly
Incidence rate of early pregnancy loss among aged <35 yrs old and >40 yrs old?
9-12% - <35
>50% - >40
Earliest time to ask for ultrasound after last menses to check for gestational sac?
5 weeks
Recurrent pregnancy loss based on ASRM?
2 or more clinical pregnancy loss not necessarily consecutive
Recurrent pregnancy loss based on ESRH and RCOG?
3 consecutive pregnancy losses including non visualized one
What type of RPL refers to multiple pregnancy losses between normal pregnancies?
Tertiary RPL
What type of RPL refers to multiple losses in a woman who
has already had a pregnancy beyond 20 gestational
weeks
Secondary RPL
What type of pregnancy refers to multiple losses in a woman with no
previous viable infants
Primary RPL
50-60% of early pregnancy losses are caused by?
Chromosomal abnormalities
Pregnancies with unbalanced translocations usually end up with?
Miscarriage
Most common type of chromosomal abnormalities?
Aneuploidy
Most common cause of early pregnancy loss <10 weeks?
Aneuploidy
Increase in RPL is caused by chromosomal abnormalities T or F?
False. Repeated RPL is caused by other factors than chromosomal abnormalities
estimated success rate of live birth after 1 miscarriage?
85%
75% after 2 miscarriages
Uterus is formed after separation of mullerian ducts? T or F?
False. Should be after joining of mullerian ducts
This condition is characterized by having completely non existent uterus?
Mayer Rokitansky Kuster Hauser Syndrome
Best diagnostic for uterine anomalies?
3D ultrasound
Most common type of uterine anomaly?
Septate uterus - Class V
type of uterine myoma causing RPL?
Submucous myoma
Another name for intrauterine adhesions?
Asherman Syndrome
intrauterine adhesions usually occur after what conditions?
curettage, uterine surgery, infection or complicated birth
What is the gold standard diagnosis of chronic endometritis?
Immunohistochemistry stains for syndecan 1
Treatment for endometritis caused by infection?
doxycycline
Appearance of uterine cavity in chronic endometritis?
Strawberry
This autoimmune disorder is characterized by recurrent thrombosis and obstetric morbidity?
Antiphospholipid syndrome
Obstetric complications associated with APAS?
IUGR, prematurity and preeclampsia
Diagnostic test for APAS?
anti cardiolipin, lupus anticoagulant and anti B2 glycoprotein 1
50% of patients with APAS have SLE? T or F?
False. 50% of those with SLE have APAS
What blood coagulation laboratory test is increased in SLE?
aPTT
Current treatment standard of APAS?
Heparin and low dose aspirin
What is the TSH threshold in diagnosing subclinical hypothyroidism in pregnancy?
> 2.5 mIU/L
What are the metabolic manifestations of PCOS?
insulin resistance and hyperinsulinemia,
hyperandrogenaemia, or increased plasminogen
activator inhibitor-1 activity.
Treatment for the insulin effects of PCOS?
Metformin
treatment for luteal phase deficiency?
Progesterone supplementation
Amount of caffeine per day allowed during pregnancy to prevent RPL?
300 mg
What is the estimated chance of live birth among women aged <30 years after 2 years of early pregnancy loss?
75%
40% for women aged >40 yrs
For women with 3 miscarriages, what is the chance of a future live birth within 2 years?
70%
45% - 6 miscarriages
