ABORTION Flashcards
What is the definition of abortion?
Termination of pregnancy by expulsion or extraction before 28 weeks of gestation and fetal weight < 1000g.
What are the two main types of abortion?
Spontaneous (miscarriage) and induced abortion.
When does early abortion occur?
Before 12 weeks of gestation.
When does late abortion occur?
After 12 weeks of gestation.
List the five major causes of abortion.
Hereditary factors, uterine abnormalities, infections, endocrine disorders, immunological factors.
What is the most common chromosomal abnormality causing spontaneous abortion?
Trisomy 16.
What are the types of chromosomal abnormalities that contribute to abortion?
Numerical (trisomies, polyploidy) and structural (monosomy X, balanced translocations).
Name some congenital uterine abnormalities that can lead to abortion.
Double uterus, hypoplastic uterus, longitudinal uterine septum.
What are some acquired uterine abnormalities that cause abortion?
Cervical incompetence, pelvic tumors (uterine myoma, ovarian tumor).
How do infections contribute to abortion?
Bacteria, toxins, and viruses can enter fetal circulation via the placenta, causing systemic or local infections.
List some infections that may lead to abortion.
Pyelonephritis, bacterial vaginosis (BV), urinary tract infection (UTI).
How do endocrine disorders cause abortion?
Hyper- or hypothyroidism, luteal phase dysfunction (low progesterone production).
What are the immunological factors contributing to abortion?
Antiphospholipid syndrome (APS), ABO/Rh incompatibility.
What is threatened abortion?
Vaginal bleeding before 28 weeks with a closed cervix, possible mild abdominal pain.
What percentage of threatened abortions result in pregnancy loss?
25-50%.
What is inevitable abortion?
Vaginal bleeding, cramp-like abdominal pain, and partial cervical dilation indicating pregnancy loss is unavoidable.
What is incomplete abortion?
Vaginal bleeding, cramping, dilated cervix, and partial passage of products of conception.
What is complete abortion?
All products of conception have been expelled, symptoms of pregnancy resolve, and pregnancy test becomes negative.
What is missed abortion?
Fetal death with retention in the uterus for weeks, absence of pregnancy symptoms, risk of DIC.
What is recurrent abortion?
Three or more consecutive spontaneous abortions.
What are the key causes of early abortion?
Chromosomal abnormalities, corpus luteum dysfunction, antiphospholipid syndrome.
What are the key causes of late abortion?
Cervical incompetence, congenital uterine anomalies, uterine myomas, blood type incompatibility.
Describe the pathology of spontaneous abortion.
Embryo/fetus compromised, hemorrhage in decidua basalis, necrosis, inflammation, conceptus detachment, uterine contractions, cervical dilation.
How is threatened abortion managed?
Bed rest, avoid intercourse, folic acid (5mg TID), progesterone (Dydrogesterone 10-20mg BD, Cyclogest 400mg OD).
How is inevitable abortion managed?
Monitor for spontaneous expulsion; if incomplete or heavy bleeding, perform manual vacuum aspiration (MVA).
What is the management of incomplete abortion?
Medical: Mifepristone/Misoprostol; Surgical: Manual Vacuum Aspiration (MVA).
What are the risks of retained products of conception in incomplete abortion?
Hemorrhage, sepsis.
What is the management of missed abortion?
Evacuation via suction or MVA, check fibrinogen levels weekly to prevent DIC.
How is septic abortion treated?
Broad-spectrum antibiotics and surgical evacuation (MVA).
What are the follow-up steps after an abortion?
Monitor for infection, ensure complete uterine involution, emotional support, contraception counseling.
