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OB/GYN > Abortion > Flashcards

Abortion Flashcards

1
Q

What is the definition of an abortion?

A

Loss of pregnancy prior to 20 weeks

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2
Q

What percent of all recognized pregnancy end with SAB?

A

20%

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3
Q

What is a threatened abortion? Is there cervical dilation and/or expulsion of the POC?

A

vaginal bleeding within the first 20 weeks of gestation, but NOT ending in a spontaneous abortion

No cervical dilation, or expulsion of the POC

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4
Q

What is an inevitable abortion? Is there cervical dilation and/or expulsion of the POC?

A

Vaginal bleeding with cervical dilation, but no passage of tissue–viable pregnancy unlikely

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5
Q

What is an incomplete abortion? Is there cervical dilation and/or expulsion of the POC?

A

Vaginal bleeding with cervical dilation and partial expulsion of POC

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6
Q

What is a complete abortion? Is there cervical dilation and/or expulsion of the POC?

A

Vaginal bleeding decreasing, all POC expelled

Cervix is close

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7
Q

What is a missed abortion? Is there cervical dilation and/or expulsion of the POC?

A
  • Fetal death with or without spotting
  • No cervical dilation
  • Complete retention of POC
  • Often proceed to complete SAB in 1-3 weeks
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8
Q

What is a septic abortion? Is there cervical dilation and/or expulsion of the POC?

A

Threatened, inevitable, or or incomplete abortion with signs of uterine infx

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9
Q

Chromosome abnormalities account for what percent of all SAB?

A

50%

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10
Q

Losses 2/2 aneuploidy occur when in gestation (early, middle, or late)?

A

early

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11
Q

What are the causes for spontaneous abortion, besides chromosomal abnormalities? (5)

A
  • Teratogen exposure
  • DM
  • Trauma
  • Anatomic ab
  • Infx
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12
Q

True or false: the is often no obvious etiology for many abortions

A

True

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13
Q

What causes a septated uterus?

A

Failure of the obliteration of the septa between the paramesonephric ducts

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14
Q

What are the common signs of a miscarriage?

A
  • Vaginal bleeding and cramping

- Decreased s/sx of pregnancy

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15
Q

How do you diagnose an abortion? (2)

A
  • Quant hCG levels

- TVUS

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16
Q

Gestational sac can be seen at what hCG level? Fetal heart activity

A

1500

13000

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17
Q

Serum progesterone level below what value is indicative of a failed/abnormal pregnancy?

A

Less than 5 ng/dL

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18
Q

What are the basic hematological labs that should be obtained with a suspected abortion?

A
  • CBC

- ABO and Rh status

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19
Q

What is implantation bleeding? Does this cause miscarriages?

A

Bleeding around the time of implantation–usually do not lead to miscarriages

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20
Q

What is the medical treatment for a suspected miscarriage?

A
  • rhoGAM if Rh

- IV Abx

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21
Q

What is the surgical treatment for a miscarriage?

A
  • D and C with suction

- d/c home with Rx for pain meds

22
Q

What is the treatment for a threatened abortion?

A
  • Pelvic rest (no sex)

- Minimal intervention

23
Q

What is the treatment for inevitable and incomplete miscarriages? (surgical/medical)

A
  • D and C

- Misoprostol

24
Q

What is a D&E? When is it done?

A

dilation and evacuation–done after 14 weeks (2nd trimester)

25
Q

How do you follow a complete abortion? (2)

A
  • Follow quant hCG weekly until 0

- TVUS to r/o retained POC

26
Q

What percent of inevitable and incomplete miscarriages will complete without intervention?

A

70%

27
Q

What is the medical treatment for a missed abortion? Surgical?

A
  • misoprostol

- D+C or D+E

28
Q

What is the expectant management with missed abortions?

A

-Uterus Evacuated if profuse bleeding

29
Q

What is the work up for septic abortions?

A
  • Obtain vaginal cultures
  • CXR
  • Coag studies + usual sepsis procedure
30
Q

What is the treatment for a septic abortion? (2)

A
  • Prompt surgical evacuation

- IV abx and IVF

31
Q

What is the most frequently performed gyn procedure? When in gestation is this performed? What is the major complication of this?

A

D+C
1st trimester
Uterine rupture

32
Q

What is the medical management of abortions? When in gestation is this safe?

A
  • Prostaglandin (misoprostol)

- Up to 49 days gestation

33
Q

Which has a higher bleeding rate: abortions done through surgical means, or medical means?

A

Medical

34
Q

In whom is medical abortion not appropriate for? Why?

A

Unsure f/u, d/t multiple visits, and protracted therapy

35
Q

What is the definition of recurrent pregnancy loss?

A

3 or more losses prior to 20 weeks gestation

36
Q

Do you include ectopic, molar, and biochemical pregnancies in the count of recurrent pregnancy loss?

A

No

37
Q

Cause of recurrent pregnancy loss can be established in what fraction of women?

A

2/3

38
Q

What are the two major immunologic causes of recurrent pregnancy losses (RPL)?

A

SLE and APLA

39
Q

What are the anatomic causes of RPL? (3)

A
  • Fibroids
  • intrauterine adhesions
  • Congential uterine malformations
40
Q

Can inherited thrombophilias cause RPL?

A

Yes

41
Q

What are the endocrine disorders that can cause RPL? (4)

A
  • Thyroid disease
  • DM
  • PCOS
  • Luteal phase defect
42
Q

What is the trend in abortions?

A

Downward

43
Q

What percent of abortions occur in women who were using a contraceptive method?

A

54%

44
Q

What is the most effective contraceptive?

A

Implantables

45
Q

What is the incidence of complications following an abortion?

A

0.3%

46
Q

Risk of maternal death is (__)x more with childbirth than an abortion?

A

12x

47
Q

Are there any adverse effect in future pregnancies with an abortion?

A

No

48
Q

How early can ovulation occur post-abortion?

A

2 weeks

49
Q

What is happening to the abortion rate in young women? Women aged 40+?

A

Adolescent abortions decreased

Increased in 40+

50
Q

True or false: abortions should be performed ASAP d/t increased complications if performed later

A

True

OB/GYN (33 decks)

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