Abortion - Mary Flashcards
definition of abortion
pregnancy termination prior to 20 wks or fetus born weight < 500 gm
when do more than 80% of spontaneous abortions of clinically recognized pregnancies occur?
within the 1st 12 weeks of pregnancy
what increases the risk for SAB?
increase with parity and maternal and paternal age
Most common cause of early pregnancy aneuploid abortions
45X
when are euploid abortions more likely to occur?
later in pregnancy
Rate of ____ and ____ are increased in women with insulin-dependent diabetes → risk is related to degree of metabolic control in early pregnancy
spontaneous abortion and major congenital malformation
Maternal risk factors that can cause SAB
infection chronic disease (Celiac dz) endocrine abnormalities (hypothyroid, DM)
Frequent alcohol use in ____ weeks of pregnany can cause SAB and fetal anomalies → dose dependent
first 8 weeks
In relation to caffeine use, increased risk of SAB is seen in women who consume ____
> 5 cups/day [500 mg caffeine]
what inherited thrombophilias put a woman at risk for SAB?
factor V leiden, prothrombin, antithrombin, proteins C and S
when is the best time to do abdominal or pelvic surgery in pregnancy?
2nd trimester if possibe → can do early if it is uncomplicated procedure
Early removal of ___ can increase the risk for SAB
corpus luteum cyst
if you remove a corpus luteum cyst before 10 weeks GA what is needed?
supplemental progesterone
acquired uterine defects that can cause SAB
leiomyomas and uterine synechiae
developmental uterine defects that can cause SAB
abnormal mullerian duct formation of fusion
vaginal bleeding with closed cervical ox
cramping/abdominal pain/low backache/pelvic pressure
threatened abortion
what percent of threatened abortions will abort?
50%
what is something important to rule out with threatened abortion?
ectopic pregnancy
90-96% of pregnancies with both _____ and _____ between 7-11 wk GA will result in continued pregnancy
fetal cardiac activity
vaginal bleeding
increasing vaginal bleeding, painful uterine cramps/contractions reach peak intensity, cervix is dilated
gestational tissue is felt or seen through internal cervical os
inevitable abortion
internal os is open and blood and tissue passes (fetus and placenta may remain inside entirely or extrude through dilated os
incomplete abortion
what will you see on US of incomplete abortion?
thickened endometrial stripe >15 mm
Management of incomplete abortion
conservative
medication (misoprostol)
surgical (D&C)
cervix is closed and all products of conception are expelled
complete abortion
