ABORTIONS/MISCARRIAGES Flashcards
what is an abx?
outline the incidence of abx
outline the etiology of abx
what is polyploidy?
Polyploidy is a genetic condition where a person has more than two sets of chromosomes. It can occur in humans in the form of triploidy (69 chromosomes) or tetraploidy (92 chromosomes).
what is a blighted ovum?
A blighted ovum, or anembryonic pregnancy, is when a fertilized egg implants in your uterine lining but doesn’t grow into an embryo. The gestational sac and placenta will grow, but an embryo doesn’t grow so the gestational sac stays empty. It causes a miscarriage in the first trimester of pregnancy.
what is hydropic degeneration of villi?
“Hydropic degeneration of villi” refers to a condition where the chorionic villi of the placenta become swollen and fluid-filled, often seen in cases of abnormal pregnancies like molar pregnancies or fetal demise, characterized by the accumulation of fluid within the villous stroma, leading to a distended and edematous appearance of the villi; essentially, it means the placental villi are degenerating by becoming excessively filled with fluid.
seen in failed or failing preg
explain how endocrine and metabolic factors cause abx
Luteal Phase Defect (LPD) results in early miscarriage as implantation and placentation are not
supported adequately. Deficient progesterone secretion from corpus luteum or poor endometrial response
to progesterone is the cause.
Thyroid abnormalities: Overt hypothyroidism or hyperthyroidism are associated with increased fetal
loss. Thyroid auto antibodies are often increased.
Diabetes mellitus when poorly controlled causes increased miscarriages
explain how immunological disorders cause abx
Autoimmune disease- can cause miscarriage usually in 2nd trimester.
* These pts form Abs against their own tissue & placenta, which ultimately cause rejection of early preg.
* Abs responsible are: (i) Antinuclear antibodies (ANAs); (ii) ds Anti-DNA Abs; (iii)
Antiphospholipid Abs includes lupus anticoagulant (LAC) & anticardiolipin Abs (aCL).
* Spiral artery & placental intervillous thrombosis, placental infarction and fetal hypoxia is the
ultimate pathology
Alloimmunity- failure of maternal recognition of trophoblast lymphocyte cross-reactive antigen (TLX).
Lead to lack of production of blocking Abs by the mother, due to sharing of Human Leucocyte Antigen
(HLA) between partners
explain how inherited thrombophilia cause abx
Causes both early and late miscarriages due to intravascular coagulation.
Protein C resistance (factor V Leiden mutation) is the most common cause. Other
conditions are: Protein C deficiency and hyperhomocysteinemia
explain how anatomical abn cause abx
Cervical incompetence- Either congenital or acquired is one of commonest cause
of midtrimester & recurrent abortion
Congenital malformation of uterus
in form of bicornuate or septate uterus may be responsible for
midtrimester recurrent abortion
Uterine fibroids
Esp of submucous variety might be responsible not only for infertility
but also for abortion, due to distortion or partial obliteration of uterine
cavity.
Other causes are: decreased vascularity at the implantation site, red
degeneration of fibroid and
increased uterine irritability.
Intrauterine adhesionso Synechiae interfere with
implantation, placentation and fetal
growth. Depending on the severity
of adhesions, e.g. total (Asherman’s syndrome), corporal or cervicoisthmic, pt suffers from amenorrhea, hypomenorrhea, infertility or
recurrent abortion
classify abx
what are the risk factors of abx?
outline the mechanism of abx
what is a threatened abx?
list the clinical featues of threatened abx
investigations of threatened abx
DDx of threatened abx
outline the management of threatened abx
what is the prognosis of threatened abx
what is cervical ectopy?
A cervical ectopy is a red, velvet like and often raw looking area with a graze type appearance on the outer surface of the cervix. This is a benign (non-cancerous) condition and does not lead to cervical cancer.
Cervical ectropion is a condition in which the cells from the ‘inside’ of the cervical canal, known as glandular cells, are present on the ‘outside’ of the vaginal portion of the cervix. The cells on the ‘outside’ of the cervix are typically squamous epithelial cells.
what is an inevitable abx?
what are the clinical features of inevitable abx
how do you manage inevitable abx
what is a complete abx?
what are the clinical features of complete abx?
how do you investigate a complete abx?
what is the management for complete abx?
what is a uterine curettage?
aka A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues
what is incomplete abx?
c/f of incomplete abx?
complications of incomplete abx?
management of incomplete abx?
describe a patulous cervical os
A “patulous cervical os” refers to a cervix (the opening of the uterus into the vagina) that dilates or opens abnormally, particularly during the second or early third trimester of pregnancy, which is a symptom of an “incompetent cervix” or cervical insufficiency, potentially leading to complications like preterm birth
what is a missed abx?
outline the pathology of missed abx
c/f of missed abx
complications of missed abx
management of missed abx
what is a laminaria tent?
A laminaria tent is a small, thin, stick-like rod made from dried seaweed stems (specifically Laminaria digitata or Laminaria japonica) that is used to slowly dilate the cervix, often before procedures like medical abortion or childbirth. It absorbs fluid from the cervical tissues and swells, gently opening the cervix.
what is a septic abx?
what are the criteria for a septic abx
what are the modes of infection for septic abx
c/f of septic abx
how do you grade septic abx
investigations for septic abx
complications of septic abx
management of septic abx
what is physometra?
“Physometra” refers to the distention of the uterine cavity with air or gas. It’s a condition where the uterus is inflated by air, rather than fluid, like in pyometra (pus in the uterus) or hydrometra (fluid in the uterus)
what is recurrent abx?
aetiology of recurrent abx
investigations for recurrent abx
what are the qualifications for performing a medical termination of pregnancy (MTP)?
outline the methods of MTP
List the post abortion care (PAC) services
how can unsafe abx be prevented
