ch 19

Question 1

Spontaneous abortion

Answer 1

Loss of a pregnancy before 20 weeks gestation
1st trimester commonly due to fetal genetic abnormalities (80%)
2nd trimester more likely related to maternal conditions (20%)

Question 2

threatened

Answer 2

slight bleeding, no cervical changes

reduce activity, ensure adequate hydration

Question 3

inevitable

Answer 3

increased vaginal bleeding, ROM, cervical dilation, strong cramping, possible passage of “POC”

U/S & hCG levels to confirm pregnancy loss, vacuum curettage if POC are not passed to prevent infection & reduce risk of excessive bleeding

Question 4

incomplete

Answer 4

heavy bleeding, intense cramping, cervical dilation

U/S to confirm, stabilize patient, u/s confirms that “POC” are still in uterus, D&C or Misopostol (prostaglandin analog)

Question 5

complete

Answer 5

hx of vaginal bleeding & abdominal pain, passage of “POC” with decrease in pain and bleeding

U/S to confirm, no med/surg intervention necessary, f/u appt for family planning discussion

Question 6

missed

Answer 6

irregular spotting, absent contractions

U/S to confirm presence of “POC”, vac.curettage-1st Tri, D&C-2nd Tri, (Induction of Labor-post 20 weeks gestation= stillbirth).

Question 7

habitual

Answer 7

hx of 3 or more consecutive spontaneous abortions

Question 8

cervical insufficiency

Answer 8

premature spontaneous dilatation of cervix
describes a weak, structurally defective cervix
Spontaneous dilation occurs without contractions in the second trimester.
It is typically rapid, relatively painless, and accompanied by minimal bleeding, and it results in the loss of the pregnancy

Presenting complaints
Pink-tinged vaginal discharge
Increase in pelvic pressure