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Cards I make > Clincal:Abortions > Flashcards

Clincal:Abortions Flashcards

1
Q

Define abortion

A

unexpected, unplanned, sponatneous loss of pregnancy BEFORE fetus is sufficiently developed to survive extrautreo

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2
Q

up to how many weeks gestation defines it to be an abortion

A

Occur up to 20 weeks gestation

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3
Q

if the abortion is spontaneous and occurs AFTER 20 week but BEFORE 37 it is a …

A

Preterm birth

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4
Q

spontaneous abortion is aka

A

miscarriage

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5
Q

how many weeks gestation defines it to be intrauterine fetal demise (IUFD)

A

Fetal death after 20 weeks but BEFORE the onset of labor

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6
Q

IUFD is considered what type of abortion BEFORE 20 weeks

A

missed abortion

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7
Q

AFTER 20 weeks gestation, fetal death is considered … and no longer a missed abortion

A

IUFD

1% of pregnancies

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8
Q

abortion incidence of all preganancies

A

50%

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9
Q

abortion incidence of clinically recognizable pregnancies

A

10-15%

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10
Q

if the fetus makes it to … weeks gestation, the loss rate is reduced to (blank)% over the next 20 weeks

A

8 weeks gestation

3%

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11
Q

what is the loss rate over the next 20 weeks if mom is < 30 yrs old

A

2%

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12
Q

what is the loss rate over the next 20 weeks if mom is >40 yrs old

A

5-10%

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13
Q

at what age does the mom start going downhill in creating healthy babies

A

35 yrs old

worse if she’s 35 and smokes

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14
Q

define threatened abortion

A

vaginal bleeding BEFORE 20 weeks and the cervical os is CLOSED

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15
Q

what % of pregnant pt have some degree of bleeding in the 1st trimester

A

25%

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16
Q

of the 25% that have some degree of bleeding in the 1 trimester, how many result in loss of the pregnancy

A

25-50%

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17
Q

define inevitable abortion

A

vaginal bleeding with the cervix open to some degree

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18
Q

what symptom is frequently seen with inevitable abortion

A

cramping

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19
Q

define incomplete abortion

A

bleeding, Os OPEN, and passage of some products of conception

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20
Q

define complete abortion

A

bleed, Os CLOSED, and passage of ALL the productions of conception

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21
Q

define missed abortion

A

fetus died and is retained in the uterus
there’s usually no bleeding and usually no symptoms
-basically the body “missed” the fact that the fetus is dead and hasn’t elicited any symptoms

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22
Q

therapeutic or elective abortions

A

Elective termination of the pregnancy

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23
Q

define septic abortion

A

any spontaneous or therapeutic abortion with intrauterine infection

24
Q

define recurrent abortion

A

3 successive abortions

-a work up should be done usually after the 2nd abortion

25
Q

what could be causing recurrent abortions

A

usually bacteria/ infections/ viruses

26
Q

what is the MOST common cause of spontaneous abortion

A

significant genetic abnormality of the conceptus –> im assuming another word for the fetus

27
Q

what are some other etiologies

A 
Infections
Environmental Exposure
Systemic disorders
Increased maternal age 
Uterine abnormalities 
Fetal/Genetic abnormalites
Immunologic
28
Q

what are some examples of infections that can cause an abortion

A

Rubella, Listeria, Mycoplasma, Toxoplasma (cat feces)

29
Q

what are examples of environmental exposures that can cause an abortion

A

smoking, alcohol, chemicals

30
Q

what are examples of systemic disorders that can cause an abortion

A

Diabetes, hypothyroidism, SLE

31
Q

How can increased maternal age affect abortions

A

the chromosomal factors

32
Q

what are examples of uterine abnormalities

A

cervical incompetence
fibroids
septums
Asherman’s syndrome - endometrial lining adhering to each other

33
Q

what can cause Asherman’s syndrome

A

scraping of the endometrial lining, D&E

34
Q

Abortions effected by serum Ab, Rh, Kell & Duffy, etc… is what etiology

A

immunologic

35
Q

Fetal/Genetic abnormalities:

what ratio of spontaneous 1st trimester abortions have significant CHROMOSOMAL abnormalities

A

2/3

36
Q

of the 2/3 with chromosomal abnormalities, 1/2 is associated with what type of chromo abnl

A

Trisomies

37
Q

What do you do for a threatened abortion

A

ultrasound

rest and reassurance

38
Q

What do you do for an inevitable abortion

A 
hospital admission
analgesia
possible D&C 
prostaglandins,
cytotec
39
Q

What do you do for a incomplete abortion

A 
same as inevitable:
hospital admission
analgesia
possible D&C 
prostaglandins,
cytotec
40
Q

D&C, Cytotec, prostaglandins, Laminaria manages which abortion type

A

Missed abortion

41
Q

**if pt is Rh - , what must be given ***

A

Rhogram injection

42
Q

what do you do for a complete abortion

A

supportive measures

43
Q

I.V, antibiotics and evacuation

A

septic abortion

44
Q

What do you need to do for recurrent abortions

A

workup with cultures, labs for Ab, and possibly chromosomal studies

45
Q

What do you do for an elective abortion

A

counselling, D&C, D&E (done in the 2nd trimester), prostglandins or laminaria

46
Q

what are the causes and their respective % for fetal death*

A 
placental and  cord - 10-20%
HTN - 5-20&
Med complications - 5-10%
Infections - 5-10%
Congential anomalies - 5-10%
unknown - >50%
47
Q

How do you diagnose IUFD

A

US
spalding’s sign
gas in the CV system

48
Q

What does an ultrasound do for IUFD

A

it confirms lack of movement and absence of fetal heart tones

49
Q

what is Spalding’s sign

A

the overlapping of the fetal skull bones on x-ray

- mostly due to liquefaction of the fetal brain

50
Q

What is important to monitor for IUFD

A

coagulopathies

51
Q

fibrinogen, fibrin split products, PT and PTT, CBC with Platelets

A

DIC

52
Q

what needs to be done as a follow up for abortions

A
  • work up pts for infections especially TORCH
  • immune diseases
  • uterine anomalies
  • chromosome defects
53
Q

What does TORCH stand for

A 
T – Toxoplasmosis / Toxoplasma gondii
    O – Other infections 
    R – Rubella
    C – Cytomegalovirus
    H – Herpes simplex virus-2 or neonatal herpes simplex
54
Q

Dont need to know, but who knows:

how do you manage IUFD

A

13 to 28 weeks- either watchful expectancy or induction of labor.
80%- spontaneous labor in 2-3 weeks.
Induction with prostaglandins 12-28 weeks.
D&E.

55
Q

Dont need to know, but who knows:

when does pitocin induction begin

A

after 28 weeks

56
Q

Dont need to know, but who knows:

what is pitocin induction

A

high rate of uterine rupture with prostoglandins at the age

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