Early pregnancy disorders

Question 1

Bleeding - mild
Pain - usually little or no pain
Cervical os - closed

Answer 1

Threatened miscarriage

Question 2

Bleeding - heavy with clots Pain - painful

Cervical os - open

Answer 2

Inevitable miscarriage

Question 3

Bleeding - heavy with production of conception partially expelled
Pain - painful
Cervical os - open
Tenderness

Answer 3

Incomplete miscarriage

Question 4

Bleeding - yes, small amount, product of conception already passed
Pain - settled
Cervical os - closed

Answer 4

Complete miscarriage

Question 5

Bleeding - No or some
Pain - No
Only recognised through USS where the foetus has not developed/died 
Uterus - small
Cervical os - close

Answer 5

Missed miscarriage

Early fetal demise

Question 6

Bleeding - yes, with some products of conception
Pain - yes
Cervical os - open
Tender uterus with/ without fever

Answer 6

Septic miscarriage

Question 7

What investigations are done to identify miscarriages? Why?

Answer 7

USS (TVS) - To check the uterus for viable/non-viable intrauterine pregnancy, any product of conception.
Blood tests -
1) FBC,
2) rhesus group,
3) beta-hCG - should double within 48 hrs for intrauterine pregnancy.

Question 8

What are the types of management in miscarriages?

Answer 8

Expectant (conservative)
Medical
Surgical

Question 9

What are used in medical management of miscarriages?

Answer 9

Misoprostol - via vaginal - in missed and incomplete miscarriages

Question 10

What procedures are involved in surgical management of miscarriages?

Answer 10

Evacuation of retained products of conception (ERPC) through vacuum aspiration