Early Pregnancy Loss Flashcards
Suspicious for Early Pregnancy Loss
- CRL is
Diagnostic of early pregnancy loss
7 = CRL 7mm no FHTs 25 = GS 25mm with no embryo 2 = 2 wks since GS seen but still no E with FHTs 11 = 11d since GS and YS seen but still no E with FHTs
Dose misoprostol outpatient management
800mcg per vagina, next dose >3 hrs within 7 days. If not successful, expectant vs D&C (length of time for expectant decided btwn pt/doctor)
Rh negative with medical management of SAB
Give anti-D RhIg within 72 hrs of cytotec administration
What percentage of early SAB due to chromosomal abnormalities?
50%
Incomplete abortion, does not want D&C yet, is stable…do you give cytotec?
Not really shown to speed things up/be more effective at complete evacuation…so not needed really
How do you prove that it has been completely expelled?
History, physical
Sono absent GS
EMS
Should you do a D&C on someone who has a thickened EMS after expectant/medical management who is asymptomatic?
Nope
Besides emergencies, what are other situations where surgical management may be better?
Severe anemia
Bleeding disorders
CV disease
Is sharp curettage necessary?
No, as long as doctor is sure all products have been removed.
How long should pt’s wait s/p SAB before getting pregnant again?
NO firm recommendations. No sex for 1-2 wks to avoid infection after complete ab, but not evidence based rec
When can SAB start contraception?
Immediately! IUD can be placed immediately after!
How much anti-D RhIG should pt’s get?
Immediately s/p D&C 50mcg or w/in 72 hrs s/p cytotec
When should you do a w/u for SAB?
after second consecutive early SAB; chromosomal/thrombophilia (APL ab syndrome)
Should you give progesterone therapy to women with prior pregnancy loss?
Only if 3 prior early SABs…may benefit, but controversial to give progesterone at all.
