Exam 3 Abortion

Question 1

Abortion is?

Answer 1

Loss < 20 wks or fetus weight <500gm

Question 2

Spontaneous Abortion most C when?

Most C cause 1st tri?

Most C cause 2nd tri?

Answer 2

First 12 wks

Chromo abn, U trisomes

Mom’s dz or anatomy
Abn placenta

Question 3

Threatened Abortion is?

W/U? (2)

Answer 3

Any bleed in early preg w/ closed cervix

Serial QhCG
TVUS/Pelvic US

Question 4

Inevitable Abortion is?

Answer 4

Bleed/Ruptured membrane + cervical dilation

Question 5

Incomplete Abortion is?

Results in?

Tx?

Answer 5

Expulsion of some products of conception (POC)

Bleed/pain

P D&C
U takes care of self

Question 6

Complete Abortion is?

Answer 6

DOCUMENTED preg w/ spontaneous expulsion of ALL POC

Question 7

Missed Abortion is?

If retention > 6 wks, risk of what?

Presentation? (2)

Tx?

Answer 7

Retention of failed preg for extended period
U > 2 cycles

DIC

Absence of uterine growth
Loss of early preg sxs

1st tri: suction curettage
2nd tri: Dilation/Evacuation, PG suppositories

Question 8

Septic Abortion is?

Presentation? (3)

Tx? (2)

Answer 8

Fetal death + intrauterine infect

Sepsis/Shock
Hemorr
Renal fail

Evacuation + ABX

Question 9

Recurrent Abortion is?

Caused by? (4)

Answer 9

> 2 consecutive

Chromo
Abn uterus
Endocrine (DM)
Thrombophilia

Question 10

Spontaneous Abort (SAB) risk factors? (6)

Answer 10

Old mom (most C)
Prior SAB
Extreme weights
Smoking
Abn uterus
Thrombophilias

Question 11

SAB maternal infection C pathogens? (5)

Answer 11

Listeria (from meat)
Toxoplasmosis (cat litter)
HSV
CMV
Chlamydia

Question 12

SAB maternal endocrine factors? (4)

Answer 12

Luteal insuff (inadequate progesterone)
Untreated thyroid
Untreated DM
SLE

Question 13

SAB maternal environmental factors? (4)

Answer 13

Toxins
High radiation
EtOH/Drugs
Smoking

Question 14

SAB maternal uterine factors? (4)

Answer 14

Leiomyoma
Anatomy
Acherman’s (scars/adhes from inf, D&C)
Incompetent cervix

Question 15

Medical Abortion methods: Pharmaceutical? (3)

Answer 15

Mifepristone (RU 486):
Blocks progest receptors
Used unto 49 days

Misostoprol:
Causes uterine contrations

Methotrexate:
Folic acid block

Question 16

Medical Abortion methods: Surgical? (3)

Answer 16

Suction Curett:
b/w 6-13 wks
Most C method
Req cervical dilation

D&E:
Transcervical dilation w/ evac
b/w 14-24 wks

Question 17

Complications of surgical elective abortions? (5)

Answer 17

Infection
Perf/laceration
Hemorr
Incomplete
Ectopic risk

Question 18

Postabortal Synd is?

Presentation? (4)

Answer 18

Uterine atony

Crampy pain
Bleed
Open cervix
Large, soft uterus

Question 19

Postabortal Synd tx? (3)

Answer 19

Oxytocic med
ABX
Repeat D&C