Fetal Demise

Question 1

what are some predictors of poor outcomes in 1st trimester pregnancy

Answer 1

• bradycardia
• arrhythmia
• abnormal yolk sac size and shape
• calcified yolk sac
• large gestational sac compared to CRL
• low bhCG levels related to gestational sac size

Question 2

___: a 25mm MSD or greater without a fetal pole TA or 16mm TV

Answer 2

blighted ovum

Question 3

what is the other name for blighted ovum

Answer 3

an embryonic pregnancy

Question 4

S/A blighted ovum

Answer 4

• large anechoic gestational sac with no fetal pole

- if yolk sac present it is usually abnormally large

Question 5

if the patent presents with blooding and a fetal pole with no cardiac activity what is occurring

Answer 5

spontaneous abortion

Question 6

what is the most common cause of fetal demise in the fist trimester

Answer 6

chromosomal abnormalities

Question 7

the gestational sac is considered abnormally small and a sign of pregnancy failure if ____

Answer 7

MSD in mm - CRL in mm= <5mm

Question 8

spontaneous abortion usually occurs how long after demise

Answer 8

1-3 weeks

Question 9

what are some risk factors of spontaneous abortion

Answer 9

• cervical dilation >3cm
• premature rupture of membranes
• extended period of moderate bleeding

Question 10

what are some signs of threatened abortion

Answer 10

• cramping
• bleeding
• closed cervix

Question 11

what are some signs of inevitable abortion

Answer 11

• bleeding more than one week
• cramping
• PROM
• cervical shortening
• cervical dilation >3cm

Question 12

S/A incomplete abortion

Answer 12

-thick irregular endo with fluid in Canal

Question 13

S/A complete abortion

Answer 13

empty uterus with normal endometrial canal

Question 14

S/S incomplete abortion

Answer 14

• cramping

- bleeding

Question 15

S/A missed abortion

Answer 15

• <20 weeks with no cardiac activity
• uterine size small for dates
• retained products of conception

Question 16

what are some characteristics of a complete abortion

Answer 16

• all products of conception expelled
• bleeding with clots
• pain
• endometrial prominence, lack of GS
• decreasing HCG

Question 17

what are some characteristics of incomplete abortion

Answer 17

• some products of conception remain
• continuous bleeding
• pain
• heterogenous or complex appearance of the endometrial cavity
• minimal decrease or lack of change in HCG

Question 18

what are sonographic signs of fetal demise that has occurred more than a week ago

Answer 18

• spalding sign
• deuel sign
• robert sign
• abnormally low AFI
• fetal edema
• separation of chorion and amnion

Question 19

what is the Robert sign

Answer 19

air in circulatory system that causes echogenic foci in the lungs and abdomen

Question 20

___: persistence of placental and or fetal tissue in the uterus following delivery, abortion or a miscarriage

Answer 20

retained products of conception

Question 21

S/S RPOC

Answer 21

• fatigue
• anemia
• bleeding
• pelvic pain
• fever

Question 22

S/A RPOC

Answer 22

• endometrial thickness >5mm followign D&C or spontaneous abortion
• variable amount of echogenic or heterogeneous material within endo
• vascularity within material
• spectral waveform will be low resistance with increased diastolic flow
• calcificatiosn may be present