Fetal Demise Flashcards
what are some predictors of poor outcomes in 1st trimester pregnancy
- 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
___: a 25mm MSD or greater without a fetal pole TA or 16mm TV
blighted ovum
what is the other name for blighted ovum
an embryonic pregnancy
S/A blighted ovum
- large anechoic gestational sac with no fetal pole
- if yolk sac present it is usually abnormally large
if the patent presents with blooding and a fetal pole with no cardiac activity what is occurring
spontaneous abortion
what is the most common cause of fetal demise in the fist trimester
chromosomal abnormalities
the gestational sac is considered abnormally small and a sign of pregnancy failure if ____
MSD in mm - CRL in mm= <5mm
spontaneous abortion usually occurs how long after demise
1-3 weeks
what are some risk factors of spontaneous abortion
- cervical dilation >3cm
- premature rupture of membranes
- extended period of moderate bleeding
what are some signs of threatened abortion
- cramping
- bleeding
- closed cervix
what are some signs of inevitable abortion
- bleeding more than one week
- cramping
- PROM
- cervical shortening
- cervical dilation >3cm
S/A incomplete abortion
-thick irregular endo with fluid in Canal
S/A complete abortion
empty uterus with normal endometrial canal
S/S incomplete abortion
- cramping
- bleeding
S/A missed abortion
- <20 weeks with no cardiac activity
- uterine size small for dates
- retained products of conception
what are some characteristics of a complete abortion
- all products of conception expelled
- bleeding with clots
- pain
- endometrial prominence, lack of GS
- decreasing HCG
what are some characteristics of incomplete abortion
- some products of conception remain
- continuous bleeding
- pain
- heterogenous or complex appearance of the endometrial cavity
- minimal decrease or lack of change in HCG
what are sonographic signs of fetal demise that has occurred more than a week ago
- spalding sign
- deuel sign
- robert sign
- abnormally low AFI
- fetal edema
- separation of chorion and amnion
what is the Robert sign
air in circulatory system that causes echogenic foci in the lungs and abdomen
___: persistence of placental and or fetal tissue in the uterus following delivery, abortion or a miscarriage
retained products of conception
S/S RPOC
- fatigue
- anemia
- bleeding
- pelvic pain
- fever
S/A RPOC
- 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
