LESSON 1 Flashcards
any interruption of a pregnancy before fetus is viable more than 20 to 24 weeks gestation or weighs at least 500 g
spontaneous miscarriage
occurs before week 16 of pregnancy
spontaneous miscarriage
Medical term of any interruption of a pregnancy before a fetus is viable
abortion
Planned medical termination of pregnancy
elective abortion
causes of this miscarriage/abortion is:
Abnormal fetal formation
•Teratogenic factors
•Chromosomal aberration
•Rejection of the embryo through immune response
elective abortion
Causes of this miscarriage
•Corpus luteum fails to produce enough progesterone
spontaneous miscarriage
causes of this miscarriage:
Rubella, syphilis, poliomyelitis, CMV and Toxoplasmosis , UTI
spontaneous miscarriage
causes of this miscarriage:
•Implantation abnormalities
•Inadequate endometrial formation or •inappropriate site of implantation •Inadequate implantation inadequate placental circulation and fetal nutrition
spontaneous miscarriage
amount of bleeding of threatened miscarriage
slight spotting
uterine cramping of threatened miscarriage
mild
is there a passage of tissue in threatened miscarriage
no
is there cervical dilation in threatened miscarriage
no
management in threatened miscarriage
bed rest sedation
what to avoid when having threatened miscarriage
stress
sexual stimulation
orgasm usually recommended
further treatment depends on the woman’s response to treatment
amount of bleeding in inevitable (imminent) miscarriage
moderate
uterine cramping of inevitable (imminent) miscarriage
mild to severe
pass-age of tissue of inevitable (imminent) miscarriage
No, loss of pro-ducts of con-ception can-not be halted
is there a cervical dilation in inevitable (imminent) miscarriage
yes
management of inevitable (imminent) miscarriage
sonogram to know if the uterus is empty or the fetus is not viable — D & E
(dilation evacuation)
and then check for post D&E
assess vaginal bleeding
Amount of bleeding in incomplete miscarriage
heavy / profuse
uterine cramping of incomplete miscarriage
severe
is there a passage of tissue in incomplete miscarriage
Yes
Membrane or placenta is retained in the uterus
is there a cervical dilation in cervix when having an incomplete miscarriage
Yes, with tissue in cervix
management in incomplete miscarriage
D & C or suction curettage to prevent hemorrhage and infection
amount of bleeding in complete miscarriage
slight
uterine cramping in complete miscarriage
mild
is there a passage of tissue complete miscarriage
yes fetus membranes, placenta
is there a cervical dilation
yes
management for complete miscarriage
•No further intervention is needed if uterine contractions are adequate to prevent hemorrhage and there is no infection.
•Suction or curettage to ensure no retained fetal or maternal tissue.
•Bleeding slows down within 2 hours and ceases within a few days after passage of products of conception
outcome in missed or (early pregnancy failure)
- fetus dies in the utero but not expelled
- no increase in fundic height
- no fetal heart rate
is there passage of tissue in early pregnancy failure
no apparent loss of pregnancy
cervical dilation in early pregnancy failure
is there passage of tissue in early pregnancy failure
management for early pregnancy failure
Sonogram – failure of growth
D & E
If over 14 weeks – induction of labor (misoprostol and oxytocin)
Spontaneous miscarriage within 2 weeks (danger of DIC)
defined as a three or more consecutive abortions
recurrent miscarriage
amount of bleeding in recurrent miscarriage
varies
uterine cramping in recurrent miscarriage
varies
is there a passage of tissue in recurrent miscarriage
yes
is there a cervical dilation in recurrent miscarriage
yes usually
management for recurrent miscarriage
Prophylactic cerclage may be done if premature cervical dilation is the cause.
•Tests :
➢ parental cytogenetic analysis
➢lupus anticoagulant and
➢anticardiolipin antibodies assay.
abortion that is complicated by infection
septic miscarriage
what is a (danger of DIC)
Disseminated intravascular coagulation
management of septic miscarriage
usually
•Immediate termination of pregnancy
•Cervical culture and sensitivity studies
•broad-spectrum antibiotic therapy (e.g. ampicillin) is started.
•Treatment for septic shock is initiated, if necessary.
•Tetanus toxoid/ tetanus Ig
management for hemorrhage
Assess amount of bleeding
•Rule of thumb: More than one sanitary pad per hour is excessive
•Monitor vital signs to detect hypovolemic shock
•Massage the uterine fundus to aid contraction
•Dilatation and curettage
•Suction curettage
•Transfusion
implantation occurs outside uterine cavity
ectopic pregnancy
signs and symptoms of ectopic pregnancy
Nausea and vomiting
–Positive pregnancy test
–6 to 12 weeks AOG
•rupture of fallopian tube
•Trophoblast cells break
•Tearing and destruction of the blood vessels
