Miscarriage Flashcards
1
Q
What are the general features of a miscarriage?
A
- PV bleeding
- May or may not be accompanied by pain
2
Q
What are the features of a missed miscarriage?
A
- No abdominal pain or PV bleeding
- Closed cervical os
- TVUS: Non-viable pregnancy
3
Q
What are the features of a threatened miscarriage?
A
- PV bleeding
- Closed cervical os
- TVUS: Viable pregnancy
4
Q
What are the features of a inevitable miscarriage?
A
- Bleeding and/or abdo pain
- Open cervical os
- TVUS: Non-viable pregnancy
5
Q
What are the features of an incomplete miscarriage?
A
- Partial expulsion of products of conception
- Open cervical os
- TVUS: Some remaining products of conception
6
Q
What are the features of a complete miscarriage?
A
- All products of conception passed and bleeding ceases
- Closed cervical os
- TVUS: No products of conception
7
Q
Describe expectant management of miscarriage.
A
- ‘Waiting for spontaneous miscarriage’
- First-line and involves waiting for 7-14 days for the miscarriage to complete spontaneously
- Offer medical or surgical management if conservative has failed
- Bring woman back into EPAU for BHCG measurement
8
Q
What is the medical management of miscarriage?
A
- Vaginal or oral prostaglandins (misoprostol)
- Give with antiemetics and pain relief
- Advise patient to contact doctor if bleeding hasn’t starting in 24h
9
Q
What is the surgical management of miscarriage?
A
2 main options:
- Vacuum aspiration (suction curettage)
- Surgical evacuation in theatre
10
Q
What are the complications of surgical management of miscarriage?
A
- Ashermann’s syndrome
- Perforation of the uterus (rare, <1%)
