miscarriage Flashcards
What happens in a threatened misscarriage
painless vaginal bleeding occurring before 24 weeks
when does a threatened miscarriage occur
6-9 weeks
What is observed in threatening miscarriage
the bleeding is often less than menstruation
cervical canal is closed
what is a Missed (delayed) miscarriage
a gestational sac which contains a dead fetus before 20 weeks without the symptoms of expulsion
what may be present in a missed miscarriage
mother may have light vaginal bleeding / discharge and the symptoms of pregnancy which disappear. Pain is not usually a feature
cervical os is closed
when the gestational sac is > 25 mm and no embryonic/fetal part can be seen it is sometimes described as what
a ‘blighted ovum’ or ‘anembryonic pregnancy’
What occurs in an inevitable miscarriage
heavy bleeding with clots and pain
cervical os is open
What happens in an incomplete miscarriage
not all products of conception have been expelled
pain and vaginal bleeding
cervical os is open
What is first line when expecting miscarriage
First-line and involves waiting for 7-14 days for the miscarriage to complete spontaneously
If expectant management is unsuccessful then medical or surgical management may be offered
when should surgical or medical management be used
increased risk of haemorrhage
she is in the late first trimester
if she has coagulopathies or is unable to have a blood transfusion
previous adverse and/or traumatic experience associated with pregnancy (for example, stillbirth, miscarriage or antepartum haemorrhage)
evidence of infection
What is the aim of medical management
Using tablets to expedite the miscarriage’
What is vaginal misoprostol
Prostaglandin analogue, binds to myometrial cells to cause strong myometrial contractions leading to the expulsion of tissue
What advice to be given to patients after administration of medication
Advise them to contact the doctor if the bleeding hasn’t started in 24 hours.
Should be given with antiemetics and pain relief
