Miscarriage Flashcards
What is the definition of miscarriage?
The spontaneous loss of pregnancy prior to 24 weeks gestation
What is defined as early and late miscarriage?
Early - before 12 weeks
Late - 12-24 weeks
What is a missed miscarriage?
Fetus is no longer alive, but there were no symptoms of miscarriage
What is a threatened miscarriage?
Vaginal bleeding with a closed cervix, and a fetus that is still alive
What is an inevitable miscarriage?
Vaginal bleeding with an open cervix
What is an incomplete miscarriage?
Retained products of conception remain in the uterus after miscarriage
What is a complete miscarriage?
A full miscarriage has occurred and there are no products of conception that remain in the uterus
What is an anembryonic pregnancy?
A gestation sac is present but contains no fetus
What is the investigation of choice for diagnosis of a miscarriage?
Transvaginal ultrasound
What other investigation is useful in diagnosis of miscarriage?
Beta hCG levels
What features on ultrasound will a sonographer look for to determine if a pregnancy is viable?
Fetal heartbeat
Fetal pole and crown-rump length
Mean gestational sac diameter
What is the definition of recurrent miscarriage?
The loss of 3 or more consecutive pregnancies
When would a fetal heartbeat be detectable?
When crown-rump length is more than 7mm
What is a fetal pole?
When the margin of the yolk sac thickens
When would a fetal pole be expected to develop?
When crown-rump length is 25mm
What is the main differential diagnosis for miscarriage?
Ectopic pregnancy
What are the fetal causes of miscarriage?
Placental failure
Abnormal development
Genetic disorders
What are the maternal causes of miscarriage?
PCOS
Poorly controlled diabetes
Uterine abnormality
Poorly controlled thyroid disease
Anti-phospholipid syndrome
What are the three management routes for miscarriage?
Expectant management
Medical management
Surgical management
What is expectant management of miscarriage?
Giving 1-2 weeks for miscarriage to occur naturally
Pregnancy test after 3 weeks to confirm pregnancy has ended
What is the medical management of miscarriage?
Misoprostol (given as a suppository, or orally) to quicken the process of miscarriage
What is misoprostol?
Misoprostol is a prostaglandin analogue - it binds to prostaglandin receptors to soften the cervix and stimulate contractions
What are the surgical management options of miscarriage?
Manual vacuum aspiration under local anaesthetic
Electric vacuum aspiration under general anaesthetic
What is the presentation of miscarriage?
Vaginal bleeding
Vaginal tissue loss
Pain - worse than normal period pain
