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Gynaecology > Miscarriage > Flashcards

Miscarriage Flashcards

1
Q

What is the definition of miscarriage?

A

The spontaneous loss of pregnancy prior to 24 weeks gestation

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2
Q

What is defined as early and late miscarriage?

A

Early - before 12 weeks
Late - 12-24 weeks

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3
Q

What is a missed miscarriage?

A

Fetus is no longer alive, but there were no symptoms of miscarriage

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4
Q

What is a threatened miscarriage?

A

Vaginal bleeding with a closed cervix, and a fetus that is still alive

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5
Q

What is an inevitable miscarriage?

A

Vaginal bleeding with an open cervix

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6
Q

What is an incomplete miscarriage?

A

Retained products of conception remain in the uterus after miscarriage

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7
Q

What is a complete miscarriage?

A

A full miscarriage has occurred and there are no products of conception that remain in the uterus

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8
Q

What is an anembryonic pregnancy?

A

A gestation sac is present but contains no fetus

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9
Q

What is the investigation of choice for diagnosis of a miscarriage?

A

Transvaginal ultrasound

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10
Q

What other investigation is useful in diagnosis of miscarriage?

A

Beta hCG levels

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11
Q

What features on ultrasound will a sonographer look for to determine if a pregnancy is viable?

A

Fetal heartbeat
Fetal pole and crown-rump length
Mean gestational sac diameter

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12
Q

What is the definition of recurrent miscarriage?

A

The loss of 3 or more consecutive pregnancies

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13
Q

When would a fetal heartbeat be detectable?

A

When crown-rump length is more than 7mm

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14
Q

What is a fetal pole?

A

When the margin of the yolk sac thickens

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15
Q

When would a fetal pole be expected to develop?

A

When crown-rump length is 25mm

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16
Q

What is the main differential diagnosis for miscarriage?

A

Ectopic pregnancy

17
Q

What are the fetal causes of miscarriage?

A

Placental failure
Abnormal development
Genetic disorders

18
Q

What are the maternal causes of miscarriage?

A

PCOS
Poorly controlled diabetes
Uterine abnormality
Poorly controlled thyroid disease
Anti-phospholipid syndrome

19
Q

What are the three management routes for miscarriage?

A

Expectant management
Medical management
Surgical management

20
Q

What is expectant management of miscarriage?

A

Giving 1-2 weeks for miscarriage to occur naturally
Pregnancy test after 3 weeks to confirm pregnancy has ended

21
Q

What is the medical management of miscarriage?

A

Misoprostol (given as a suppository, or orally) to quicken the process of miscarriage

22
Q

What is misoprostol?

A

Misoprostol is a prostaglandin analogue - it binds to prostaglandin receptors to soften the cervix and stimulate contractions

23
Q

What are the surgical management options of miscarriage?

A

Manual vacuum aspiration under local anaesthetic
Electric vacuum aspiration under general anaesthetic

24
Q

What is the presentation of miscarriage?

A

Vaginal bleeding
Vaginal tissue loss
Pain - worse than normal period pain

Gynaecology (27 decks)

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