Miscarriage

Question 1

What is the term for a loss preior to implantation?

Answer 1

Pre-implantation pregnancy loss

Question 2

What is a biochemical pregnancy?

Answer 2

Peri-implantational loss: positive pregnancy test but no gestational sac anywhere

Question 3

What are the weeks that a pregnancy is considered a miscarriage?

Answer 3

5-19

week 20+ is a stillbirth

Question 4

What is an embryonic loss?

Answer 4

5-10 weeks gestational age

Question 5

What is an early fetal loss?

Answer 5

10-16 weeks

Question 6

What is a late fetal loss?

Answer 6

16-20 weeks

Question 7

What is an early pregnancy loss?

Answer 7

before 10 weeks

Question 8

What is a threatened miscarriage?

Answer 8

Pregnancy bleeding but no tissue passed- possible viable pregnancy

Question 9

What is a missed miscarriage?

Answer 9

pregnancy not viable via US or HCG but little to no bleeding yet

Question 10

What is a complete miscarriage?

Answer 10

Everything has happened

Question 11

At what week is miscarriage most likely?

Answer 11

Week 8

Question 12

What is the overall risk of miscarriage?

Answer 12

12-15%

Question 13

What is defined as a recurrent miscarriage?

Answer 13

Two or more

Question 14

What are the main known risk factors for miscarriage?

Answer 14

Genetic abnormality- chromosomal (AGE)
Previous history of miscarriage

Question 15

What proportion of miscarriages are most likely preventable based on our current knowledge?

Answer 15

Less than 30%

Question 16

In attempting to achieve pregnancy what is the TSH level at which thyroid replacement will happen?

Answer 16

Thyroid replacement for TSH > 2.5

Question 17

What was the PROMISE study and what did it show?

Answer 17

Vaginal progesterone for recurrent miscarriage

Showed a 3% increase of live births with progesterone treatment

Question 18

What is the PRISM study and what did it show?

Answer 18

Vaginal progesterone for threatened miscarriage

3% increase in live births with progesterone

Question 19

A couple is trying to get pregnant after using the Creighton method for 7 cycles following three miscarriages. At their 8 week ultrasound there was a fetal heartbeat and embryo visible. At 8 weeks 6 days the woman experienced bleeding. She called her physician and asked for an intervention which could increase the probability of the continuation of a successful pregnancy.

What intervention could be offered to this patient that has been shown to increase the live birth rate?

Answer 19

progesterone 400mg PV twice daily