Miscarriage Flashcards
OBS
Miscarriage
1 in… PG end in spontaneous T1 miscarriages
1 in 9
Miscarriage
PG ends spontaneously before the fetud has reached a viable gestational age (28 weeks)
Miscarriage
When the PG ends spontaneously after 28 weeks it is considered to be…
Intra- uterine death
Miscarriage
Intra- uterine death presents as
ante- partum hemorrhage
Miscarriage
Threatened miscarriage is
fetal demise ( early bleeding)
Miscarriage
Causes
- embryonic anomalies
- chromosomal anomalies
- Increased maternal age
- Uterine anomalies
- Intrauterine devices
- Teratogen
- Infections- Rubella, CMV, Malaria, Syphillis, Chlamydia, gonorrhea
- Drugs and chemicals
- Maternal disease - thyroid disease, uncontrolled DM
- Placental anomalies
- Extensive maternal trauma
Miscarriage
Types of Miscarriage
- Threatened Miscarriage
- Inevitable
- Incomplete
- Complete
- Missed
- Recurrent
Miscarriage
Hx of a threatened Miscarriage
- Vaginal bleeding before a viable gestational age
- Pain- mild, cramping
Miscarriage
Hx of an inevitable Miscarriage
- Uterine bleeding before viable gestational age
- Bleeding and pain- often greater pain
Miscarriage
Hx of an incomplete Miscarriage
- Bleeding, pain ( severe) resembling labour
- Expulsion of some BUT NOT ALL of the products of conception before the viable gestational age
Miscarriage
Hx of a complete Miscarriage
- Spontaneous expulsion of all fetal and placental tissue from the uterine cavity before the viable gestational period.
- Bleeding- minimal +/- pain
Miscarriage
Examination of threatened Miscarriage
- Fundus/ uterine size compatible with POA
- VE and speculum examination - OS closed
Miscarriage
Examination of inevitable Miscarriage
- VE and speculum- OS open w some cervical dilatation
- but still WITHOUT EXPULSION OF PLACENTAL OR FETAL TISSUE THROUGH THE CERVIX
Miscarriage
Examination of incomplete Miscarriage
- Fundus/ uterus smaller than POA
- Speculum- products in the cervical canal
- VE- cervix dilated and effaced
Miscarriage
Examination of Complete Miscarriage
OS closed
