Miscarriage Flashcards
What is a miscarriage?
A miscarriage, or early pregnancy loss, is the spontaneous loss of a pregnancy before 24 weeks of gestation, most commonly before 12 weeks.
What are the types of miscarriage?
Types include threatened, incomplete, complete, missed, septic, and inevitable miscarriage.
What are common symptoms of a miscarriage?
Symptoms include vaginal bleeding, abdominal or pelvic pain, passing of tissue or clots, and sometimes no symptoms in missed miscarriage.
What is the aetiology of miscarriage?
Causes include chromosomal abnormalities, maternal health conditions, uterine abnormalities, infections, and environmental factors.
What is the pathophysiology of miscarriage?
It typically involves genetic or environmental factors leading to impaired embryonic development, placental dysfunction, or uterine factors.
How prevalent is miscarriage?
Miscarriage affects about 1 in 4 recognised pregnancies, with the majority occurring in the first trimester.
What are the risk factors for miscarriage?
Risk factors include advanced maternal age, previous miscarriage, smoking, obesity, poorly controlled diabetes, and uterine abnormalities.
What are protective factors against miscarriage?
Protective factors include optimal maternal health, avoiding smoking and alcohol, and managing chronic conditions like diabetes or thyroid disease.
How is a miscarriage diagnosed?
Diagnosis is made through clinical history, pelvic examination, and ultrasound to confirm intrauterine pregnancy and assess viability.
What are the clinical findings in a miscarriage?
Findings may include vaginal bleeding, cervical dilation, absence of fetal heart activity, or passage of products of conception.
What investigations are used for suspected miscarriage?
Investigations include ultrasound, serum beta-hCG levels, complete blood count (CBC), and blood group with Rhesus typing.
What is the role of ultrasound in miscarriage?
Ultrasound confirms the presence and location of the pregnancy, assesses fetal viability, and identifies retained products of conception.
What is the role of serum beta-hCG in miscarriage?
Serial beta-hCG levels help assess pregnancy progression or failure in cases of uncertain viability on ultrasound.
What are the key features of a threatened miscarriage?
Features include vaginal bleeding with a closed cervix and no evidence of fetal loss on ultrasound.
What are the key features of a missed miscarriage?
A missed miscarriage involves fetal demise without expulsion of tissue, often identified on ultrasound with no symptoms.
What is conservative management for miscarriage?
Conservative management involves allowing the pregnancy tissue to pass naturally, often monitored with follow-up to ensure completion.
What are the medical management options for miscarriage?
Medical management includes the use of medications like misoprostol to induce uterine contractions and expel pregnancy tissue.
What is the surgical management for miscarriage?
Surgical options include manual vacuum aspiration (MVA) or dilatation and curettage (D&C) to remove retained products of conception.
What are the indications for surgical management of miscarriage?
Indications include heavy bleeding, infection, or failure of conservative or medical management.
What is an incomplete miscarriage?
An incomplete miscarriage occurs when some pregnancy tissue remains in the uterus after partial expulsion.
What is an inevitable miscarriage?
An inevitable miscarriage is characterised by vaginal bleeding, an open cervix, and inevitable loss of the pregnancy.
What is a septic miscarriage?
A septic miscarriage occurs when there is infection of the uterus associated with miscarriage, presenting with fever, pelvic pain, and discharge.
How is Rhesus factor relevant in miscarriage?
Women who are Rhesus-negative require anti-D immunoglobulin to prevent isoimmunisation in future pregnancies.
What are the complications of miscarriage?
Complications include infection, haemorrhage, emotional distress, and, rarely, uterine perforation or Asherman’s syndrome after surgery.
What support should be provided to women after a miscarriage?
Support includes counselling, information about the cause, future pregnancy planning, and emotional and psychological care.
