Miscarriage Flashcards
Frequency of miscarriages? %
Around 30%
When do most miscarriages occur?
1st trimester, <12 weeks
Types of miscarriages that occur?
Threatened Inevitable Incomplete Complete Missed Septic (Recurrent)
Missed abortion is discovered how?
Missed period, positive preg. Nothing on U/S. Notice symptoms of preg disappear.
Septic miscarriage happens how?
Incomplete miscarriage, but cervical OS is open, necrosis, infection, septic shock
Key examination in miscarriage?
Cervix
Uterus
Cervix and uterus in threatened miscarriage?
Cervix closed
Uterus small/equivalent for dates
Cervix and uterus in inevitable miscarriage?
Cervix: open
Uterus: expectant
Cervix and uterus in incomplete miscarriage?
Cervix: open
Uterus: small for dates
Cervix and uterus in complete miscarriage?
Cervix: closed if all passed
Uterus : small for dates
Cervix and uterus in missed carriage?
Cervix: closed
Uterus: small for dates
DDx for miscarriage?
ectopic
Gestational trophoblastic Disease
-molar preg, choriocarcinoma
Ectopic rate?
1:100
Gestational trophoblastic disease rate?
1:600
Most common cause for miscarriage?
Chromosomal abnormality
Cause of miscarriage past 12 weeks usually?
Cervical insufficiency “silent miscarriage”
Pain in ectopic usually?
Unilateral
Miscarriage pain is usually?
Central?
Ectopic preg bleeding?
Mostly intraperitoneal
Revealed bleeding: from endometrium (not maintained as bHCG isn’t as high, less corpus luteum, ‘menses’
Ectopic, cervix and uterus description?
Cervix is closed
Uterus is small
Cervical excitation in ectopics?
Would be unilateral: If ectopic is on the right and you push cervix to the left, it will worsen the pain as it strains the right Fallopian tube. it lessens the pain if you push cervix to right
If pale, blood pressure low and heart rate is LOW. What is the Dx?
Cervical shock - vasovagal from products passing through the OS
If pale and BP is low and the heart rate is high. Dx?
Hypovolaemia shock
