Miscarriage

Question 1

Frequency of miscarriages? %

Answer 1

Around 30%

Question 2

When do most miscarriages occur?

Answer 2

1st trimester, <12 weeks

Question 3

Types of miscarriages that occur?

Answer 3

Threatened
Inevitable
Incomplete
Complete
Missed
Septic
(Recurrent)

Question 4

Missed abortion is discovered how?

Answer 4

Missed period, positive preg. Nothing on U/S. Notice symptoms of preg disappear.

Question 5

Septic miscarriage happens how?

Answer 5

Incomplete miscarriage, but cervical OS is open, necrosis, infection, septic shock

Question 6

Key examination in miscarriage?

Answer 6

Cervix

Uterus

Question 7

Cervix and uterus in threatened miscarriage?

Answer 7

Cervix closed

Uterus small/equivalent for dates

Question 8

Cervix and uterus in inevitable miscarriage?

Answer 8

Cervix: open
Uterus: expectant

Question 9

Cervix and uterus in incomplete miscarriage?

Answer 9

Cervix: open
Uterus: small for dates

Question 10

Cervix and uterus in complete miscarriage?

Answer 10

Cervix: closed if all passed

Uterus : small for dates

Question 11

Cervix and uterus in missed carriage?

Answer 11

Cervix: closed
Uterus: small for dates

Question 12

DDx for miscarriage?

Answer 12

ectopic
Gestational trophoblastic Disease
-molar preg, choriocarcinoma

Question 13

Ectopic rate?

Answer 13

1:100

Question 14

Gestational trophoblastic disease rate?

Answer 14

1:600

Question 15

Most common cause for miscarriage?

Answer 15

Chromosomal abnormality

Question 16

Cause of miscarriage past 12 weeks usually?

Answer 16

Cervical insufficiency “silent miscarriage”

Question 17

Pain in ectopic usually?

Answer 17

Unilateral

Question 18

Miscarriage pain is usually?

Answer 18

Central?

Question 19

Ectopic preg bleeding?

Answer 19

Mostly intraperitoneal

Revealed bleeding: from endometrium (not maintained as bHCG isn’t as high, less corpus luteum, ‘menses’

Question 20

Ectopic, cervix and uterus description?

Answer 20

Cervix is closed

Uterus is small

Question 21

Cervical excitation in ectopics?

Answer 21

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

Question 22

If pale, blood pressure low and heart rate is LOW. What is the Dx?

Answer 22

Cervical shock - vasovagal from products passing through the OS

Question 23

If pale and BP is low and the heart rate is high. Dx?

Answer 23

Hypovolaemia shock