Miscarriage Flashcards
How many pregnancies miscarry?
When do they tend to?
15-20%
in the first trimester
does vaginal bleeding in pregnancy have a high chance of miscarriage?
60% will stay viable (pregnant with bleeding)
What will a pregnancy test show after a miscarriage
it will stay positive for a few days after the loss
causes of miscarriage
HTN endocrine - PCOS, low progesterone, other uncontrolled endocrine chromosome abnormality uterine abnormality (septate, fibroid etc) anti-phospholipid syndrome SLE thrombophilia maternal illness teratogen damage (murcury etc) listeria
anti-phospholipid syndrome treatment
aspirin
LMWH
thrombophilia - heparin too
presentation of a miscarriage
vaginal bleeding (may be very heavy) pain
miscarriage vs stillbirth
before 24 weeks is a miscarriage
after = still birth
inevitable miscarriage
the cervical os is open
threatened miscarriage
the cervical os is closed with pain/bleeding
incomplete miscarriage
fetus partly expelled - products of conception remaining
delayed miscarriage
no fetal heart - not viable but mum is still pregnant, hCG is high
investigation of miscarriage
TVS
b hCS
treatment of miscarriage with retained products of conception
> 12 weeks - mifepristone (progesterone analogue)
misoprostol - prostaglandin analogue (will pass in 48-72 hours)
surgical evacuation
when does a pregnancy test show positive?
after 4 weeks
how do you decide if bleeding amount is significant and not just spotting?
if its like a period - its bad
