Miscarriage Flashcards
1
Q
define this
A
pregnancy loss <24 weeks gestation
2
Q
aetiology?
A
- non-viable foetus
- uterine abnormality
- cervical incompetence
- maternal factors
- diabetes, SLE etc
3
Q
epidemiology?
A
- happens to 1/5 pregnancies
- most common in 1st trimester
4
Q
types?
A
- Threatened
- Missed
- Inevitable
- Incomplete
- Complete
5
Q
describe threatened
A
- os is closed
- PV bleeding & pain
- foetus alive and viable
6
Q
describe inevitable
A
- os open
- PV bleeding and pain
7
Q
describe missed
A
- os closed
- no PV bleeding or pain
- foetus dead but remains in uterus
- this can be seen on USS as absence of foetal pole or heart beat
body has ‘missed’ it
8
Q
describe incomplete
A
- os open
- PV bleeding and pain
- foetus expelled but retained products of conception in uterus –> infection risk
9
Q
describe complete
A
- os closed
- no PV bleeding or pain
- miscarriage complete; POC have been evacuated
10
Q
types of miscarriage where there is pain?
A
threatened, inevitable, incomplete
11
Q
Mx?
A
- conservative
- expectant; watch and wait - most will resolve this way
- medical
- Mifepristone PO
- Misoprostol PV
- Surgical evacuation of retained products of conception
- dilatation of cervix + suction
12
Q
how does mifepristone work?
A
switches off corpus luteum; anti-progesterone
13
Q
how does misoprostol work?
A
prostaglandin- softens cervix and causes uterus to contract
14
Q
what is the definition of recurrent miscarriage?
A
>3 consecutive loss of pregnancy
15
Q
aetiology?
A
- idiopathic
- antiphospholipid syndrome
- other thrombophilias
- chromosomal abnormalities (balanced translocatino) in parents
- uterine abnormalities
- maternal factors
- chronic histiocytic intervillositis
