Miscarriage. Prolonged Pregnancy.

Question 1

Up to how many weeks of gestation would a breaking of pregnancy be classed as involuntary abortion and how many weeks would it be classed as premature?

Answer 1

Before twenty - two weeks is considered involuntary abortion and before thirty - seven weeks would be premature.

Question 2

How do you classify involuntary abortions?

Answer 2

By terms of pregnancy: up to twelve weeks is classed as early, between twelve and twenty - two weeks would be classified as late involuntary abortion.

By clinical form: threatening; abortion in motion; incomplete; complete; that did not take place; infected.

Question 3

How do you classify premature birth?

Answer 3

Unfavourable prognosis: between twenty - two and twenty - seven weeks (mass 500 - 1000g);
Doubtful prognosis: twenty - eight to thirty - three weeks (1000 - 1800g);
Sufficiently favourable prognosis: thirty - four to thirty - seven weeks (1900 - 2500g).

Question 4

What are the two groups of anomalies of the development of the fetus?

Answer 4

Aneuploid (anomalous set of chromosomes);

Euploid (normal set of chromosomes).

Question 5

What maternal factors cause euploid abortion?

Answer 5

1. Acute and chronic infectious diseases;
2. Endocrine disturbances;
3. Toxic factors;
4. Immunologic factors;
5. Age of gametes;
6. Anomalies of development and defects of the uterus;
7. Social - biological factors.

Question 6

What acute and chronic infectious diseases of the mother can cause euploid abortion?

Answer 6

Toxoplasmosis; ureaplasmosis; mycoplasmosis; chlamidiosis; rubella; cytomegaloviral infection; genital herpes etc.

Question 7

What endocrine disturbances of the mother can cause euploid abortion?

Answer 7

Diabetes mellitus; hypothyroidism; steroido - resistance of the receptors of the uterus; lack of progesterone; hyperandrogenism; hyperprolactinemia.

Question 8

What toxic factors of the mother can cause euploid abortion?

Answer 8

Consumption of alcohol and tobacco; exposure to formaldehyde, gasoline, arsenic, lead; using contraceptives and irradiation.

Question 9

What immunologic factors of the mother can cause euploid abortion?

Answer 9

Autoimmune disorders (SLE, antiphospholipid antibodies which injure thrombocytes and epithelium leading thrombus formation and damage of the placenta); alloimmune (hystocompatible factors, circulating blocking antibodies, local factors of supression, antibodies against the placenta and fetus and HLA incompatibility).

Question 10

What anomalies of development and defect of the uterus can cause euploid abortion?

Answer 10

Aschermann’s syndrome; isthmicocervical insufficiency and surgical procedures during pregnancy.

Question 11

What is the pathogenesis of spontaneous abortion?

Answer 11

Bleeding in the basal layer of decidual membrane and necrotic changes in the adjoining tissues –> ovum separates completely or partially and is pushed from the uterus.

Question 12

What are the signs of abortion?

Answer 12

Signs of premenstrual syndrome, bloody vaginal discharge as well as disturbances of the neuroendocrine and vascular symptoms.

Question 13

What are the clinical types of spontaneous abortion?

Answer 13

Threatened; incipient; inevitable; incomplete; complete; missed; recurrent or relapsing.