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Obstetrics > misscarriage > Flashcards

misscarriage Flashcards

1
Q

what

A

spontaneous loss of pregnancy <25wks

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2
Q

early misscarriage

A

before 12wks

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3
Q

late misscarriage

A

12-24wks

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4
Q

missed misscarriage

A

fetus died

uterus made no attempts to expel it

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5
Q

threatened miscarriage

A

vaginal bleeding closed cervix

viable pregnancy

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6
Q

inevitable miscarriage

A

vaginal bleeding

open cervix

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7
Q

incomplete miscarriage

A

retained products of conception
open cervix
vaginal bleeding

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8
Q

complete miscarriage

A

complete expulsion
cervix closed
bleeding stopped

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9
Q

anembryonic pregnancy

A

gestational sac present but contains no embryo

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10
Q

Ix of choice

A

transvaginal USS

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11
Q

USS - fetal heartbeat visible

A

pregnancy is viable

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12
Q

when is a fetal heartbeat expected

A

once crown-rump length is 7mm or more

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13
Q

USS - crown-rump length is less than 7mm, without a fetal heartbeat

A

USS repeated after 1 wk to ensure heartbeat develops

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14
Q

USS - crown-rump length of 7mm or more, without a fetal heartbeat

A

scan repeated after 1wk before confirming non-viable pregnancy

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15
Q

when is a fetal pole expected

A

once mean gestational sac diameter is 25mm or more

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16
Q

USS - mean gestational sac diameter of 25mm or more, without a fetal pole

A

the scan is repeated after one week before confirming an anembryonic pregnancy

17
Q

Mx - <6wks gestation

A

expectant Mx as long as have no pain, complications or risk factors (e.g. prev ectopic)

wait misscarriage w/o Ix or Rx

urine pregnancy test after 7-10days to confirm miscarriage

18
Q

why is USS not helpful <6wks gestation

A

pregnancy too small to be seen

19
Q

Mx - >6wks gestation

A

3 options

  • expectant
  • medical - misoprostol
  • surgicla
20
Q

Mx - >6wks - medical Mx

A

misoprostol (prostaglandin analogue)

expedites miscarriage

can be given as suppository or oral

21
Q

misoprostol side effects

A

heavier bleeding
pain
vomit
diarrhoea

22
Q

Mx - >6wks - surgical options

A

mannual vaccum aspiration

electric vaccum aspiration

23
Q

Manual vacuum aspiration

A

local anaesthetic
woman must be okay with it
<10wks

24
Q

Electric vacuum aspiration

A

traditional surgical Mx

general anaesthetic

25
Q

what is given before surgical management

A

misoprostol to soften cervix

26
Q

incomplete miscarriage - risk of

A

infection

27
Q

incomplete miscarriage - Mx

A

medical managment - misoprostal

surgical - evacuation of retained products of conception

28
Q

Evacuation of retained products of conception (ERPC)

A

general anaesthetic

risk endometritis

Obstetrics (61 decks)

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