Misscarriage

Question 1

What percentage of identified pregnancies result in misscarriage?

Answer 1

12.5%

Higher of unidentified

Question 2

What is a threatened miscarriage?

Answer 2

Bleeding w/ or w/o abdominal pain <24 weeks of gestation

Question 3

Is miscarriage inevitable once the cervical OS is open enough to admit a finger?

Answer 3

Yes

Sometimes a cervical stitch is used to try to prevent this

Question 4

What is delayed miscarriage and how is it best diagnosed?

Answer 4

An anembyonic pregnancy, an empty gestational sac or fetal pole with no heart beat

Question 5

What proportion of pregnancies complicated by vaginal bleeding will remain viable?

Answer 5

Approx 60%

Question 6

When might an incomplete miscarriage be managed conservatively?

Answer 6

If not associated with heavy bleeding
Early gestation <8 weeks
Confirmed with pregnancy test

Question 7

What is a rare but significant risk of surgical management of miscarriage?

Answer 7

Uterine perforation

Question 8

What drugs would be used in the medical management of a delayed miscarriage (>12 weeks)?

Answer 8

Anti-progesterone = Mifepristone
Synthetic prostaglandin = Misoprostol (36-48 hr later)
If <12 weeks, general anaesthesia + suction.