Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ob/Gyne > Module 6.1 : Classification of Abortions > Flashcards

Module 6.1 : Classification of Abortions Flashcards

1
Q

abortion - definition

A
  • termination of pregnancy prior to 20 weeks, either spontaneous or induced
  • rate of pregnancy loss is 25%
  • over 40 years old increases to 50%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Threatened abortion

A
  • bleeding with a viable intrauterine pregnancy
  • heart beat is seen
  • usually result of implantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

embryonic demise

A
  • an embryo is present but no heart beat is detected
    or
  • no fetus is visualized within the retained membranes, inly gestational sac visualized
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

spontaneous abortion with no retained parts

A
  • uterus is normal or non gravid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

factors causing SA - maternal

A 
- malformations of uterus 
    \+ synechiae (scars)
    \+ fibroids (take up volume)
    \+ septet uterus 
- toxic agents 
    \+ tabacco 
    \+ alcohol
- systemic infection
- hormonal failure
- poor trophoblastic reaction 
- advanced maternal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

factors causing SA - fetal

A
  • malformations

- genetic (50-70%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

factors causing SA - maternal and fetal

A
  • RH incompatibility
    + RH is the Rhesus factor an antigen on the red blood cells
    + mother is Rh- and the fetus (2nd pregnancy) is Rh+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

clinical signs of abortion

A 
- vaginal bleeding 
    \+ spotting 
    \+ light 
    \+ heavy 
- cramping 
- dilated cervix
- uterine contractions 
* heavy bleeding with painful cramps is 3x more likely to miscarry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

vaginal bleeding

A
  • 50% will lose pregnancy
  • heavy bleeding and pain pose greater risk
  • 17% that don’t miscarry will have complications with the pregnancy such as PROM (premature rupture of membranes) and preterm labor
  • not all bleeding comes from pregnancy, can arise from cervix, vagina or uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment

A
  • do nothing
    + let nature take its course
  • have a D & C
    + dilation and curettage
    + dilate the cervix and scrape the uterine cavity
    + curettage means the cleansing of diseased surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

changes in uterine size

A
  • at 6 weeks the gestational sac occupies less than 1/2 of total uterine cavity
  • by 8 weeks the gestational sac occupies 1/2 of the uterine cavity
  • by 10 weeks the sac occupies the entire cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MSD and yolk sac visualization

A
  • EV = see yolk sac when MSD 8mm

- TA = see yolk sac when MSD 20mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

viable pregnancies

A
  • a 6 week normal intrauterine pregnancy ultrasound results in favourable outcome =s
  • a 12 6/7 week normal intrauterine pregnancy ultrasound
    + reduces risk of loss to 1-2%
    + not because ultrasound but demonstrates of a confirmation of normal pregnancy by US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

classifications of abortions

A
  • threatened abortion
  • anembryonic/blighted ovum
  • embryonic demise/missed abortion
  • inevitable abortion/in progress
  • incomplete abortion
  • complete abortion
  • habitual abortions
  • specific abortions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

threatened abortion

A
  • vaginal bleeding
  • ultrasound shows normal pregnancy
  • cervix is closed
  • may have cramping
  • possibly implantation bleed
  • could be a resolving coexisting twin or vanishing twin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

anembryonic

A
  • aka blighted ovum
  • gestational sac develops
  • no embryo
  • usually no yolk sac
  • bleeding with ‘’+” pregnancy test
17
Q

sonographic appearance of anembryonic

A
  • uterus is small for dates
  • gestational sac without a fetus
  • MSD greater than 20mm and no embryo seen
  • F/U (follow up) in 10 days
    + to see if anything changed, give pregnancy benefit of the doubt
  • may need D & C
18
Q

embryonic demise

A
  • aka missed abortion
  • fetus dies but remains in uterus
  • bleeding
  • small for dates uterus
  • 5mm or greater embryo without fetal heart
  • occurs between 10 and 14 weeks
    + embryo died earlier but the patient hasn’t had any symptoms of loosing the pregnancy yet
19
Q

embryonic demise - sonographic appearance

A
  • no FH
  • macerated uterus
    + fetal tissue breaking down
  • irregular walls
  • spalding sign
    + brain atrophy and skull bones collapsing
  • M mode only definitive way to show demise
    + color doppler over fetal heart to confirm demise
20
Q

Inevitable abortion

A
  • in progress
  • patient presenting with active bleeding and cramping
  • clinically patient has an open cervix
21
Q

inevitable abortion - sonographic appearance

A
  • clot in endometrium
  • sac low in uterus
  • may still see a FH but placenta detached
22
Q

differential diagnosis - inevitable abortion

A
  • cervical ectopic pregnancy
    + negative dynamic EV
    - dynamic EV putting pressure to see if structures move + if structures move - if structures do not move
    + dynamic EV scan will help differentiate from inevitable abortion
23
Q

incomplete abortion

A
  • some parts of conception have passed but some still remain
  • ask patient if they haves passed clots or tissue
24
Q

incomplete abortion - sonographic appearance

A
  • enlarged uterus
  • poorly defined gestational sac
  • may see an echogenic mass like structure
25
Q

complete abortion

A
  • all products of conception have passed

- bleeding and cramping have ceased

26
Q

complete abortion - sonographic appearance

A
  • empty uterus
  • enlarged uterus
  • may see some blood between the endometrium lining
  • deciding if need a D&C
27
Q

habitual abortions

A
  • 3 or more consecutive abortions
  • may be due to
    + luteal failure
    + retroverted uterus
    + DES exposure - T shaped uterus
    + unicornuate uterus
    + chromosomal abnormalities
28
Q

septic abortion

A
  • infected products of conception
  • after a spontaneous or therapeutic abortion
  • pain, FEVER, bleeding, and discharge
29
Q

septic abortion - sonographic appearance

A
  • retained products
  • thick endometrium
  • if their are gas producing organisms air shadow may be visualized
30
Q

Therapeutic abortions

A
  • selective abortions are performed for malformations
  • in Alberta therapeutic abortions are performed
    + up to 20 weeks for personal reasons or fetal abnormalities
    + from 20w 1d to 22w 6d for any fetal abnormalities
    + from 23weeks to term only if lethal fetal abnormality is diagnosed
31
Q

role of sonography for TA

A
  • dating of pregnancy prior to termination when a size discrepancy is suspected
  • diagnosis of masses or malformations that might hinder procedure
  • localizations of IUCD
  • guidance in difficult cases
  • post TA
    + diagnosis of complications from termination
32
Q

methods of inducing abortion

A
  • less than 14 weeks = D&C

- greater than 14 weeks = induction of labor using prostaglandin or hypertonic saline urea

Ob/Gyne (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions