Nonviable Pregnancy & Abortion

Question 1

Describe the etiology of ectopic pregnancy

Answer 1

Question 2

Describe the prognosis & complications of ectopic pregnancy

Answer 2

Question 3

Describe the presentation of ectopic pregnancy

Answer 3

Question 4

Describe the presentation of a ruptured ectopic pregnancy

Answer 4

Question 5

Describe the PE for ectopic pregnancy

Answer 5

Question 6

Describe the workup for ectopic pregnancy

Answer 6

Question 7

Describe the pharmacologic treatment of ectopic pregnancy

Answer 7

Question 8

Describe the surgical management of ectopic pregnancy

Answer 8

Question 9

Describe the etiology of gestational trophoblastic disease

Answer 9

Question 10

Describe the etiology of molar pregnancy aka hydatidiform mole

Answer 10

Question 11

Describe the presentation & PE of molar pregnancy

Answer 11

Question 12

Describe the workup for molar pregnancy

Answer 12

Question 13

Describe the treatment & follow up of molar pregnancy

Answer 13

Question 14

Describe the prognosis & complications of a molar pregnancy

Answer 14

Question 15

Describe the etiology of spontaneous abortion

Answer 15

Question 16

Describe the types of spontaneous abortion

Answer 16

Question 17

Describe the workup for spontaneous abortion

Answer 17

Question 18

Describe the treatment for a threatened spontaneous abortion

Answer 18

Question 19

Describe the treatment for missed spontaneous abortion

Answer 19

Question 20

Describe the treatment for incomplete and inevitable spontaneous abortion

Answer 20

Question 21

Describe the two med regimen for first trimester spontaneous abortion

Answer 21

Question 22

Describe the 2nd trimester pharmacologic treatment for spontaneous abortion

Answer 22

Question 23

Describe the risks & complications of spontaneous abortion

Answer 23

Question 24

List some differential diagnoses for bleeding in the first trimester of pregnancy

Answer 24

Question 25

Define induced abortion

Answer 25

when a procedure is performed or a medication is taken to terminate a pregnancy

Question 26

When do most induced abortions occur

Answer 26

2/3 occur at 8 weeks of pregnancy or earlier

88% occurred in first 12 weeks

Question 27

Describe the steps taken prior to induced abortion (varies by state)

Answer 27

• counseling and informed consent
• mandatory waiting times or parental consent/notification
• contraception
• lab testing (confirm pregnancy, CBC, RhD status)

Question 28

Describe the induced abortion procedures (meds/surgical)

Answer 28

Meds
- mifepristone combo with misoprostol (up to 70 days but routinely used up to 77 days/11 wks), 95-98% success in 1st tri

Surgical
- uterine aspiration MC in US

(Mifepristone once then misoprostol 1-2 days later, repeat misoprostol in 1-2 days if 9-11+ weeks)

Question 29

Describe what to expect in a medication induced abortion

Answer 29

From Mifepristone: light cramping +/- bleeding

From Misoprostol:
- within 3 hrs: strong painful cramping, heavy bleeding +/- clots, fever
- within 24 hrs: n/v, HA, dizziness, diarrhea
- within 2 weeks: light bleeding

Question 30

Describe the administration of medication induced abortion

Answer 30

Take Mifepristone (200 mg PO) with water, use crackers to ease GI effects

wait 24-48 hrs

Take Misoprostol (800 mcg buccally), place in mouth for 30 mins then swallow remnants with water

Question 31

Describe some complications of induced abortion

Answer 31

hemorrhage, uterine perforation, infection, retained products of conception

LOW RISK

Question 32

Answer 32

Question 33

Answer 33

Question 34

Answer 34

Question 35

Answer 35