OB/GYN 12/20/2016

Question 1

2 top causes of septic abortion

Answer 1

retained poc from elective abortion using unsterile technique

missed or incomplete abortion (rare)

Question 2

presentation of septic abortion

Answer 2

fev chil ab pain
heavy bleeding
malodorous purulent vaginal drainage
boggy tender uterus dilated cervix
thickened endometrial stripe and retained poc (echogenic material w blood flow) on pelvic us representing inflammation amd infection

Question 3

mgmt of septic abortion

Answer 3

ivf
ivabx
suction curettage

Question 4

tf

in septic abortion, infected tissue usually remains confined to retained poc

Answer 4

t
but treated as medical emergency (broad spectrum abx and suction curettage) as can be complicated by spread to myometrium, peritonitis, septic shock, death

Question 5

when is hysterectomy indicated for septic abortion

Answer 5

no improvement post suction curretage or 48 hrs post broad spectrum abx start

and/or pelvic abscess

Question 6

tf

methotrexate used in abortion mgmt

Answer 6

f

used for hemodynamically stable ectopic or gestational trophoblastic neoplasm

Question 7

methotrexate moa

Answer 7

dihydrofate reductase inhibitor…

Question 8

tf

misoprostal used for septic abortion

Answer 8

f
synthetic prostaglandin used for medical mgmt of spontaneous abortion by uterine contraction and retained poc expulsion
but onset too slow for emergent septic abortion needing ivf ivabx suction curretage to evacuate uterus to avoid sepsis as best as possible

Question 9

at what age is it a risk for oa

Answer 9

^50yo

can start thinking oa…