Pregnancy Loss

Question 1

Almost 20% of all clinically recognized pregnancies terminate in spontaneous abortion.

Answer 1

20%

Question 2

What issue?
(increased risk of miscarriage)
(a) Bleeding or cramping occurs, but the pregnancy continues.
(b) The cervix is not dilated.

Answer 2

Threatened abortion

Question 3

What issue?
(a) Products of conception are completely expelled.
(b) Pain ceases, but spotting may persist.
(c) Cervical os is closed, some blood in the vaginal vault

Answer 3

Complete abortion ( a competed miscarriage)

Question 4

What issue?
(a) The cervix is dilated.
(b) Some portion of the products of conception remains in the uterus.
(c) Only mild cramps are reported,
(d) Bleeding is persistent and often excessive.

Answer 4

Incomplete abortion

Question 5

What issue?
(a) The pregnancy has ceased to develop, but the conceptus has not been expelled.
(b) Symptoms of pregnancy disappear.
(c) There may be a brownish vaginal discharge but no active bleeding.
(d) Pain does not develop. The cervix is semi firm and slightly patulous;
(e) The uterus becomes smaller and irregularly softened;
(f) The adnexa are normal.
(g) Women may be indicated for abortifacient and correttage.

Answer 5

Missed abortion

Question 6

All tissues recovered should be sent to _____ if possible.

Answer 6

pathology

Question 7

Imaging considerations for abortion

Answer 7

Transvaginal ultrasound

Question 8

Treatment for abortion

Answer 8

(1) Stabilize and resuscitate patient if needed.
(2) MEDEVAC
(3) If products of conception are visible
–(a) Gently remove and place in a specimen bottle
(4) Analgesics
–(a) Acetaminophen 325-650mg PO Q6H PRN Pain
–(b) Can consider narcotic pain meds

Question 9

Complications for abortion

Answer 9

(1) Hemorrhage
(2) Anemia
(3) Recurrent abortions

Question 10

hCGdurring or after abortion is going to show what?

Answer 10

Low or falling levels