Pregnancy loss Flashcards
Threatened abortion- Eti
- Bleeding from uterus before 20th wk
- 25% with sig bleeding
- Age, hx of SAB, infection, anatomic malformation, aneuploidy
Threatened abortion- Sx
1st trimester bleeding
- +/- pain/ cramping
- No cervical dilation
Threatened abortion- Dx
- Transvag US
- hCG
- CBC (anemia)
Threatened abortion- Tx
- Acetaminophen
- Rhogam
- Evacuation of pregnancy
Incomplete abortion- Eti
- Partial or complete separation of placenta, dilation of cervix, passage of some on products of contraception
Incomplete abortion- Sx
Severe cramping & heavy bleeding
Incomplete abortion- Dx
- Transvaginal US
- Irregular gestational sac
Incomplete abortion- Tx
- Curretage
- Misoprostol
Inevitable abortion- Eti
- Rupture of amniotic membrane
- Bleeding with cervial delation
- Products of contraception still in uterine cavity
Inevitable abortion- Sx
- Bleeding and gush of fluid
- Back or abd cramping
Inevitable abortion- Tx
- 48 hr obs
- Bed rest
- If bleeding, cramping, fever immediate evacuation
Missed abortion- Eti
- Pregnancy retained in uterus after fetal demise
- Closed cervix
Missed abortion- Sx
- Asymptomatic
- Some bleeding or cramping
Missed abortion- Dx
hCG & CBC
- Ultrasound to confirm fetal demise
Missed abortion- Tx
- Curettage
- Misoprostol
Complete abortion- Eti
- All products of contraception pass and cervix closed
Complete abortion- Sx
- Slight bleeding & cramping
- May last weeks
Complete abortion- Dx
hCG, CBC, US
- Empty uterus with thin endometrial lining
Complete abortion- Tx
Curettage, misoprostol
Septic abortion- Eti
- Intrauterine infection involving endometrium & products of contraception
- Endometritis from ascending bacterial infection or retained products of contraception
Septic abortion- Sx
Fever, chills
- Abd pain
- Bleeding with malodorous discharge
Septic abortion- Dx
- CBC, hCG
- UA, US, Abd x-ray to r/o perforation
Septic abortion- Tx
IV abx
- D & C
