Recurrent pregnancy loss Flashcards
What is the definition of spontaneous abortion?
Loss prior to 20 weeks or below 500 g
What is the definition of recurrent pregnancy loss?
Two or more consecutive spontaneous miscarriages
What is the definition of anembryonic pregnancy?
empty gestational sac at 4-5 weeks of pregnancy
What is the definition of yolk sac misscariage?
Yolk sac present by no embryo by 5-6 weeks
What is the definition of fetal demise?
fetus with cessation of cardiac activity after 10 weeks
What is the definition of early pregnancy loss?
nonviable, intrauterine pregnancy prior to 13 weeks gestation
Crown rump length of ____mm or greater and no heart beat is diagnostic of early pregnancy failure.
7
Mean Sac diameter of ___mm or greater and no embryo present is diagnostic of early pregnancy failure.
25
Absence of embryo with heartbeat ____ days or more after scan showed gestational sac WITHOUT yolk sac is diagnostic of early pregnancy failure.
14
Absence of embryo with heartbeat _____ days or more after scan showed gestational sac WITH yolk sac is diagnostic of early pregnancy failure.
11
What medications should be given preop for a D&C for missed SAB?
Doxycyline 200 mg
What is the recommended regimen for medical management of missed SAB?
Misoprostal 800 mcg vaginally
What medication and dose can be added to misoprostal to improve the efficacy for missed SAB?
Mifepristone 200 mg 24 hrs prior to Misoprostal
Misscariage affects what percentage of pregnancies?
12-15%
What is the rate of recurrent pregnancy loss?
1-2%
What is the most common cause of recurrent pregnancy loss?
Chromosomal abnormalities
What is the rate of miscarriage in women < 30 years?
25%
What is the rate of miscarriage in women 31 - 35 yrs?
28%
What is the rate of miscarriage in women 36 - 39 yrs?
33%
What is the rate of miscarriage in women > 40yrs
52%
What percentage of 1st trimester pregnancy loss is attributed to chromosomal abnormalities?
> 75%
What is the most common Trisomy associated with SAB?
Trisomy 16
What is the most common chromosomal abnormality resulting in SAB?
Trisomies
What is the second most common chromosomal abnormality resulting in SAB?
Monosomy X, Turners
What is the most common type of genetic mutation associated with parental chromosomal abnormalities?
balanced translocation
What is the most common congenital uterine anomaly associated with recurrent pregnancy loss?
Septate Uterus
What is the best treatment for recurrent pregnancy loss associated with a septate uterus?
Hysteroscopic septoplasty
Which type of fibroids carry risk of miscarriage?
Submucosal and intramural
In a patient with previous curretage for septic SAB who has recurrent pregnancy loss, what would you anticipate the cause?
Asherman’s syndrome
What percentage of women with recurrent pregnancy loss have positive antiphospholipid antibodies?
5 - 20%
What three antiphospholipid antibodies can cause recurrent pregnancy loss?
Lupus anticoagulant, Anticardiolipin antibody, Anti-B2 Glycoprotein I antibody
True/False: subclinical hypothyroidism cause recurrent pregnancy loss
True
What two infectious organisms are associated with Recurrent pregnancy loss?
Ureaplasma and Mycoplasma
Do obese women have a higher rate of SAB?
Yes
