spontaneous abortion Flashcards
abortion
termination of prego by any means before 20 wks gestation
spontaneous abortion
premature expulsion of the products of conception, it occurs in up to 15-20% of clinically recognized preg
what is the most common cause of spontaneous abortion
chromosomal abnormalities
what are maternal facotrs that may increase the risk of spontaneous aborion?
smoking, infxn, maternal systemic dz, immunologic parameters, drug use, high BMI, heavy caffeine use, submusocal fibroids, uterine abnormalitly,
Ashermans, hx of prior SAB
when do most spontaneous abortions occur? (aka miscarries)
first trimester
threatened SA
+ vag bleed
- cevix opening
- no product of conception passes
inevitable SA
+ vag bleed
+ cervix opening
- not product of conception yet, but no way to maintiain prego
incomplete aSA
+ vag bleed
+ cervix opening
partial products
complete SA
+vag bleed
+cervix opeing
+product
missed SA
- vag bleed
- cervix
- no (fetal demise w/o sx)
tx of SA
o If the pregnancy has been definitively determined to be no longer viable, the uterus must be emptied
o If the pregnancy is early and the patient is managed expectantly (allow the products of conception to pass naturally), careful follow-up with pelvic examinations, serial hCG titers, and transvaginal ultrasonography can be used to determine whether the abortion is complete
o Dilation and curettage also may be necessary to ensure complete emptying of the uterus or as one form of induced abortion. Morbidity is caused by uterine perforation or cervical laceration
tx of complete SA
RhoGam
tx of Threatened SA
avoid heavy activity, pelvic rest (no tampons, sex)
tx of missed
D&C; expectant management; RhoGAM if appropriate
INcomplete tx
D&C; expectant management; RhoGAM if appropriate
