Spontaneous Abortion Flashcards
What are the signs and symptoms of uterine perforation?
lower abdominal pain, nausea, scant bleeding and fever; PE revealing rebound tenderness and guarding, with soft and slightly tender uterus; possibly after D&C
What are signs and symptoms of hematometra?
can develop after an abortion, and pt would complain of cyclic midline abdominal cramping pain
What signs and symptoms of retained products of conception cause?
profuse vaginal bleeding and if not removed septic abortion
What accounts for majority of first trimester spontaneous abortions?
50-60% of embryos and early fetuses that are spontaneously aborted contain some form of chromosomal abnormality
_____ diseases are associated with early pregnancy loss.
Systemic diseases such as diabetes mellitus, chronic renal disease, and lupus. In insulin dependent diabetes, rates of spontaneous abortion and major congenital malformations are both increased. Risk related to degree of metabolic control in first trimester.
What are environmental factors that are causes of spontaneous abortion?
smoking, alcohol, radiation
What is treatment in a patient that is hemodynamically unstable and anemic having a spontaneous abortion?
Immediate surgical treatment with dilation and suction curettage
When should a cervical cerclage be placed for cervical incompetence?
14 weeks
What tests should be done in a patient with recurrent abortion?
lupus anticoagulant, anticardiolipin antibodies, diabetes mellitus and thyroid disease; maternal and paternal karyotype; consider infectious causes; uterine imagine by hysteroscopy or hysterography
Why is misoprostol used for termination?
shortens time to expulsion, has been shown to reduce need for curettage; dose of 800mcg causes complete expulsion in 71% after 1 dose and 84% after second; expect heavy bleeding and cramping–>pain meds given
when should rhogam be given?
within 72 hours of pregnancy loss regardless of how it is managed
