UW abortions 02-19 (2) Flashcards
UW table. Spontaneous. Definition?
pregnancy loss < 20 weeks
UW table. Spontaneous. Risk factors? 3
Advanced maternal age;
Previous spontaneous abortion;
Substance abuse
UW table. Spontaneous. Tx options?3
Expectant
Medical induction (misoprostol)
Suction curettage if infection or HD instability
UW table. Spontaneous. Additional management? 2
Rho (D) immune globulin
Pathology examination
UW table. Spontaneous. Complications? 5
Hemorrhage
Retained products of conception
Septic abortion
Uterine perforation
Intrauterine adhesions
Common cause of 1st/2nd trim bleeding?
Spontaneous abortion
UW additional text. Spontaneous. Presentation? 4
Heavy vaginal bleeding
Cramping
Dilated cervix
Nonviable intrauterine gestation in the lower segment of uterus
UW additional text. Spontaneous. Tx if HD stable?
Expectant management
Misoprostol
UW additional text. Spontaneous. Tx if HD unstable?
Suction curettage
UW abortu fotkes. Inevitable (spontaneous) CP?
vaginal bleeding
dilated cervical os
products of conception may be seen or felt at or above cervical os
UW additional text. Missed abortion. onset?
intrauterine pregnancy demise at < 20 weeks gestation
UW additional text. Missed abortion. risk factors?
advanced maternal age (due to incr. of fetal chromosomal abnormalities)
UW additional text. Missed abortion. presentation?
Asymptomatic
decreased pregnancy symptoms (nausea, breast tenderness)
UW additional text. Missed abortion. physical examination? 2
Closed cervix
No bleeding
UW additional text. Missed abortion. UG findings?
a) Embryo without cardiac activity
b) Empty gestational sac without fetal pole. (some early pregnancies can present without a fetal pole. Hence viability is determined by serial ultrasounds and serial b-hCG levels). Repeat b-hCG normally increase until the end of first trimester but in case of missed abortion, decreasing levels are seen
UW abortu fotkes. Missed abortion. Cp3
No vaginal bleeding
Closed cervical os
NO FETAL CARDIAC ACTIVITY or empty sac
UW additional text. Complete abortion. risk factors? 3
Cocaine, alcohol, tobacco
UW additional text. Complete abortion. presentaton? 2
Lower abdominal pain
Heavy vaginal bleeding with passage of clots at < 20 weeks gestation
UW additional text. Complete abortion. examination?
closed cervix
UW additional text. Complete abortion. Diagnosis? 2
Ultrasonography (empty uterus; normal adnexa)
b-hCG positive because it can take up to 6 weeks for b-hCG to become undetectable
UW abortu fotkes. Complete abortion. CP3?
vaginal bleeding
closed cervical os
products of conception COMPLETELY EXPELLED
UW additional text. Threatened abortion. features? 4
Closed cervix
viable intrauterine gestation
vaginal bleeding
SUBCHORIONIC HEMATOMA
UW abortu fotkes. Threatened abortion. cp3?
vaginal bleeding
closed cervical os
FETAL CARDIAC ACTIVITY
UW abortu fotkes. Incomplete abortion. 3cp?
Vaginal bleeding
dilated cervical os
some products of conception expelled and some remain
UW table. Septic abortion. risk factors? 3
Retained products of conception from:
a) elective abortion with nonsterile technique
b) Missed or incomplete abortion (rare)
UW table. Septic abortion. CP? 4
Fever, chills, abdominal pain
Sanguinopurulent vaginal discharge
Boggy, tender uterus, dilated cervix
Pelvic UG: retained POC, thick endometrial stripe
UW table. Septic abortion. management? 3
IV fluids
broad spectrum antibiotics
suction curettage
UW additional text. Septic abortion. Note about hysterectomy?
Not indicated.
it is indicated in following case:
a) Pelvic abscess;
b) if the patient does not improve after suction curretage and 48h of broad spectrum abs
UW additional text. Septic abortion. Note about misoprostol?
misoprostol causes uterine contractions and expels products of conception for spontaneous abortion. However, it is not used for septic abortion because of slow onset of action
paveiksliukai.
paveiksliukai.
paveiksliukai.
No vaginal bleeding
Closed cervical os
NO FETAL CARDIAC ACTIVITY or empty sac
which one?
Missed abortion
paveiksliukai.
Vaginal bleeding
Closed cervical os
FETAL CARDIAC ACTIVITY
which one?
Threatened abortion
paveiksliukai.
Vaginal bleeding
Dilated cervical os
Products of conception may be seen or felt at or above cervical os
which one?
Inevitable abortion
paveiksliukai.
Vaginal bleeding
Dilated cervical os
Some products of conception expelled and some remain
which one?
Incomplete abortion
paveiksliukai.
Vaginal bleeding
Closed cervical os
Products of conception COMPLETELY expelled
which one?
Complete abortion
(Choice D) Case - inevitable abortions. patient’s uterine bleeding will likely stop after the uterus has been evacuated. A hysterectomy would be indicated for persistent bleeding after suction curettage only if all other treatments (eg, uterine tamponade, uterine artery embolization) have failed.
.
A complete abortion, a type of spontaneous abortion.
.
A complete abortion, a type of spontaneous abortion, typically presents as lower abdominal pain and heavy vaginal bleeding with the passage of clots at <20 weeks gestation. These symptoms worsen until the products of conception—often described as a solid or sac-like bloody purple to white mass—are expelled and the symptoms lessen and resolve.
.
A complete abortion, a type of spontaneous abortion. Cervix? size of uterus?
Pelvic examination findings include a normal-sized uterus with a closed cervix.
When finishes - the cervix closes, and the associated pain and bleeding subside.
A complete abortion, a type of spontaneous abortion. hCG levels?
hCG yra positive.
It can take up to 6 weeks for β-hCG levels to become undetectable while the levels clear and trophoblastic tissue resolves
A complete abortion, a type of spontaneous abortion. Ug of uterus?
Empty uterus, but other findings, including a small simple (unilocular) ovarian cyst with fluid in the pelvis, are common.
These findings are common in early pregnancy and represent the corpus luteum and retrograde bleeding from the spontaneous abortion, respectively.
(Choice C) Although some pain and/or [Mehl – light bleeding can occur 1-2 weeks post ovulation when implantation begins] bleeding can occur with a normal pregnancy (ie, implantation site bleeding), ultrasound would reveal an intrauterine pregnancy (at 7 weeks gestation, ultrasound would show a fetal pole with a normal heartbeat).
.
what would show UG in ectopic? bleeding?
common cause of first trimester bleeding.
ectopic pregnancy typically presents with a complex adnexal mass with surrounding vascularity, and if ruptured, a large amount of complex fluid in the pelvis
