Early Pregnancy Loss/ Spontaneous Abortion Flashcards Preview

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Flashcards in Early Pregnancy Loss/ Spontaneous Abortion Deck (43)
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1

Spontaneous abortion occurs most frequently in the _____ trimester

First

2

When recurrent,
spontaneous abortion can be associated with ______

Infertility

3

Spontaneous abortion can result in ______

Grief Reactions

4

What are the 5 broad causes of early pregnancy loss/ spontaneous abortion?

1)Genetic factors (e.g., chromosomal abnormalities)
2)Reproductive tract abnormalities (e.g., uterine anomalies)
3)Prothrombotic factors (e.g., thrombophilia)
4)Endocrinologic factors (e.g., polycystic ovary syndrome)
5)Immunologic factors (e.g., antiphospholipid syndrome)

5

What are critical investigations for early pregnancy loss/ spontaneous abortion

critical investigations, including
a)transvaginal ultrasound;
b)laboratory investigations when appropriate (e.g., maternal antibody screen, complete blood count, beta-hCG);
c)proper investigation regarding recurrent abortion (e.g., anti-phospholipid antibody screen, karyotype,
hystero-salpingogram);

6

Construct an effective initial management plan for early pregnancy loss/ spontaneous abortion

a)emergent management in case of hemodynamic instability (e.g., ruptured ectopic pregnancy);
b)referral for surgical evacuation or medical management (e.g., incomplete or missed abortion), if necessary;
c)counseling (e.g., grief, fertility implications, contraception);
d)referral for specialized care, if indicated (e.g., serious hemorrhage, recurrent abortion).

7

WHO defines abortion as any spontaneous or induced pregnancy termination
before how many weeks?

20 weeks

8

Approximately, what % of first trimester abortions results from chromosomal anomalies?

15%

9

What is the most common cause of early first trimester bleeds?

chromosomal abnormalities

10

From 12 wk - 20 wk what is the most common cause of early loss?

antiphospholipid abnormalities (autoimmune)

11

What is the most common chromosomal abnormality that causes abortion

autosomal trisomy

12

What karotype abnormality is consistent with turners disease (r/t early fetal loss)

cystic hygroma

13

Up to what percentage of women experience vaginal spotting/bleeding
during a first –trimester?


A-3%
B-5%
C-15%
D-25%
E- 43%

25%

14

Of those pregnant women having first trimester bleeding, approximately what percentage will abort
A-3%
B-5%
C-15%
D-25%
E- 43%

43%

15

25 year old multigravida with a previous confirmed early pregnancy presents with vaginal bleeding and pelvic pain.
Which of the following tests can help ascertain if the fetus is viable or if it is located in the uterus?

A- serum progesterone levels
B- serial quantitative B-HCG
C- Transvaginal ultrasound
D- All of the above
E- B and C only

All of the above

16

Septic abortion deaths following medical abortion , are more notably caused
by toxic shock syndrome from which of the following bacterial infections?


A- Staph. aureus
B- Neisseria gonorrhoeae
C- Chlamydia trachomatis
D- strep pyogenes
E- strep bovis
F - Clostridium (perfigens or sordelli)

Clostridium perfingens or clostridium sordellii

17

What are the three sx of Toxic shock syndrome?

fever, hypotension, rash (palms and soles)

18

A proven , effective therapy for threatened abortion includes which of the following?



A- Daily AM acetomenophen
B- Daily AM Ibuprofen
C- Increased fluid intake
D- Bed rest
E- none of the above

None of the above

19

A 32 year old woman with 4 previous recurrent second trimester pregnancy losses, presented at 8 weeks gestation
You decided that she is a good candidate for cervical cerclage?
When is it best placed?

A- 16 to 24 weeks
B- 12 to 14 weeks
C- 8 to 10 weeks
D- 20 to 24 weeks
E- 24 to 28 weeks

12 - 14 weeks

20

25 year old Miss F primigravida presents with vaginal spotting.
Her LNMP is 6 weeks ago. Transvaginal US reveals a fetal pole and fetal heart rate. Which of the following is your diagnosis?


A- Incomplete abortion
B- Threatened abortion
C- Missed Abortion
D- Ectopic pregnancy
E- none of the above

Threatened Abortion

21

25 year old Miss F primigravida presents with vaginal spotting.
Her LNMP is 6 weeks ago. Transvaginal US reveals a fetal pole and fetal heart rate. Same above patient , return 3 days later with 8/10 pelvic cramps and light vaginal bleeding, She is AVSS. HCT 40%, repeat US showed no fetal pole or heart beat,
Appropriate management include ?

A- Await spontaneous miscarriage
B- perform emergent cerclage placement
C- Administer IM methotrexate
D- None of the above
E- All of the above

Await spontaneous miscarriage

22

T/F; is fetal and embryonic tissue present in a partial hydatiform mole?

Yes

23

T/F; is fetal and embryonic tissue present in a complete hydatiform mole?

No

24

In women experiencing a first trimester SA, without dangerous hemorrhage or
infection, expectant management results in spontaneous resolution of the pregnancy in what percentage?



A- 80%
B- 100%
C- 10%
D- 40%
E- 25%

80%

25

Recurrent spontaneous abortion/miscarriage is defined by which of the following?


A- Two pregnancy losses in 10 years at 20 weeks gestation or less
B- Two consecutive pregnancy losses at 20 weeks gestation or less
C- Three or more consecutive pregnancy losses with fetal weights greater than 500g
D- Three or more consecutive pregnancy losses with fetal weight less than 500g
E- Three or more consecutive pregnancy losses at 20 weeks gestation or less.

E- Three or more consecutive pregnancy losses at 20 weeks gestation or less.

26

Acquired defects that may lead to recurrent SA, include which of the following?


A- Asherman syndrome
B- Leiomyoma
C- Cervical incompetence
D- all of the above
E- none of the above

All of the above

27

Acquired defects that may lead to recurrent SA, include which of the following?


A- Asherman syndrome
B- Leiomyoma
C- Cervical incompetence
D- all of the above
E- none of the above

All of the above

28

What estimated percentage of immunological factors causing recurrent SA?


A- 15 %
B- 40%
C- 0.1%
D- 2%
E- 35%

15%

29

Antiphospholipid antibodies clinical and laboratory diagnostic criteria include?



A- Lupus anticoagulant presence.
B- 3 or more consecutive abortions before 20 weeks.
C- Moderate levels of IGG anticardiolipin
D- High levels of IGM anticardiolipin
E- all of the above

All of the above

30

Early pregnancy loss is most common in women with which of the following ?


A- Type 2 DM- well controlled
B- Gestational HTN
C- HIV
D- PCOS-Stein Leventhal synd.
E- SLE with antiphospholipid antibodies

E- SLE with antiphospholipid antibodies