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Flashcards in Miscarriage Deck (15)
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1
Q

What is a threatened miscarriage? What are the sx?

Is the os open or closed?

A

painless vaginal bleeding occurring before 24 weeks
usually at 6-9 weeks
cervical os cLOSED

2
Q

What is a missed miscarriage? What are the sx?

Is the os open or closed?

A

when fetes has died, but miscarriage not occurred yet
Painless light vaginal bleeding
Cervical os is closed

3
Q

What is the Rx of a missed miscarriage

A

mifepristone and misoprostol

4
Q

How is a missed miscarriage confirmed/

A

US:
→ Fetal pole >7mm
→ No fetal heart activity
→ Mean gestation sac diameter >25mm w no fetal pole or yolk sac

5
Q

What is an inevitable miscarriage?
What are sx?
Is os open or closed

A

Miscarriage that is going to happen
Heavy bleeding
Clots and pain
Cervical os is OPEN

6
Q

What is an incomplete miscarriage?
What are sx
is os open or closed?

A

Not all products of conception have been expelled
Pain and vaginal bleeding
Cervical os is open

7
Q

When does a mid-trimester miscarriage occur?

A

13-26 weeks - second trimester

8
Q

What are the causes of mid-trimester miscarriage

A
∞	Mechanical - cervical weakness
∞	Uterine abnormalities 
∞	Chronic maternal disease - DM, SLE
∞	Infection 
∞	No cause identified
9
Q

What is the management of mid-trimester miscarriage

A

Cervical cerclage at around 14 weeks,

10
Q

What is the management of profuse bleeding in miscarriages?

A

ergometrine 0.5mg IM

11
Q

When is surgical management of miscarriage necessary?

A

If extreme pain or bleeding or significant retained products on US

12
Q

What is recurrent miscarriage?

A

3 or more consecutive spontaneous abortions (<24 weeks) w the same biological father

13
Q

What are the cause s of recurrent miscarriage?

A
  • Antiphospholipid syndrome - give aspirin from day of +ve pregnancy + LMWH (enoxaparin) until delivery
  • Endocrine disorders: poorly controlled DM, thyroid disorders, PCOS
  • Uterine abnormality e.g. uterine septum
  • Parental chromosome abnormalities - usually balanced reciprocal or Robertsonian translocation
  • Smoking
  • BV associated w 2nd trimester loss
14
Q

What are the ix for recurrent miscarriage?

A
  1. ALP antibodies - 2 tests must be +ve 12 weeks apart
  2. Thrombophilia screening
  3. Pelvic US to assess uterus
  4. Karyotype fetal products
15
Q

What is the management of ALP in pregnancy to prevent miscarriage?

A

give aspirin from day of +ve pregnancy + LMWH (enoxaparin) until delivery