Miscarriage

Question 1

during which trimester do most pregnancies miscarry

Answer 1

1st

Question 2

what is cervical shock

Answer 2

stimulation of the cervical canal by products in it stimulates the parasympathetic system causing bradycardia and hypotension

Question 3

is cervical shock serious?

Answer 3

it should resolve quickly when products ar removed from the cervix

resuscitation with IV fluids and uterotonics (to induce contraction of uterus)

Question 4

is older maternal age a risk factor for miscarriage?

Answer 4

yes

Question 5

when do most spontaneous miscarriages occur

Answer 5

1st trimester

Question 6

what is the main cause of 1st trimester miscarriages

Answer 6

80% are chromosomally abnormal - embyronic disease, disorder or damage

Question 7

is a FH of spontaenous miscarriage a risk factor for spontaneous miscarriage

Answer 7

yes

Question 8

what are the common maternal causes of miscarriage

Answer 8

ascending infection from lower genital tract

exposure to toxic agents, irradiation or chemo

PCOS

asympatomatic BV

Question 9

asymptomatic BVis implicated in 2nd trimester BV - treat asympatomic women?

Answer 9

there is no proven benefit

Question 10

does CVS carry a risk of miscarriage?

Answer 10

yes! 1 in 100

performed between 11 and 14 weeks of pregnancy

Question 11

during which trimester are miscarriages due to anti phospholipid syndrome

Answer 11

1st and 2nd trimester

Question 12

can a threatened miscarriage be saved?

Answer 12

yes, there is a risk to pregnancy but 75% will settle

risk of subsequent preterum rupture of membranes and preterm delivery

Question 13

how does a threatened miscarriage present

Answer 13

vaginal bleeding

Question 14

can an inevitable miscarraige be saved?

Answer 14

no, it is in the process pf physiological expulsion from the uterine cavity

Question 15

incomplete miscarriage

Answer 15

some products of pregnancy have been expulsed and some remain

Question 16

what happens in a missed miscarriage

Answer 16

the foetus dies but is retained within the gestational sac

Question 17

what are the clinical signs of a missed miscarriage

Answer 17

symptoms of pregnancy which then disappear (falling beta hCG), small uterus for dates (not growing) –> confirm on US

Question 18

which Ab can be checked for if there is a suspicion of APS

Answer 18

lupus anticoagulant

anti cardiolipin

beta 2 glycoprotein

Question 19

what would typically been seen on an US of a missed miscarriage

Answer 19

empty gestation sac, no foetal cardiac activity, MSD >25mm, absent foetal pole and CRL >7mm (wont get any bigger on follow up)

Question 20

how many miscarriages define recurrnet miscarriage

Answer 20

≥3