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Questions and Answers
What is the age of viability in pregnancy?
Which type of abortion is characterized by sharp stabbing pain in the lower abdominal quadrant?
What is the main cause of miscarriage due to rejection of the embryo?
Which infection is NOT listed as a potential cause of miscarriage?
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What is the typical management option for a ruptured ectopic pregnancy?
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Which factor is NOT a known cause for the implantation of the embryo outside the uterine cavity?
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Which type of spontaneous miscarriage is characterized by slight spotting, mild uterine cramping, and no cervical dilation?
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What is a common symptom of an inevitable/imminent spontaneous miscarriage?
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Which management approach is typically recommended for an incomplete spontaneous miscarriage?
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What distinguishes a complete spontaneous miscarriage from the other types?
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Which type of spontaneous miscarriage is likely caused by the absence of fetal heartbeat and uterine/embryo enlargement?
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What symptom differentiates an incomplete spontaneous miscarriage from the others?
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Study Notes
Types of Spontaneous Miscarriage
- Threatened miscarriage:
- Good prognosis, cervix remains closed, and embryo can be saved
- Symptoms: slight bleeding, mild uterine cramping, no passage of tissue, and no cervical dilation
- Causes: stress, work
- Management: sonogram, HCG determination, bed rest, and no coitus for 2 weeks after bleeding
- Inevitable/Imminent miscarriage:
- Open cervix
- Symptoms: mild to severe bleeding, mild to severe uterine cramping, no passage of tissue, and fully dilated cervix
- Causes: no fetal heartbeat, no uterine/embryo enlargement, and possibly due to UTI
- Management: sonogram, dilatation and curettage, and assess vaginal bleeding post D&C
- Incomplete miscarriage:
- Fragments retained and expelled, uterus not contracting, and bleeding
- Symptoms: heavy bleeding, severe uterine cramping, passage of tissue, and open cervix
- Causes: unknown
- Management: dilatation and curettage to prevent hemorrhage and infection
- Complete miscarriage:
- Complete expulsion of fragments, full cervical dilation, and open cervix
- Symptoms: slight bleeding, mild uterine cramping, passage of tissue, and open cervix
- Causes: stress, work
- Management: no further management needed if uterine contractions are adequate to prevent hemorrhage and infection; suction or curettage to ensure no fragments left
Early Bleeding in Pregnancy
- Refers to vaginal bleeding before 12 weeks of gestational age
- Danger signs of bleeding during 4-6 weeks:
- Heavy bleeding
- Severe uterine cramping
- Passage of tissue
- Open cervix
Types of Abortion/Miscarriage
- Spontaneous miscarriage:
- Interruption of pregnancy before the fetus is viable (20-24 weeks gestation)
- Early: occurs before week 16 of pregnancy
- Late: between 16-24 weeks
- Elective abortion:
- Planned medical termination of pregnancy based on the situation
- Miscarriage:
- Spontaneous interruption in pregnancy
- Types:
- Threatened
- Imminent or Inevitable
- Missed
- Incomplete
- Complete
- Recurrent
Causes of Miscarriage
- Abnormal fetal formation
- Teratogenic factors or congenital malformations
- Chromosomal aberrations
- Rejection of the embryo through immune response
- Implantation abnormalities
- Inadequate endometrial formation
- Inadequate placental circulation and fetal nutrition
- Corpus luteum fails to produce enough progesterone
Infection Causes of Miscarriage
- Rubella
- Syphilis
- Poliomyelitis
- CMV
- Toxoplasmosis
- UTI (transcends to the placenta)
- Fetal growth failure
- Placental production of estrogen and progesterone fails
- Endometrial sloughing
- Prostaglandins released
- Early uterine contraction and cervical dilation
Ectopic Pregnancy
- Implantation occurs outside the uterine cavity (ampulla of the fallopian tubes)
- Symptoms:
- Sharp stabbing pain in the lower abdominal quadrant
- Difficulty moving due to excruciating pain upon pelvic area
- Scant vaginal spotting
- Nausea and vomiting
-
- pregnancy test
- 6-12 weeks AOG
- Causes:
- Tubal scarring from PID
- IUD slows transport of zygote
- History of ectopic pregnancy
- Smoking
- Management:
- History taking
- Sonogram to confirm and check if ruptured
- If ruptured, stat salpingectomy (removal of affected fallopian tube)
- If not ruptured, methotrexate (targets folic acid) or mifepristone (abortifacient) is given.
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Description
This quiz covers information related to early bleeding in pregnancy, including the danger signs during 4-6 weeks of gestational age, as well as different types of abortion and miscarriage such as spontaneous, early, late, and elective abortion. Test your knowledge on these important topics!
