Abortion

Question 1

definition: abortion

Answer 1

loss of pregnancy prior to 20 weeks

Question 2

what are the 6 types of abortion?

Answer 2

• threatened
• inevitable
• incomplete
• missed
• septic
• induced

Question 3

definition: threatened abortion

when / dilation / expulsion

Answer 3

• vaginal bleeding within first 20 weeks of gestation not ending in spontaneous abortion
• no cervical dilation
• no expulsion of products of conception

Question 4

definition: inevitable abortion

dilation / expulsion

Answer 4

• vaginal bleeding with cervical dilation but no passage of tissue
• a viable pregnancy is unlikely

Question 5

definition: incomplete abortion

dilation / expulsion

Answer 5

• vaginal bleeding with cervical dilation

- partial expulsion of products of conception

Question 6

definition: complete abortion

bleeding / expulsion / cervix presentation

Answer 6

• vaginal bleeding
• all products of conception expelled
• cervix closed

Question 7

definition: missed abortion

dilation / expulsion

Answer 7

• fetal death without spotting
• no cervical dilation
• complete retention of products of conception
• often proceed to complete spontaneous abortion in 1-3 weeks

Question 8

definition: septic abortion

what are the signs?

Answer 8

• threatened, inevitable, or incomplete abortion with signs of uterine infection
• elevated temp
• leukocytosis
• lower abdominal tenderness
• cervical motion tenderness
• foul smelling discharge

Question 9

what are the causes of abortion?

Answer 9

• chromosomal abnormality
• congenital anomaly
• no obvious etiology

Question 10

what are risk factors for abortion?

Answer 10

• increasing maternal age
• ETOH / smoking / drug use
• recurrent pregnancy loss
• extremes of weight

Question 11

what are the diagnosing criteria for abortion?

Answer 11

• vaginal bleeding and cramping
• decreasing signs of pregnancy
• quantitative HCG level
• transvaginal US

Question 12

what tests are done to evaluate for abortion?

Answer 12

• sterile speculum exam
• sterile vaginal exam
• serum progesterone
• CBC
• blood type and Rh

Question 13

what is the treatment for a threatened abortion?

Answer 13

• pelvic rest (no sex)

- minimal to no intervention

Question 14

what is the treatment for inevitable and incomplete abortions?

Answer 14

• surgical (D&C/E)
• medical (misoprostol)
• expectant management

Question 15

what is misoprostol?

Answer 15

PG to induce cervical dilation and uterine contractions

Question 16

what is the treatment for a complete abortion?

Answer 16

• follow quantitative BHCG weekly until it is zero

- may need transvaginal US to rule out retained products of conception

Question 17

what is the treatment for a missed abortion?

Answer 17

• surgical (D&C/E)
• medical (misoprostol)
• expectant

Question 18

what is the treatment for a septic abortion?

Answer 18

• obtain vaginal cultures, chem panel, blood cultures, CXR, coagulation studies
• surgical evacuation promptly
• IV abx with BSA
• IV fluids

Question 19

medical management for an abortion with misoprostol / methotrexate / mifepristone can be done safely through what day?

Answer 19

day 49

Question 20

definition: recurrent pregnancy loss

Answer 20

3 or more losses prior to 20 weeks