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44 Cards in this Set

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  • Back

What is the termination of a pregnancy prior to viability?

Abortion
What does TAB stand for?
Therapeutic Abortion- elected
What is a loss of a fetus during pregnancy due to natural causes less than 20 weeks?
Spontaneous Abortion
What does FDIU stand for?
If the baby is lost less than 20 weeks due to natural causes it stands for :
Fetal demise or Fetal Death In Utero
What are the 5 classifications of an SAB?
1. Threatned
2. Inevitable
3.Complete
4.Incomplete
5. Missed
What happens during an SAB?
usually begin w/ hemorrahge in decidua Basalis causing a detachment of the conceptus (developing embryo) also...."anembryonic aka Blighted Ovum"
-fetal heart should be above 90-100
-75% occur before the 16th week
-occurs 1-3 wks after embryonic death
75 % of ______ happens before the 16th week of pregnancy?
SAB
What does "anembryonic" mean?
A blighted ovum
What are the possible causes of an SAB?
-hormonal factors (corpus luteum)
-Muellerian defects
-Chromosomal defects
-Unknown
What type of "abortion" is the most common reason for 1st trimester scan?
Threatned Abortion
What is a Threatned abortion?
cramping & bleeding w/o passage of tissue in a pregnancy that is < 20 weeks
What are the clinical symptons of a Threatned abortion?
-Closed cervical Os
-possible bleeding or spotting from the dec. basalis
-cramping
-"SCH" often seen but not always diagnosed with u/s
Advanced Maternal age can be a factor
What are some "facts" about Threatned abortions?
-Closed cervical Os
-1/2 will end in miscarriage
-patient will have decreasing hCg levels
-assumed due to chrom. abnormalities
What is a Subchorionic Hemorrhage ("SCH")?
"hemorrhage w/in the decidua basalis layer surrounding the gestational sac."
Whats another name for "implantation bleeding?"
Subchorionic Hemorrahge
or SCH
Describe the appearance of a "SCH?"
Normal appearing Gestational sac surrounded by crescent shaped fluid collection
-varying echogenicity
When is a "SCH" most likely to happen?
Within the 1st 2 months of pregnancy
What is a "SCH" most often mistaken for?
A twin pregnancy
What is an Inevitable Abortion?
aka.. "eminent" AB or "impending" AB

"an abortion in progress: Threatned AB with more severe cramping
What are the chararteristics of an Inevitable AB?
-cervical os is open
-continuation of bleeding
-thinning & dilating of cervix
-cannot be haulted
-GS may be seen in LUS or cervix
Sac oftern appears "collapsed"
-SCH is very likely
-If bleeding more than 7 days- AB is likely
What is a "Complete Abortion?"
"all products of conception have been expelled from the uterus at anytime during pregnancy"
-passage of GS, fetus, placenta, etc (POC)
What are the clinical signs of an Complete abortion?
heavy bleeding with tissue clots
-cramping, cessation of pain and brisk bleeding after conceptus has passed
-disappearance of pregnancy systems
-no further treatment is needed
Whats the diagnosis for a Complete Abortion?
- rapidly declining hCg levels
-empty uterus (clean endo)
-Abortion is now complete. tissue has passed, cervical os is closed
Thickening of the endo may be seen approx.______ post SAB due to trophoblastic tissue reaction
3 days
What is an Incomplete Abortion?
"Partial evacuation of products of conception"
Diagnosis of an Incomplete Abortion:
-varying amount of tissue remains w/in endo
-slowly decreasing hCg levels
-cervix will be thin & dilated
U/S appearance of an Incomplete Abortion:
-echoes seen w/in endo due to air bubbles or retained bony fragments

- diagnosed at the time while the even is taking place
What is a "Missed abortion?"
aka embryonic demise
"prescence of an embryo w/in the uterus, but without heart beat.
Visual findings of a Missed abortion
- may have irregular shaped sac
-fetus may be small, poorly definted
What are the symptons of a Missed Abortion?
loss of signs of pregnancy
-decrease in Uterine size
-brownish discharge

-hCg will still be high if it just happened but low if its been a while
-could go on for months/weeks before its discovered
What is an "Anembryonic Pregnancy?"
aka blighted Ovum
-Prescence of a gestational sac in the uterus in which an embryo has failed to develop
When you should you be able to visualize the fetal pole on U/S?
When the GS is > or = to 3 cm
Symptons of an Anembryonic Pregnancy:
-sac should be present but may be irregular
-hCG levels are increasing BUT @ slower rate than normal
-eventual spotting: closed cervix
-abscence of double decidual sac sign
In what type of pregnancy is there an abscence of the double decidual sac sign?
Anembryonic Pregnancy
What are the clinical signs for an Anembryonic Pregnancy?
-patient measures small for dates
-low hCG levels
-spotting
-closed cervix
What is an habitual aborter?
someone who has had more then 3 abortions
What is an Ectopic Pregnancy?
implantation of the conceptus outside of the endometrial cavity

"invasion of trophoblastic tissue w/in the fallopian tube"
What is responsible for 10% of maternal deaths related to pregnancy?
Ectopic Pregnancy
Why are Ectopic Pregnancys more common now a days?
1. STD's/PID
2. reconstructive surgery
3. fertility drugs
4. IUD's
What are the implantation sites for Ectopic Pregnancies?
Adnexal ectopic
Uterine Ectopic
Cervical ectopic
Abdominal Pregnancy
heterotopic Pregnancy
What is a sign for intraperitoneal bleeding?
Shoulder pain
What are patient symptons of Ectopic Pregnancy?
The classic triad:
1. some bleeding
2. pelvic pain
3. adnexal pain
4. positive preg test
5. hCg will be lower than expected
Describe an "Adnexal Pregnancy?"
pregnancy implanted w/in any portion of the fallopian tube or ovary
(isthmic- ampullary- Fimbrial- Interstitial
-can be tubo ovarian
or abdomino ovarian
-95 % are w/in the ampulla of the tube
-max is 8 1/2- 9 wks before they rupture
What is the most common site for Adnexal Ectopic pregnancies?
w/in the ampulla of the tube