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44 Cards in this Set
- Front
- Back
What is the termination of a pregnancy prior to viability? |
Abortion
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What does TAB stand for?
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Therapeutic Abortion- elected
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What is a loss of a fetus during pregnancy due to natural causes less than 20 weeks?
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Spontaneous Abortion
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What does FDIU stand for?
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If the baby is lost less than 20 weeks due to natural causes it stands for :
Fetal demise or Fetal Death In Utero |
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What are the 5 classifications of an SAB?
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1. Threatned
2. Inevitable 3.Complete 4.Incomplete 5. Missed |
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What happens during an SAB?
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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 |
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75 % of ______ happens before the 16th week of pregnancy?
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SAB
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What does "anembryonic" mean?
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A blighted ovum
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What are the possible causes of an SAB?
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-hormonal factors (corpus luteum)
-Muellerian defects -Chromosomal defects -Unknown |
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What type of "abortion" is the most common reason for 1st trimester scan?
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Threatned Abortion
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What is a Threatned abortion?
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cramping & bleeding w/o passage of tissue in a pregnancy that is < 20 weeks
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What are the clinical symptons of a Threatned abortion?
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-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 |
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What are some "facts" about Threatned abortions?
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-Closed cervical Os
-1/2 will end in miscarriage -patient will have decreasing hCg levels -assumed due to chrom. abnormalities |
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What is a Subchorionic Hemorrhage ("SCH")?
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"hemorrhage w/in the decidua basalis layer surrounding the gestational sac."
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Whats another name for "implantation bleeding?"
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Subchorionic Hemorrahge
or SCH |
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Describe the appearance of a "SCH?"
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Normal appearing Gestational sac surrounded by crescent shaped fluid collection
-varying echogenicity |
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When is a "SCH" most likely to happen?
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Within the 1st 2 months of pregnancy
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What is a "SCH" most often mistaken for?
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A twin pregnancy
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What is an Inevitable Abortion?
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aka.. "eminent" AB or "impending" AB
"an abortion in progress: Threatned AB with more severe cramping |
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What are the chararteristics of an Inevitable AB?
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-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 |
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What is a "Complete Abortion?"
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"all products of conception have been expelled from the uterus at anytime during pregnancy"
-passage of GS, fetus, placenta, etc (POC) |
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What are the clinical signs of an Complete abortion?
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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 |
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Whats the diagnosis for a Complete Abortion?
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- rapidly declining hCg levels
-empty uterus (clean endo) -Abortion is now complete. tissue has passed, cervical os is closed |
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Thickening of the endo may be seen approx.______ post SAB due to trophoblastic tissue reaction
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3 days
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What is an Incomplete Abortion?
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"Partial evacuation of products of conception"
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Diagnosis of an Incomplete Abortion:
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-varying amount of tissue remains w/in endo
-slowly decreasing hCg levels -cervix will be thin & dilated |
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U/S appearance of an Incomplete Abortion:
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-echoes seen w/in endo due to air bubbles or retained bony fragments
- diagnosed at the time while the even is taking place |
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What is a "Missed abortion?"
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aka embryonic demise
"prescence of an embryo w/in the uterus, but without heart beat. |
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Visual findings of a Missed abortion
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- may have irregular shaped sac
-fetus may be small, poorly definted |
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What are the symptons of a Missed Abortion?
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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 |
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What is an "Anembryonic Pregnancy?"
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aka blighted Ovum
-Prescence of a gestational sac in the uterus in which an embryo has failed to develop |
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When you should you be able to visualize the fetal pole on U/S?
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When the GS is > or = to 3 cm
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Symptons of an Anembryonic Pregnancy:
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-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 |
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In what type of pregnancy is there an abscence of the double decidual sac sign?
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Anembryonic Pregnancy
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What are the clinical signs for an Anembryonic Pregnancy?
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-patient measures small for dates
-low hCG levels -spotting -closed cervix |
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What is an habitual aborter?
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someone who has had more then 3 abortions
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What is an Ectopic Pregnancy?
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implantation of the conceptus outside of the endometrial cavity
"invasion of trophoblastic tissue w/in the fallopian tube" |
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What is responsible for 10% of maternal deaths related to pregnancy?
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Ectopic Pregnancy
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Why are Ectopic Pregnancys more common now a days?
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1. STD's/PID
2. reconstructive surgery 3. fertility drugs 4. IUD's |
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What are the implantation sites for Ectopic Pregnancies?
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Adnexal ectopic
Uterine Ectopic Cervical ectopic Abdominal Pregnancy heterotopic Pregnancy |
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What is a sign for intraperitoneal bleeding?
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Shoulder pain
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What are patient symptons of Ectopic Pregnancy?
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The classic triad:
1. some bleeding 2. pelvic pain 3. adnexal pain 4. positive preg test 5. hCg will be lower than expected |
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Describe an "Adnexal Pregnancy?"
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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 |
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What is the most common site for Adnexal Ectopic pregnancies?
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w/in the ampulla of the tube
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