Vaginal Bleeding Answers 459gestation. The risk of miscarriage is approximately 35% to 50%, depending
on the patient population and severity of symptoms.
(a)Anembryonic gestation is the term used for what was described as
a missed abortion, which referred to clinical failure of uterine growth over
time. It is now known that fetal death occurs weeks before symptoms of
spontaneous abortion and ultrasound is able to diagnose fetal death.
(b)Complete abortion occurs when the uterus has expelled all of the fetal
and placental material, the os is closed, and the uterus is contracted. This
diagnosis should only be made after a dilation and curettage with pathologic
confirmation of gestational products or by a conversion of β-hCG to 0 mIU/mL),
which may take up to 4 weeks. (c)Incomplete abortion is a term used to
describe products of conception that are present at the os or vaginal canal.
(d)Inevitable abortion is the term used to describe vaginal bleeding with an
open internal os but no products of conception visualized.
419.The answer is a.(Rosen, p 2415.)Rh isoimmunizationoccurs
when a Rh-negative female is exposed to Rh-positive blood during pregnancy
or delivery. Initial exposure leads to primary sensitization with production
of immunoglobulin M antibodies. A patient with a threatened abortion,
who has Rh-negative blood, is at increased risk for Rh isoimmunization
and therefore should receive anti-D immune globulin.A 50 μg dose is
used during the first trimester and a 300 μg dose after the first trimester.
(b)Eclampsia is a syndrome of hypertension, proteinuria, generalized
edema, and seizures that usually occurs after the second trimester in preg-
nancy.(c)Chorioamnionitis is an infection of the chorioamniotic membrane.
Pregnant patients after 16 weeks present with fever and uterine tenderness.
(d)Ferrous sulfate is used as a supplement to help treat anemia. This patient
is not anemic. (e)This patient does not require a blood transfusion; her BP
is normal and her hematocrit is normal.