WorksheetsAbortion
Total questions: 15
Worksheet time: 9mins
Which of the following sonogram findings is consistent
with the American College of Obstetricians and
Gynecologists definition of early pregnancy loss?
An anembryonic pregnancy
A crown-rump length of 7 mm with no cardiac
motion
A fetus measuring 13 weeks' gestation with no
cardiac motion
All of the above
What percent of spontaneous abortions occur within
the first 12 weeks of gestation?
60%
70%
80%
90%
A 22-year-old G 1 PO presents for a follow-up visit
after receiving care for a spontaneous abortion at
8 weeks' gestation. She has many questions regarding
the possible cause of her miscarriage, and the risk of
recurrence. You counsel her that approximately what
percentage of pregnancies end in miscarriage?
3-5%
5-10%
10-25%
40%
For the patient in Question 18-3, you also counsel
her regarding the rate of aneuploidy in first-trimester
miscarriages. What is the approximate rate of
aneuploidy in pregnancies that end in a clinically
apparent first trimester spontaneous abortion?
10%
20%
33%
50%
Which of the following chromosomal abnormalities
is most common in the setting of first-trimester
spontaneous abortion?
Trisomy 18
Trisomy 21
Tetraploidy
Monosomy X (Turner syndrome)
A 40-year-old G5PlA3 at 7 weeks' gestation presents
with a spontaneous abortion. Her medical history
is remarkable for hypothyroidism with a TSH of
1.5 μIU/mL on levothyroxine, type 2 diabetes mellicus
with a hemoglobin A1 c of 10% on metformin, and
MTHFR heterozygous mutation. She underwent
testing with another physician following her prior
miscarriages, with normal maternal karyorype and
negative antiphospholipid antibody syndrome testing.
The products of conception are sent for karyorype,
which is normal. Her 44-year-old husband is the
father of all of her pregnancies. She requests use of
prophylactic anticoagulation in future pregnancies
to improve her pregnancy outcomes. Which of the
following recommendations is most appropriate?
Initiation of insulin therapy
Increase dose of levothyroxine
Consider sperm donor given likely paternal factor
Begin heparin prophylaxis with missed menses
next pregnancy
Consumption of which of the following legal
substances in large quantities is most clearly
associated with an increased risk of miscarriage?
Alcohol
Tobacco
Caffeine
Phthalates
The patient in Question 18-10 presents for follow-up
48 hours later, she denies further bleeding or
abdominal pain. Her B-hCG level is 796 mIU/mL.
What is the most appropriate course of action?
Repeat pelvic sonogram
Administer methotrexate
Repeat B-hCG level in 48hrs
Administer supplemental progesterone
The patient in Question 8 presents for followup
with appropriately rising (3-hCG levels and is
eventually diagnosed with a threatened abortion.
When counseling her regarding adverse outcomes
related to threatened abortion, you inform her she
may be at increased risk of which of the following?
Preterm birth
Placental previa
Placental abruption
All of the above
The patient in Question 18-13 elects for administration
of misoprostol, 800 μg vaginally. When called
for follow-up 48 hours later she reports some light
spotting, but no bleeding or passage of tissue. She
would like ro avoid surgical dilation and curettage if
possible. Which of the following regimens should be
recommended?
Mifepristone 200 mg orally
Misoprostol 800 μg vaginally
Misoprostol 200 μg sublingual
Misoprostol 800 μg vaginally plus mifepristone
600 mg orally
A 20-year-old G2P0A2 presents for follow-up after
a spontaneous miscarriage at 7 weeks' gestation.
She demands that you "do something" to prevent
miscarriages in her future pregnancies. You offer
evaluation for recurrent pregnancy loss, but provide
reassurance that her likelihood of a successful next
pregnancy is approximately what percent?
74%
82%
86%
92%
Which of the following is not a widely accepted
cause of recurrent pregnancy loss?
Uterine structural abnormalities
Parental chromosomal abnormalities
Antiphospholipid antibody syndrome
Progesterone deficiency ([urea! phase defect)
What percen rage of recurrent pregnancy loss is due
to parental chromosomal abnormalities?
2-4%
6-8%
10%
15%
Which of the following clinical scenarios is not an
indication for antiphospholipid antibody testing?
History of three embryonic losses
History of fetal loss ar 16 weeks' gestation
History of unexplained thromboembolism
History of severe preeclampsia requiring delivery
at 38 weeks' gestation
A 32-year-old multigravida is diagnosed with an
embryonic demise at 7 weeks' gestation. When
counseling her regarding options other than expectant
management, you explain that as compared to
suction curettage, which has an efficacy rate of
96-100%, medical abortion is associated with what
risk of failure?
2-17%
4-9%
5-26%
10-20%
