DrVirgo
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answer and briefly explain.
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| cirus
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Recommend Autopsy ( always investigate for the cause, but here in UW they say from the first time, while Kaplan say u should't investigate from the first time, start from the second but ill stick to UW)
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| DrVirgo
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agree with answer...
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| robin082006
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C
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| DrVirgo
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cirus wrote:
Recommend Autopsy ( always investigate for the cause, but here in UW they say from the first time, while Kaplan say u should't investigate from the first time, start from the second but ill stick to UW)
i agree with your answer but...
what do you mean "first time" ??? first incidence of fetal death?
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| cirus
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first abortion or fetal death (Both)
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| Justice
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C
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| dr_arc
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fetal autopsy to try to figure out what went wrong? is there anyhing wrong with the bay that might have implications for future pregnancies.
as cirus says you do not investigate a coulple with a h/o a single early pregnancy loss, but a still born baby you definitely need to investigate,
the rationale here is that more than 50% of first pregnancies end in spont abortion, therefore a woman who has suffered a first pregnancy abortion is not considered a cause for worry , not so with a full term infant, here a different set of rules apply. a baby that has reached term and died inutero around the time of delivery warrants a thorough investigation to look for what went wrong. babies that reach full term are expected to come out healthy.hence the need for autopsy.
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| DrVirgo
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I agree with dr_arc -good explanation...
Here is another one:
A 24 year old woman comes to the physician 2 weeks after experiencing a spontaneous abortion at 6 weeks' gestation. She has no vaginal bleeding, abdominal pain, fevers or chills. Examination is unremarkable, including a normal pelvic examination. She states that this was her first pregnancy and she wants to know whether she and her husband need testing to determine why teh miscarriage occured. After comforting the patient, which of the following is the most appropriate response?
A. Investigation is initiated after teh first, first-trimester miscarriage
B. Investigation is initiated after two consecutive first-trimester miscarriages
C. Investigation is initiated after three consecutive first-trimester miscarriages
D. Investigation is initiated after four consecutive first-trimester miscarriages
E. There is no need to investigate recurrent miscarriages
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| cirus
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dr_arc wrote:
fetal autopsy to try to figure out what went wrong? is there anyhing wrong with the bay that might have implications for future pregnancies.
as cirus says you do not investigate a coulple with a h/o a single early pregnancy loss, but a still born baby you definitely need to investigate,
the rationale here is that more than 50% of first pregnancies end in spont abortion, therefore a woman who has suffered a first pregnancy abortion is not considered a cause for worry , not so with a full term infant, here a different set of rules apply. a baby that has reached term and died inutero around the time of delivery warrants a thorough investigation to look for what went wrong. babies that reach full term are expected to come out healthy.hence the need for autopsy.
as a matter of fact, UW says that u should investigate abortions as well from the first time, they comment that yes it has a 50 % prevelance in primigravid, & most of the time the cause is unknown?? but u should do some karyotyping so if possible prevent this devestating outcome again SO THEY SAY INVESTIGATE ABORTION FROM FIRST TIME, NOT AFTER RECURRENCE, kaplan says no, only in case of recurrence or preg past 20 weeks??
so im kind of lost here, do or don't, but kaplan seems more rationale, yet UW seems more ethical??
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| cirus
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for the second quest...
Ill stick to Kaplan, B
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