Interactive Session - Society for Reproductive Endocrinology and Infertility - A Nonviable Early Pregnancy, When and How Do You Intervene

Presenters

A Nonviable Early Pregnancy, When and How Do You Intervene

Needs Assessment and Description
Up to one-third of all conceptions end in miscarriage or ectopic pregnancy. Recognizing when pregnancies will no longer progress as an ongoing pregnancy, and when to intervene, is a common but often difficult clinical decision. This live course will provide information to help a clinician make the diagnosis of a nonviable gestation and if (or when) medical or surgical intervention is necessary.

Learning Objectives
At the conclusion of this session, participants should be able to: 

1. Examine the need and the methods to distinguish between a viable and nonviable early pregnancy. 
2. Appraise the possible advantages and pitfalls of medical management of miscarriage and ectopic pregnancy.

ACGME Competency
Patient Care

TEST QUESTION:
A woman with a history of 2 first-trimester losses presents 6.5 weeks after her last menstrual period with moderate cramps and vaginal bleeding. She has a positive pregnancy test and an ultrasound that identifies an 8-mm hypoechogenic structure in the uterine cavity, without a yolk sac or fetal pole. After participating in this session, in my practice I will diagnose and treat this patient as follows: 

1. She has an ongoing intrauterine pregnancy and should be referred for prenatal care. 
2. She has a third first-trimester loss and can be treated with misoprostol. 
3. She has an ectopic pregnancy and can be treated with methotrexate. 
4. She has a probable intrauterine pregnancy and should be followed up with serial ultrasound. 
5. She has a third miscarriage and should be treated with uterine evacuation to obtain chromosomes. 
6. Not applicable to my area of practice.