A couple has experienced three spontaneous abortions (SABs) before week 9 of gestation and one SAB at week 20. What should the nurse consider when preparing to counsel this couple?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The earlier the SAB, the more likely a rare genetic defect.
2. Most SABs are related to genetic changes.
3. Later-gestation SABs are more likely than early-gestation SABs to reflect genetic disorders that are seen in live newborns.
4. If a genetic defect was present in the first SAB, it is more likely to be present in subsequent SABs.
5. Trisomies, monosomy X, and polyploidy make up the majority of genetic abnormalities associated with SAB.
1,2,3,4,5
Rationale 1: The proportion of abnormal karyotypes in abortus specimens is highest earlier in gestation, with more unusual aneuploidies noted during that stage.
Rationale 2: It is estimated that genetic changes are responsible for 50% to 70 % of SABs.
Rationale 3: Late-gestation SAB genetic disorders are comparable to those seen in live newborns, indicating that the disorder is more survivable than those that occur in early gestation.
Rationale 4: A higher rate of aneuploidy has been reported in subsequent losses when the karyotype was abnormal in the first loss.
Rationale 5: The most common abnormalities are autosomal trisomies (particularly trisomy 16), monosomy X, and polyploidy.
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