A perinatal nurse is working with a woman who has had four perinatal losses in the first 20 weeks of pregnancy. The nurse should anticipate orders for which of the following diagnostic tests? (Select all that apply.)
A. Cervical cultures
B. Hysterosalpingogram
C. Maternal/paternal karyotype
D. Sickle cell screening
E. Thyroid-stimulating hormone (TSH) levels
ANS: A, B, C, E
Patients who experience habitual (three or more) spontaneous abortions may be offered these tests as part of the diagnostic workup: a karyotype obtained from the products of conception and from both parents and an examination of the maternal anatomy, beginning with a hysterosalpingogram. Additional testing may include hysteroscopy or laparoscopy; screening tests for maternal hypothyroidism, diabetes mellitus, antiphospholipid syndrome (APS), and systemic lupus erythematosus (SLE); testing of the serum progesterone level during the luteal phase of the menstrual cycle; cultures of the cervix, vagina, and endometrium; and endometrial biopsy during the luteal phase of the menstrual cycle. Sickle cell screening would not be part of this workup.
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