Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            ng:
Related to pregnant state:
Abortion
Ectopic pregnancy
Hydatidiform mole
Implantation bleeding
Associated with the pregnant state:
Cervical lesions
Miscarriage or abortion:
An abortion is the expulsion of the products of conception before the
24th week of pregnancy.
Types of abortion:
1- Threatened abortion:
Bleeding in early pregnancy with no pregnancy loss
diagnosis:
- Made bu ultrasound or beta hCG
- growing early pregnancy , but with vaginal bleeding.
2
Management:
Medical treatment not necessary.
Advise woman to avoid strenuous activity and sexual intercourse .
Bed rest not necessary.
If bleeding stopped, followup in antenatal clinic.
If bleeding persists , assess for pregnancy test .
2- Inevitable miscarriage
Symptoms
- Bleeding and pain are characteristic, bleeding is heavier than in
threatened miscarriage.
- low abdominal pains and an escape of amniotic fluid.
Examination
• Uterus enlarged.
• The internal os of the cervix is dilated. Products of conception may be
felt in the cervical
canal. Once this has occurred, miscarriage is
inevitable.
Treatment
if pregnancy is less than 16 weeks , plan for evacuation of
uterine contents .
If evacuation not immediately possible:
Give ergometrine 0,2 ml IM (Repeated after 15 minutes , if necessary)
OR misoprostol 400 microgram per mouth (Repeated once after 4 hours
if necessary)
Arrange for evacuation as soon as possible.
3
3- Incomplete miscarriage
An incomplete miscarriage occurs when some of the products of
conception are retained in the uterus. These are usually parts of the
placenta or chorionic tissue attached to the uterine wall.
Symptoms
• Continued bleeding after a period of amenorrhoea.
4- Complete miscarriage
If all the products of conception have been passed and the uterus is
empty, the miscarriage is complete. There is little bleeding, the uterus is
small with the cervix closed
- No treatment is required provided the differential diagnosis of ectopic
pregnancy has been excluded.
5- Missed miscarriage
The embryo dies in early development and is retained there and/or the
sac continues to develop.
4
ectopic pregnancy
Ectopic pregnancy is one outside the uterine cavity, the commonest site
being the fallopian tube. It may also occur, although rarely, in:
• uterine corner
• ovary
• cervix
• abdominal cavity
• broad ligament.
Pathology
The muscular walls of the tube do not allow the embryo to grow beyond
a certain size. The trophoblast gradually invades and erodes the tubal
wall which, unlike the endometrium, is not prepared for implantation.
Blood vessels are damaged and eventually bleeding takes place.
Signs and symptoms of ruptured ectopic pregnancy:
Collapse and weakness
Fast , weak pulse
Hypotension
Hypovolemia
Acute abdominal and pelvic pain
Abdominal distension
Rebound tenderness
Pallor
5
Differential diagnosis for Ectopic pregnancy :
Threatened abortion
Pelvic inflammatory disease
Ovarian cysts
Acute appendicitis
General management of bleeding in early pregn

            Quiz: