12458042
Description
Flashcards by Ashutosh Kumar, updated more than 1 year ago
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Created by Ashutosh Kumar
about 6 years ago
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| Question | Answer |
| Miscarriage definition: | Miscarriage definition: Loss of pregnancy before 20 weeks. |
| Miscarriage types: | Miscarriage types: Complete All products of conception expelled Incomplete Some products of conception passed, some not. Inevitable Cervix has dilated but fetus is yet to be expelled. Missed Embryo or fetus has died, but yet to be expelled. Threatened Any bleeding during pregnancy, prior to viability, that is yet to be assessed. |
| Discuss Complete in terms of: Bleeding Cervix Ultrasound scan Management | Decreased bleeding Closed NAD Reassure - Its common - If relieved educate on contraception If deve If devastated, tell them they can try again next cycle |
| Discuss Incomplete in terms of: Bleeding Cervix Ultrasound scan Management | Bleeding Closed Conceptual products Inflammation and infection may be present so surgical Rx may disseminate infection causing sepsis. Rx is antibiotics +/- misoprostol (I.V for 12 hr coverage) |
| Discuss Inevitable in terms of: Bleeding Cervix Ultrasound scan Management | Lots of bleeding Open Sac +/- FHR Speculum in, pull out or misoprostol to help evacuate |
| Discuss missed in terms of: Bleeding Cervix Ultrasound scan Management | Little Closed Set of criteria (no FHR) Conservative/medical/surgical- evacuation of residual products of conception (ERPOC) Medical- if cervix open give misoprostol which causes uterine contraction and softening of cervix |
| Discuss Threatend in terms of: Bleeding Cervix Ultrasound scan Management | Bleeding Closed Fetal heart rate (FHR) present Reassure |
| Discuss utility of bHCG in Dx of pregnancy: |
Beta HCG:
A single test only confirms pregnancy
Serial testing every 48 hrs can elucidate type of pregnancy
In symptomatic bleeding the bHCG double every 48 hrs
Symptomatic means that
Ex- cervical excitation
U/S
Caveats:
Doubling does not rule out ectopic nor do falling levels
Image:
B Hcg (binary/octet-stream)
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| Ectopic pregnancy management: | Ectopic pregnancy management: Medical: Methotrexate 1 mg/m2 I.M bHCG goes up and then down Surgical: Salpingectomy or salpingostomy |
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