O+G
FIRST TRIMESTER BLEEDING/MISCARRIAGE
PromptClinical features of intrauterine misscarriage
ResponsePassage of products of conception
Heavy bleeding
Known intrauterine gestation on prior US
Absence of lateralising pain
Heavy bleeding
Known intrauterine gestation on prior US
Absence of lateralising pain
PromptAnembryonic pregnancy/Blighted ovum
ResponseGestational sac develops but the embryo does not form.
U/S report in question reads: “There is an intrauterine gestational sac which has a mean sac diameter of 26.2mm but no fetal pole is visualised. There is no evidence of extrauterine pregnancy and no free fluid”
U/S report in question reads: “There is an intrauterine gestational sac which has a mean sac diameter of 26.2mm but no fetal pole is visualised. There is no evidence of extrauterine pregnancy and no free fluid”
PromptManagement of anembryonic miscarriage
ResponseExpectant
Medical - misoprostol 800 mg PV
Surgical - Suction evacuation
Medical - misoprostol 800 mg PV
Surgical - Suction evacuation
PromptAbsolute indications for surgery in miscarriage
ResponseSevere bleeding/haemorrhagic shock
Septic miscarriage
Septic miscarriage
PromptImmunoglobulin (Anti D) dose and indications
ResponseGive to Rh NEGATIVE mothers with PV bleeding.
1st trimester 250 IU
2nd-3rd trimester 625 IU
Large fetomaternal haemorrhage do a Kleihauer test to quantify dose
Lots of variations in guidelines. According to O+G friend guidelines often vary depnding on anti-D stock vs how much its indicated.
1st trimester 250 IU
2nd-3rd trimester 625 IU
Large fetomaternal haemorrhage do a Kleihauer test to quantify dose
Lots of variations in guidelines. According to O+G friend guidelines often vary depnding on anti-D stock vs how much its indicated.