Bleeding in pregnancy Flashcards Preview

Obstetrics and Gynaecology > Bleeding in pregnancy > Flashcards

Flashcards in Bleeding in pregnancy Deck (10):
1

DDx for bleeding in early pregnancy (6)

Miscarriage
Ectopic
Molar pregnancy
Trauma
Fibroids
Endometrial/cervical ca/chorioCa
Hematuria
Hemorrhoids

2

History required for bleeding in early pregnancy

Complete gynae and obstetric history (Pap smears, previous pregnancy etc)
LMP, EDD
Amount of blood loss, clots
Details of pregnancy thus far
Trauma
Coagulopathy
Dizzy/fatigue
Fever
Bladder/bowel
Pain, discomfort, ++vomiting, ++abdominal girth
History of tissue passing
Past medical/surgical
Social
Occupation
Allergies

3

Examination

General examination-> Pallor, pulse, BP->rule out shock/sepsis
CVS examination
Pelvic/speculum, bimanual examination
Must visualise the os

4

Difference between abdominal palpation in miscarriage vs ectopic

Miscarriage- SNT
Ectopic- pain, rigid

5

When is bHCG considered positive

>25mlIU/ml

6

When does urine become positive for bHCG

10-14 days post missed perior inurine

7

When is serum bHCG positive

9-10 days post ovulation in serum

8

Investigations

Transvaginal US->look for fetus/heart
FBC, Group/Screen/Cross match
bHCG->serial levels
Rhesus blood group
Progesterone

9

What is the expected doubling time for bHCG

66% increase every 48 hours

10

When should anti-D be given to pregnant women

Vaginal bleeding
RhD ve
RhD screen negative