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Ob-Gyn

High Risk Bleeding

QuestionAnswer
Threatened miscarriage/abortion characteristics: Mild cramping, little spotting, NOT PASSING ANY TISSUE, cervix is NOT DILATED
Management of threatened miscarriage Put her on bedrest. If first trimester (80% of miscarriages occur then) won't stop it since cannot
Inevitable abortion characteristics: Cramping, MODERATE bleeding, cervix is DILATING, has NOT PASSED any POC/tissue yet but may start soon
Inevitable abortion management Watch how much POC is there; if POC expelled does bleeding ease off afterward? If cont. to bleed heavily after POC expelled, will do a D
Incomplete abortion characteristics HEAVY/PROFUSE BLEEDING, has dilation, MOST OF TISSUE has been passed but NOT EVERYTHING
Incomplete abortion management Emergent D&C d/t risk of bleeding out. If 1st trimester = D&C. 2nd tri = D
Complete abortion characteristics Uterus EMPTY, everything evacuated. If truly complete, bleeding will go down, pain will resolve
Complete abortion management No further interventions unless cont. to bleed.
Missed abortion characteristics Fetus has EXPIRED; NO SIGNS of miscarriage. Absent fetal heartbeat during prenatal visit. Retained expired fetus a RISK FACTOR for DIC
Missed abortion management 1st trimester = D&C. End of 2nd - 3rd tri = induce labor to allow body to empty uterus. Make sure good pain control. If mother septic, then D&E + antibiotics
Habitual abortion definition Woman has 3+ recurring miscarriages; unable to maintain pg
Habitual abortion management Check hormone levels; if cervix dilates too quickly then cerclage (suture) cervix closed and release as nearing 3rd tri
Created by: choel