Bleeding during pregnancy

Question 1

Miscarriage types and cervical os open or closed?

Answer 1

Threatened: CLOSED

Delayed: : CLOSED

Inevitable: : OPEN

Incomplete: OPEN

Question 2

Ectoptic pregnancy symptoms

Answer 2

6-8 weeks
lower abdo pain that radiates to shoulder tip
dark brown bleeding

Question 3

Medical management of a miscarriage

Answer 3

Vaginal misoprostal

Question 4

Management of ectopic pregnancy

Answer 4

ASx: conservative monitoring of BHCG

BhCG not falling: methotrexate

If significant pain, adnexal mass >35mm, bHCG>5000: surgical management of salpingectomy or salpingotomy (no Fallopian tubes)

Question 4

Management of ectopic pregnancy

Answer 4

ASx: conservative monitoring of BHCG

BhCG not falling: methotrexate

If significant pain, adnexal mass >35mm, bHCG>5000: surgical management of salpingectomy or salpingotomy (no Fallopian tubes)

Question 5

Placental abruption symptoms

Answer 5

shock, pain, tenderness, distressed foetus, bleeding

Question 6

Placental abruption management

Answer 6

Foetus alive and distressed: C section
Foetus alive and fine: >36 weeks, vaginal delivery <36 weeks closely observe with steroids
Foetus dead: deliver

Question 7

Miscarriage 4 types and explain

Answer 7

Threatened: bleeding, foetus alive
Delayed/missed: contents gone, foetus dead
Inevitable: cervix open, foetus alive
Incomplete: cervix open, not all contents out

Question 8

Management of miscarriage if medical doesn’t work OR if excessive bleeding, infection risk, unstable patient, or failure of medical therapy

Answer 8

Surgical dilation and curettage

Question 9

First line management of miscarriage

Answer 9

Conservative, wait 7-14 days for contents to pass