BLEEDING IN THE 1ST TRIMESTER Flashcards
Implantation bleeding vs Abortion
6-12 days LMP = implantation bleeding
Abortion = <20 weeks or (500 grams kasi hindi naman tinitimbang ang fetus)
if more than 20 weeks = preterm labor
Don’t use abortion, instead…
Miscarriage
THREATENED ABORTION
- Clinical Presentation,
- PE
- Management
- how many weeks?
bed rest for 2 weeks (acc to studies)
COMPLETE ABORTION
- Clinical Presentation,
- PE
- Management
na-abort na si baby so yung uterus parang walang nangyari, normal sized na
INCOMPLETE ABORTION
- Clinical Presentation,
- PE
- Management
passage of tissues so lumiit na si uterus (smaller than AOG)
MISSED ABORTION
- Clinical Presentation,
- PE
- Management
INEVITABLE ABORTION
- Clinical Presentation,
- PE
- Management
Normal sized na si
Upon IE, the cervix is DILATED. Which type of abortion will you consider?
Tip: “Ay ay dilated yung cervix” ay = letter I
Inevitable
Incomplete
On missed abortion
Management <12 weeks or 3 months and >12 weeks or 3 months
Spontaneous expulsion
Dilatation and curettage
expectant management
SEPTIC ABORTION
Give characteristics
Cervical os
Fetal tissue passage
Infection of the uterus during miscarriage, fever and chills
(+) open cervix with purulent cervical discharge
(+) uterine tenderness
none/incomplete passage of fetal tissue
Pathophysiology of Abortion
Maternal Factors
TOP 3 DIFFERENTIALS of VAGINAL BLEEDING
Triad of Ectopic Pregnancy
“SAC”
(+) colicky abdominal pain
(+) amenorrhea
(+) spotting
CC: if Ectopic Pregnancy
Give differentials
(+) abdominal pain
NEPHROLITHIASIS
APPENDICITIS
ONG with TORSION
Highest risk factor for Ectopic pregnancy
PID
(inflammation –> fibrosis –> adhesion; you have to be aggressive cos if hindi, masisira anatomy)
(Gonorrhea, Chlamydia, Candidiasis)
