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)
Describe rupture based on anatomical location
Differentiate threatened abortion from Implantation Bleeding
Implantation Bleeding Happens for a day or two Minimal in amount Not accompanied by other symptoms Occurs at about just the same time as expected menstruation
Best measure to confirm inevitable abortion
The best measure is the physical evidence of the fluid pooling at the cul-de-sac |
