early pregnancy Flashcards
common early pregnancy symptoms
N+V, tiredness, MSK pain
differentials for bleeding in the first trimester
miscarriage // ectopic // implantation bleeding // ectropion, vaginitis, trauma, polyps
immediate referral criteria for ectopic
+ive pregnancy plus one of: pain and abdo tenderness // pelvic tenderness // cervical motion tenderness
invx + mx bleeding if <6 weeks pregnant
if NO pain or RF for ectopic –> manage expectantly (repeat pregnancy test in 7-10 days and return if positive)
invx if >6 weeks pregnant and bleeding
TVUS (location, fetal pole, HB)
where do most ectopic pregnancues occur
tubal- ampulla!!!!
where is most dangerous location for ectopic
isthmus
progression of ectopic
absorption or ruptured
what is an ectopic
implantation of fertilised ovum outside uterus
RF ectopic pregnancy
PID, surgery // previous ectopic // endometriosis // IUD // POP // IVF
symptoms ectopic
lower abdo pain (1st symptom, may be unilat) / vaginal bleeding (dark) // amenorrhoea for 6-8 weeks // shoulder tip or pain on bowels // dizzy, syncope
o/e ectopic
abdo tenderness // cervical motion tenderness // adnexal mass (do NOT examine as may rupture
invx ectopic
bHCG > 1500 // TVUS for ectopic = best
when can expectant mx for ectopic be suitable
<35mm // unruptured + asymptomatic // no HB // hCG <1000
when can medical mx for ectopic be suitable
same as expectant (eg <35, uruptured, no Hb) // + some pain, hCG <1500 (not if twins)
