Emergencies Flashcards
CXR findings of a PE
Normal wedge-shaped infarction, pleural effusion, atelectasis, area of translucency in underperfused lung
Give 3 causes of painful uterine contractions in early pregnancy
1) Threatened miscarriage
2) Inevitable or incomplete miscarriage (more painful + more bleeding)
3) Septic miscarriage (+ fever)
4) Pregnancy in a uterine horn (colicky pain)
Give 3 causes of painful uterine contractions in late pregnancy
1) Late miscarriage
2) Preterm labour (uterine over distension e.g. multipreg, polyhydraminos, fibroids)
3) Uterine irritability (abruption, chorioamnionitis pyelonephritis)
Give 3 causes of painful uterine contractions during labour
1) Uterine hyperstimulation (too much oxytocin)
2) Placental abruption
3) Uterine scar rupture
4) Intrapartum infections (chorioamnionitis, pyelonephritis)
Give 3 causes of painful uterine contractions after delivery
1) Retained products of conception
2) Acute inversion of the uterus (bradycardia and hypotension)
When might a fluid thrill be heard over a tender gravid uterus?
Polyhydraminos
Sharp uterine pain + late/prolonged CTG decelerations
Acute fetal compromise secondary to placental abruption or scar rupture
Pain + increased contraction frequency (>6-10 per min)
uterine hyperstimulation/
irritability
Pain + increased baseline tone of contractions
Placental abruption, impending uterine
rupture. After rupture, the contractions may not be recordable
How to Tx uterine hyperstimulation?
- Stop oxytocin
- IV fluids
- Left lateral postition
- Acute tocolysis
Dx of greyish frothy discharge + strawberry punctation of the cervix
Trichomoniasis
Treat with metronidazole
Dx urinary frequency
> 7 day + 1 night
**Exclude infection and then reassure, normal in pregnancy even before the 1st period missed
Mx of urinary retention in pregnancy
- Catheter
- ## Test for UTI
Causes of low UO intrapartum?
- Dehydration
- Retention - Descent of fetal head + epidural
How does urinary frequency change following delivery?
Increased UO D2-5 due to dieresis of increased extracellular fluid vol.
Enlarged uterus can continue to give frequency and urgency symptoms
Why is monitoring postpartum UO important?
Over distention can lead to serious longstanding voiding difficulties, chronic infection and renal damage
**If UO on catheterisation is >800mls keep catheter in for at least 24hours + after removal measure until >100mls per void