Gynecology Management: NICE Guidelines

Question 1

Management for fibroids under 3cm

Answer 1

Depending on symptoms:

Give COCP

Second Line: Mirena Coil if contraindicated or first line with menorrhagia

Question 2

Management of fibroids in women who wish to conceive

Answer 2

Initially give Transexamic Acid to control bleeding (as long as fibroid is under 3cm)

Then a myomectomy

Question 3

Management of a fibroid over 3cm

Answer 3

Surgical removement

Question 4

First line management of a post menopausal woman with fibroids over 3cm (distorting the uterine cavity), looking for HRT

Answer 4

Referral to specialists

Question 5

First line management of a molar pregnancy

Answer 5

Dilation and curettage

Question 6

When is a medical termination of pregnancy indicated?

Answer 6

Before 10 weeks (but can be done after if the woman wishes)

Question 7

What is a medical termination of a pregnancy

Answer 7

Take a mifepristone tablet, then multiple misoprostal tablets (under the tongue, inside cheek or vaginally)

Question 8

How long does a medical termination of pregnancy take

Answer 8

4-6 hours after last misoprostal tablet

Question 9

Indications for surgical management of pregnancy

Answer 9

After 14 weeks (or before if the mother wishes to do so)

Question 10

First step of surgical TOP

Answer 10

Given misoprostols to open the cervix before 14 weeks or OSMOTIC DILATORS after 14 weeks

Then surgery

Question 11

What prophylaxis is given before termination of pregnancy

Answer 11

Anti-D

Question 12

What antibiotic prophylaxis is given after TOP

Answer 12

7 Day course of Doxycycline