Miscarriage, abortion and ectopic pregnancy

Question 1

Risk factors of miscarriage

Answer 1

-Hx of miscarriage
-previously identified potential miscarriage at scan
-smoker
-obesity

Question 2

Signs of miscarriage

Answer 2

-common signs= pain and bleeding
-these don’t always indicate a problem with the pregnancy

Question 3

Management fetal tissue before 22wks

Answer 3

-after 22wks consider new born life support but discuss with midwife
-must comply with human tissue act (in JRCALC)
-convey baby to hospital and give to nurse/ midwife
-communicate with patient about their preferences
-misoprostol- to control haemorrhage, only if confirmed miscarriage and no other fetus in utero

Question 4

Common calls after abortion and management

Answer 4

-bleeding- may be normal but check patient info sheet
-infection
-pain- lots of reasons eg. retained products of conception
-no specific management, just manage shock and convey if time critical to ED

Question 5

Ectopic pregnancy-

Answer 5

-embryo implants outside uterus
-most commonly in fallopian tube

Question 6

Risk factors ectopic pregnancy

Answer 6

-had ectopic pregnancy before
-pelvic inflammatory disease (PID)
-IUD/ coil

Question 7

Signs + Symptoms ectopic pregnancy

Answer 7

-pain lower abdo/ back
-shoulder tip pain

Question 8

Managing ectopic pregnancy

Answer 8

-shock management
-convey to ED with pre alert