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Miscarriage-and-Ectopic-Slides.powerpoint
- 2. Definition
- 3. Definition • The expulsion or extraction of an fetus less then 500 gr • OR • Pregnancy Loss before 20 weeks gestation
- 4. Incidence • 0-3% • 4-7% • 7-10% • 10-12% • 13-15%
- 5. Incidence • 0-3% • 4-7% • 7-10% • 10-12% • 13-15%
- 6. Aetiology • Early Spontaneous – Sporadic chromosome defects – Corpus luteum defects – Poor placentation
- 7. Aetiology • Mother • Fetus • Woumb
- 8. Clinical Presentation • Threatened miscarriage • Inevitible • Incomplete • Complete • Missed
- 9. Diagnosis • Clinical • Ultrasounds (TVUS) – Gestational sac > 25mm and no yolk sack Or – Fetal CRL of 7 mm and no cardiac activity
- 10. Management • Bloods – Rh, VDRL, Hb • Medical • Evac
- 11. Complications • Infection • Bleeding • Renal failure • Anaemia • Trauma • Infertility
- 13. Types • Tubal • Ligamentous • Ovarian • Abdominal • Cervical • Heterotopic
- 14. Causes • Embryonal • Maternal – Previous PID – Endometriosis – Tubal surgery – IVF – Hormones – ?? IUCD
- 16. Clinical Presentation • Acute • Chronic • Acute on Chronic
- 17. Differential • Gynae – Miscarriage – Cyst complication – ? PID
- 18. Differential • Surgical – Appendix – Perforated viscous – Volvulus – Splenic Rupture – Mesenteric Adenits
- 19. Differential • Medical – Pyelonephritis – Porphyria
- 24. Diagnosis • BHCG – Must double in 48hrs – Eg 1200 IU to 2800 over 48 hrs OK – But 1200 to 1600 IU not OK
Editor's Notes
- Mother: smoking, alcohol, cocaine, nsaids, severe weight loss, previous pregnancy losses, teratogenic, colitis, fever Fetus: chromosomal: trisomy 16, congenital, trauma Woumb: fibroids, septums, anatomical variants: bicorneate uterus
- Rhesus factor: Rhogam, Winrho anti-d Ig for Ab for bleeding second pregnancy and auto-immune hydrops (Rh neg mother, Rh + fetus) Misoprostil: prostaglandin analogue (PGE1), Methotrexate D&C, Suction D&C, D&E