Abortion resident survival guide: Difference between revisions

Revision as of 20:09, 11 October 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifeoma Anaya, M.D.[2]

Synonyms and keywords:

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Ruptured ectopic pregnancy
Abdominal trauma with hemodynamic instability

Common Causes

Chromosomal abnormalities such as:
- Trisomies
- Molar pregnancies
- Blighted ovum
Infections
Cervical insufficiency
Uterine malformations
Drug and alcohol use
Smoking
Uncontrolled chronic diseases (Diabetes, Hypertension, Hypo/Hyperthyroidism, etc)

Diagnosis

Female of reproductive age, gestation <20weeks, bleeding per vagina, +/-pelvic pain

Targeted history and examination, β-hcg,CBC, type and screen

Hemodynamically stable?

No

Yes

IV access and fluid resuscitation, move to the ED and send consult to OBGYN

Signs of peritonitis?

Yes

No

Pelvic ultrasound

Intrauterine

Extrauterine, confirmed ectopic?

Treat acordingly. Stabilise if need be

Yes

Threatened abortion; viable preganancy+closed cervix

Missed abortion; non-viable pregnancy+closed cervix

Inevitable abortion; viable pregnancy+open cervix

Incomplete abortion; Retained Products of Conception+closed cervix

Complete abortion; empty uterus+closed cervix

Uncertain

Serail prpogesterone, β-hcg, ultrasound

Ectopic Pregnancy

↑β-hcg >66% in 48hrs,normal ultrasound, progesterone >25ng/ml

Progesterone <5ng/ml, β-hcg ↓or↔, non-viability on ultrasound

β-hcg equivocal, ultrasound not diagnostic, progesterone 5-25ng/ml

Treat accordingly

Surgery

Uncertain

β-hcg every 2-3 days, repeat ultrasound weekly till viability is ascertained

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

The content in this section is in bullet points.

Don'ts

The content in this section is in bullet points.

References

Template:WikiDoc Sources

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 {{familytree | | | | | | | | | | | | | | |!| | | | | |!| | | |!| | | |!| | | |!| | | |!| | | | | | | | | }}
 {{familytree | | | | | | | | | | | | | | |!| | | | | L01 | | L02 | | L03 | | L04 | | L05 | | | | | | | | | |L01=Threatened abortion; viable preganancy+closed cervix|L02=Missed abortion; non-viable pregnancy+closed cervix|L03=Inevitable abortion; viable pregnancy+open cervix|L04=Incomplete abortion; Retained Products of Conception+closed cervix|L05=Complete abortion; empty uterus+closed cervix}}
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+{{familytree | | | | | | | | | | | | | | H01 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |H01=Uncertain }}
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+{{familytree | | | | | | | | | | | | | | M01 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |M01=Serail prpogesterone, β-hcg, ultrasound }}
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-{{familytree | | | | | | | | | | N01 | | N02 | | N03 | | N04 | | | | | | | | | | | | | | | | | | | | | | | | |N01=Ectopic Pregnancy}}
+{{familytree | | | | | | | | | | N01 | | N02 | | N03 | | N04 | | | | | | | | | | | | | | | | | | | | | | | | |N01=Ectopic Pregnancy|N02=↑β-hcg >66% in 48hrs,normal ultrasound, progesterone >25ng/ml|N03=Progesterone <5ng/ml, β-hcg ↓or↔, non-viability on ultrasound|N04=β-hcg equivocal, ultrasound not diagnostic, progesterone 5-25ng/ml}}
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+{{familytree | | | | | | | | | | |!| | | |`| R01 |'| | | |!| | | | | | | | | | | | | | | | | | | | | | | |R01=Treat accordingly }}
-{{familytree | | | | | | | | | | O01 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |O01=Surgery }}
+{{familytree | | | | | | | | | | O01 | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | |O01=Surgery }}
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+{{familytree | | | | | | | | | | | | | | | | | | | | | | P01 | | | | | | | | | | | | | | | | | | | | | | |P01=Uncertain }}
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+{{familytree | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | }}
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+{{familytree | | | | | | | | | | | | | | | | | | | | | | Q01 | | | | | | | | | | | | | | | | | | | | | | |Q01=β-hcg every 2-3 days, repeat ultrasound weekly till viability is ascertained }}
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