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Slide 1
Incidence of Miscarriage
1 in every 6 pregnancies
Risk of subsequent miscarriage 1/6 Bedrest will not prevent miscarriage but may postpone it
Slide 2
Causes of Miscarriage
60% chromosome abnormalities
Slide 3
Threatened Abortion
1 in every 4 pregnancies
1st TM bleeding/cramping Half will abort, Half will be OK
Slide 4
Complete Abortion
9-week spontaneous complete abortion
Slide 5
Uterus tender
Fever if infection present Ultrasound helpful if available
Slide 6
Antibiotics
Rhogam D&C
Inevitable Abortion
Slide 8
Septic Abortion
Antibiotics
MEDEVAC D&C
Slide 9
Slide 10
+ HCG
Unilateral pelvic pain and tenderness Pelvic mass? DD: CL cyst, Appy, PID Lie still MEDEVAC
Slide 11
Slide 12
Surgery
MEDEVAC IVs, oxygen, lie still
Slide 13
Blood Transfusion
O Negative blood
Slide 14
Placental Abruption
>20 weeks
Slide 15
Placenta Previa
>20 weeks Painless vaginal bleeding No pelvic exam unless instructed by an OBGYN Pelvic exam may cause torrential hemorrhage, exsanguination and death within minutes Rest, IVs, MEDEVAC
Slide 16
Toxemia of Pregnancy
Elevated BP (>140/90) Proteinuria (>300 mg in 24 hours) Weight Gain (>2 pounds/week) Swelling (?) Increased reflexes (Clonus)
Slide 17
Pre-Eclampsia
Naval Hospital Jacksonville
BP, Protein Stable and unstable Risk of IUGR Risk of Abruption Risk of maternal seizures Risk of HELLP syndrome
Hemolysis Elevated Liver Enzymes Low Platelets
Slide 18
Eclampsia
Slide 19
Slide 20
Slide 21