Bleeding in Early Pregnancy

-

 ðŸ©¸ Flowchart: Bleeding in Early Pregnancy
Step 1: Triage
     •     Assess haemodynamic stability
     •     Unstable → Resuscitate (ABC, IV fluids, blood products) → Urgent surgical             referral
     •     Stable → Proceed to history & examination

Step 2: History & Examination
     •     Gestational age, bleeding details, pain, risk factors
     •     Abdominal exam → tenderness, guarding
     •     Speculum exam → source of bleeding, products of conception
     •     Avoid bimanual exam if ectopic suspected

Step 3: Investigations
    •     Urine/serum pregnancy test
    •     Quantitative β-hCG (repeat in 48–72 hrs)
    •     Transvaginal ultrasound (TVS)
    •     Blood group & antibody screen (Rh immunoglobulin if Rh-negative)
    •     CBC

Step 4: Diagnosis
   •     Threatened miscarriage → Bleeding, closed cervix, viable pregnancy
   •     Incomplete/missed miscarriage → Open cervix or non-viable pregnancy
   •     Ectopic pregnancy → Empty uterus, adnexal mass, abnormal hCG rise
   •     Pregnancy of unknown location (PUL) → Positive test, no IUP/ectopic seen
   •     Other causes → Cervical polyps, infection, trophoblastic disease

Step 5: Management
   •     Threatened miscarriage → Expectant, reassurance, consider progesterone              if recurrent miscarriage
   •     Incomplete/missed miscarriage → Expectant / medical                                                     (misoprostol ± mifepristone) / surgical (suction curettage)
  •     Ectopic pregnancy → Methotrexate if stable and criteria met; surgery if                    unstable
  •     Rh-negative women → Administer Rh immunoglobulin
  •     Follow-up → Repeat scan/hCG, counselling, contraception advice

Comments

Post a Comment

Popular posts from this blog

IV Drip Rate: Formula

-
Image
  What is IV drip rate?  IV drip rate describes the rate at which an intravenous infusion is administered in drops per minute. Use of an IV pump to automatically control the rate of infusion is now common in most medical settings in the United States; however, an IV pump may not be available in some settings/emergencies. In these situations, it is important that nurses know how to calculate the IV drip rate then set the rate of infusion using the IV tubing roller clamp. How to select the correct tubing type Factors such as client age and size will guide the selection of IV tubing. Different tubing types deliver a varying number of drops per milliliter. Pediatric clients are susceptible to fluid volume, so micro-drip tubing is used to tightly control fluid volume administration (60 gtt(mL). Macro-drip tubing (10, 15, or 20 gtt/mL) is typically used for adult clients. What is the drop factor?  The drop factor (or drip factor) refers to the number of drops (gtts) ...
Read more

🩺 Key Nursing Care Protocol Before Transfer

-
  1. Immediate Patient Assessment a.        Check vital signs: Blood pressure, heart rate, respiratory rate, oxygen saturation, and temperature. b.        Airway patency: Ensure endotracheal tube, tracheostomy, or airway adjuncts are secure. c.        Level of consciousness: Assess response to verbal/tactile stimuli. d.        Pain and comfort: Evaluate pain score and administer prescribed analgesics if needed. 2. Stabilization Before Transfer a.        Hemodynamic stability: Confirm the patient is not in shock or unstable. b.        Fluid balance: IV lines should be patent, fluids running as prescribed. c.        Drainage tubes/catheters: Check patency, secure placement, and ensure no leakage. d.        Dressings: Inspect sur...
Read more