Prep for USMLEPrep for USMLE Forum
   Forum    Step 1  Step 2 CK Step 2 CS Step 3  Match  IMGs Resources Search






Previous Topic | Next Topic  bleeding at 12 weeks 




 
Kaplan Qbank USMLE



Author8 Posts
  #1

sally, 28 years old primigravida comes to the emergency room for check up at 12 weeks of gestational age. her blood group was O negative , and her husband is B positive. she complained of minimal spotting but absolutely no pain. on examination, her vitals were with in normal limits and gynaecological examination is unremarkable with internal os not dialated. ultrasound examination has shown no heart beat in foetus. what is the diagnosis
a.missed abortion
b.threatened abortion
c.incomplete abortion
d.complete abortion
e.septic abortion

___________________
vyseerx

  #2

:oops: complete abortion

___________________
have fun

  #3

non viable + no ceervical dilation + minimal bleeding = missed abortion

  #4

I am going with A too, missed abortion.
What's the next best step in the management?

___________________
deep breathing...

  #5

u can either schedule an elective D&C or wait 4 spontanteous abortion to occur

  #6

What about the risk of DIC and she is also Rh negative.

___________________
deep breathing...

  #7

a couple of remarks ro maty...

1st) any Rh neg gravidas gets rhogam when scheduling a d&c..by the way..mode is suction d&c

2nd) since this is a missed abortion..and the fact that she has sought help....i very much doubt that she will go with a dead fetus for more than a month...and even then, DIC would still be a rare occurence

3rd) you could also treat the patient with mefepristone as a medical rx instead of surg rx, but chances of POC is more in med rx

  #8

Thanks, I think DIC is more commun with fetal demise.

___________________
deep breathing...







You don't have permission to post.




Login or Register to post messages in this topic





















Contact | Leaders | Disclaimer | Privacy

Copyright @ Prep for USMLE. All rights reserved.