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 bleeding at 12 weeks  



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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




  #2

:oops: complete abortion


  #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?


  #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.


  #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.





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