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Miscarriage and Ectopic Pregnancy

Miscarriage and Ectopic Pregnancy. Definition. Definition. The expulsion or extraction of an fetus less then 500 gr OR Pregnancy Loss before 20 weeks gestation. Incidence. 0-3% 4-7% 7-10% 10-12% 13-15%. Incidence. 0-3% 4-7% 7-10% 10-12% 13-15%. Aetiology. Early Spontaneous

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Miscarriage and Ectopic Pregnancy

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  1. Miscarriage and Ectopic Pregnancy

  2. Definition

  3. Definition • The expulsion or extraction of an fetus less then 500 gr • OR • Pregnancy Loss before 20 weeks gestation

  4. Incidence • 0-3% • 4-7% • 7-10% • 10-12% • 13-15%

  5. Incidence • 0-3% • 4-7% • 7-10% • 10-12% • 13-15%

  6. Aetiology • Early Spontaneous • Sporadic chromosome defects • Corpus luteum defects • Poor placentation

  7. Aetiology • Mother • Fetus • Woumb

  8. Clinical Presentation • Threatened miscarriage • Inevitible • Incomplete • Complete • Missed

  9. Diagnosis • Clinical • Ultrasounds (TVUS) • Gestational sac > 25mm and no yolk sack Or • Fetal CRL of 7 mm and no cardiac activity

  10. Management • Bloods • Rh, VDRL, Hb • Medical • Evac

  11. Complications • Infection • Bleeding • Renal failure • Anaemia • Trauma • Infertility

  12. Ectopic Pregnancy

  13. Types • Tubal • Ligamentous • Ovarian • Abdominal • Cervical • Heterotopic

  14. Causes • Embryonal • Maternal • Previous PID • Endometriosis • Tubal surgery • IVF • Hormones • ?? IUCD

  15. Clinical Presentation • Acute • Chronic • Acute on Chronic

  16. Differential • Gynae • Miscarriage • Cyst complication • ? PID

  17. Differential • Surgical • Appendix • Perforated viscous • Volvulus • Splenic Rupture • Mesenteric Adenits

  18. Differential • Medical • Pyelonephritis • Porphyria

  19. Diagnosis • Ultrasound BHCG>1500

  20. Diagnosis • Ultrasound BHCG<1500

  21. Diagnosis • BHCG • Must double in 48hrs • Eg 1200 IU to 2800 over 48 hrs OK • But 1200 to 1600 IU not OK

  22. Management • Pre-op • Surgery

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