By S. Arulkumaran

ISBN-10: 019108025X

ISBN-13: 9780191080258

ISBN-10: 0199651388

ISBN-13: 9780199651382

Supplying a pragmatic, obtainable consultant to emergency events encountered in obstetrics and gynaecology, the second one version of this crucial instruction manual is designed round the signs and symptoms a sufferer offers with.

summary: supplying a pragmatic, obtainable consultant to emergency events encountered in obstetrics and gynaecology, the second one version of this crucial guide is designed round the signs and indicators a sufferer offers with

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Sample text

The combination of TVS with quantitative serum hCG levels are well-​described diagnostic tools. Laparoscopy should be used to confirm TVS findings and treat tubal ectopic pregnancies rather than as a diagnostic tool. TVS should not be performed in a clinically unstable woman, thus delaying theatre. Surgical treatment • Indications: haemodynamic instability, pain, an ectopic pregnancy with fetal cardiac activity on TVS, significant haemoperitoneum on TVS, hCG >5000 U/​L . • Laparoscopy preferable to laparotomy: decreased admission time, shorter postoperative recovery, and reduced analgesic requirements.

Consider delivery—​depending on the underlying cause, seizure activity, gestational age, and fetal well-​being. 12. Establish a cause—​if this is the first seizure, investigations are required after the acute event and should include specialist neurological assessment, FBC, U&E, LFTs, glucose and calcium, imaging (MRI or CT scan), and in some cases EEG or lumbar puncture. 13. Debrief prior to discharge—​ensure that prior to discharge the patient understands their diagnosis, seizure safety, driving regulations, and that adequate follow-​up is made.

They invade the uterus and spread widely by vascular dissemination. • Persistent trophoblastic disease (PTD) is a general term for persistently elevated β-​hCG and can occur with moles, invasive moles, and choriocarcinoma—​there is considerable overlap and little attempt is made to distinguish them as management is similar and driven by β-​hCG and evidence of metastases. Clinical presentation and diagnosis of moles • Irregular bleeding with a positive pregnancy test is invariably present (>90%).

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Emergencies in Obstetrics and Gynaecology by S. Arulkumaran


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