By S. Arulkumaran
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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Additional resources for Emergencies in Obstetrics and Gynaecology
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%).
Emergencies in Obstetrics and Gynaecology by S. Arulkumaran