Assessment and management of issues in early pregnancy

2021 ◽  
Vol 13 (12) ◽  
pp. 500-506
Author(s):  
Sean Robert Te Haara
Keyword(s):  
Critical Illness ◽  
Ectopic Pregnancy ◽  
Clinical Review ◽  
Early Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Prehospital Care ◽  
Management Strategies ◽  
Alternative Management ◽  
Rhesus Incompatibility ◽  
Emergency Ambulance

Approximately 5% of the workload of UK emergency ambulance services involves managing obstetric patients. This places pregnancy firmly within the scope of prehospital care but training often focuses on critical illness during pregnancy rather than the range of presentations seen. This clinical review aims to discuss the implications of early pregnancy with a focus on ectopic pregnancy, rhesus incompatibility, miscarriage and hyperemesis gravidarum. Normal presentations of pregnancy and alternative management strategies, including early pregnancy units, are also discussed.

Early pregnancy problems

2021 ◽  
pp. 467-494
Author(s):  
Fiona Phillips
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Early Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Recurrent Miscarriage ◽  
Psychological Care ◽  
Assessment Unit

This chapter covers the role of the early pregnancy assessment unit, the care of women with bleeding or pain in early pregnancy, the definition, causes, assessment, and treatments for miscarriage, as well as caring for the patient who experiences recurrent miscarriage. The diagnosis, assessment, and both medical and surgical management of ectopic pregnancy is explained. Nausea, vomiting, hyperemesis gravidarum, and psychological care in early pregnancy are also all covered.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

Chronic ectopic pregnancy mimicking pelvic malignancy

2021 ◽  
Vol 14 (3) ◽  
pp. e233534
Author(s):  
Edwin Omih ◽  
Argyrios Makris ◽  
Cheng Choy ◽  
Nikhil Bhuskute
Keyword(s):  
Weight Loss ◽  
Ectopic Pregnancy ◽  
Bowel Obstruction ◽  
Early Pregnancy ◽  
Pelvic Mass ◽  
Common Complication ◽  
Pelvic Malignancy ◽  
Atypical Case ◽  
Ectopic Gestation ◽  
Negative Pregnancy Test

Ectopic pregnancy is a common complication of early pregnancy. We present a very atypical case of an ectopic gestation in a woman who presented with a negative pregnancy test, a large pelvic mass, weight loss and bowel obstruction.

scholarly journals Variation in Out-of-Hospital Cardiac Arrest Management

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Jason M. Jones ◽  
Joseph A. Tyndall ◽  
Christine M. Van Dillen
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Prehospital Care ◽  
Management Strategies ◽  
Retrospective Chart Review ◽  
Airway Device ◽  
Care Providers ◽  
One Airway ◽  
Time And Energy ◽  
Hospital Cardiac Arrest

Objective. To evaluate variation in airway management strategies in one suburban emergency medical services system treating patients experiencing out-of-hospital cardiac arrest (OHCA). Method. Retrospective chart review of all adult OHCA resuscitation during a 13-month period, specifically comparing airway management decisions. Results. Paramedics demonstrated considerable variation in their approaches to airway management. Approximately half of all OHCA patients received more than one airway management attempt (38/77 [49%]), and one-quarter underwent three or more attempts (25/77 [25%]). One-third of patients arrived at the emergency department with a different airway device than initially selected (25/77 [32%]). Conclusion. This study confirmed our hypothesis that paramedics’ selection of ventilation strategies in cardiac arrest varies considerably. This observation raises concern because airway management diverts time and energy from interventions known to improve outcomes in OHCA management, such as cardiopulmonary resuscitation and defibrillation. More research is needed to identify more focused airway management strategies for prehospital care providers.

scholarly journals Clinical review: Adiponectin biology and its role in inflammation and critical illness

Critical Care ◽  
2011 ◽  
Vol 15 (2) ◽  
pp. 221 ◽  
Author(s):  
Katherine Robinson ◽  
John Prins ◽  
Bala Venkatesh
Keyword(s):  
Critical Illness ◽  
Clinical Review

Determination of early pregnancy

1935 ◽  
Vol 31 (2) ◽  
pp. 279-279
Author(s):  
I. Danilov
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Accurate Diagnosis ◽  
To Receive

The author, recognizing the Zondek-Aschheim'a reaction extremely valuable for determining early pregnancy, considers its length of time to receive a response (100 hours) to be a great disadvantage, and therefore it is not very suitable in cases where it is required to quickly achieve an accurate diagnosis (ectopic pregnancy).

Endocrine disorders in pregnancy

2018 ◽  
pp. 283-296
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Thyroid Hormone ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Management Strategies ◽  
Normal Pregnancy ◽  
Endocrine Disorders ◽  
Pituitary Diseases ◽  
Pregnant State ◽  
Pituitary Adrenal Axis ◽  
In Pregnancy

This chapter discusses thyroid, adrenal, and pituitary diseases that occur during pregnancy. A series of changes in thyroid hormone economy take place in normal pregnancy. As a result of these changes, thyroid hormone levels in pregnancy differ from those in the non-pregnant state. This chapter includes a description of normal thyroid physiology and thyroid pathophysiology, including hyperemesis gravidarum, post-partum thyroiditis, hypothyroidism, and hyperthyroidism. Changes in the hypothalamo-pituitary–adrenal axis during normal and abnormal pregnancies are also described, with syndromes such as Cushing’s syndrome and Addison’s disease listed. Finally, pituitary adenomas in pregnancy, and their respective features and management strategies, are listed, including acromegaly, hypopituitarism, TSH-secreting adenomas, and prolactinoma.

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