FIRST TRIMESTER EMERGENCIES
Goals and Objectives
Goals
- Resident will be comfortable with initial evaluation and basic management of patients with abdominal pain and/or vaginal bleeding in early pregnancy
Learning Objectives
- For patients presenting with abdominal pain and/or vaginal bleeding in early pregnancy, resident will be able to:
- List and define differential diagnoses, including:
- Ectopic Pregnancy
- Abortion / Miscarriage
- Threatened
- Inevitable
- Complete
- Incomplete
- Missed
- Septic
- List early interventions and their indications, including
- Large-bore IV access
- Blood transfusion
- OB-GYN consultation (stat)
- Vaginal packing
- List common laboratory tests and their indications, including:
- CBC
- Type and screen
- Quantitative B-hCG
- Coagulation studies
- Recite B-hCG "discriminatory zones" for transabdominal and transvaginal ultrasound
- Describe the technique and indications for transvaginal and transabdominal ultrasound
- List the ultrasound findings required to confirm an intrauterine pregnancy
- Define and discuss the incidence of heterotopic pregnancy in both assisted and unassisted methods of conception
- Describe the role of methotrexate in ectopic pregnancy
- Describe the role of RhoGAM in first trimester bleeding and discuss the ACEP and ACOG consensus statements on this topic
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Recommended Resources
Prior to Conference
Additional Resources
Review
Consensus Statements
Transvaginal Ultrasound
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Original Post by Eric Shappell on 12/04/2014
Reviewed by James Ahn on 01/06/2015
Last Updated by Eric Shappell on 06/12/2015
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