Pitfalls in First-Trimester Bleeding

“…A large amount of free fluid is abnormal, and strongly suggests a ruptured ectopic pregnancy in the right clinical setting. For those patients with a concerning history and indeterminate US finding, a gynecologist should be consulted before final disposition [20].…”

Section: Pelvismentioning

confidence: 99%

Clinical applications of bedside ultrasonography in internal and emergency medicine

Vincenzo¹,

Camaggi²

2010

Intern Emerg Med

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Ultrasonography (US) is an invaluable tool in the management of many types of patients in Internal Medicine and Emergency Departments, as it provides rapid, detailed information regarding abdominal organs and the cardiovascular system, and facilitates the assessment and safe drainage of pleural or intra-abdominal fluid and placement of central venous catheters. Bedside US is a common practice in Emergency Departments, Internal Medicine Departments and Intensive Care Units. US performed by clinicians is an excellent risk reducing tool, shortening the time to definitive therapy, and decreasing the rate of complications from blind invasive procedures. US can be performed at different levels of practice in Internal Medicine, according to the experience of ultrasound practitioners and equipment availability. In this review, the indications for bedside US that can be performed with basic or intermediate US training will be highlighted.

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“…If the focused goal directed ultrasound does not reveal a normal intrauterine pregnancy, then the other diagnoses that must be considered in women with vaginal bleeding and pelvic pain include ectopic pregnancy, spontaneous abortion, failed pregnancy and molar pregnancy. 10,11 Focused goaldirected pelvic ultrasound should not wait on serum hCG levels, especially in a true emergency. It should be noted however, that it is important for the resident to be aware…”

Section: First Trimester Abnormal Ultrasound Imagingmentioning

confidence: 99%

“…An inappropriate rise or fall of the β-hCG plus ultrasound findings of an abnormal pregnancy requires immediate obstetrical consultation and/ or clinic follow-up. 7,[9][10][11] In patients presenting with bleeding, the type and Rh of the patient should be determined; if a patient is Rh negative, Rhogam should be given. 11…”

Section: Dsjuogmentioning

confidence: 99%

“…Definitive management once an ectopic is seen includes any resuscitation that may need to be done in the emergency department and emergent gynecology consultation. 10 Spontaneous abortions: Spontaneous abortion is defined as pregnancy terminating before the 20th completed week of in Morison's pouch gestation due to partial or complete expulsion. Approximately 80% of spontaneous abortions occur in the first trimester.…”

Section: Dsjuogmentioning

confidence: 99%

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Obstetrics and Gynecology Ultrasound Topics in Emergency Medicine Resident Training

Greer¹,

Brosseit²

2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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The evaluation of abdominal or pelvic pain and/or vaginal bleeding using pelvic ultrasound is a common practice of the emergency physician. In fact, the American College of Emergency Physicians (ACEP) in 2008 published guidelines listing evaluation of pregnancy as a core application and evaluation of the adnexa as a secondary application for emergency bedside pelvic ultrasound. In 2012 the Accreditation Council of Graduate Medical Education (ACGME) along with the American Board of Emergency Medicine (ABEM) introduced milestones into residency programs to provide a framework of cognitive and behavioral performance standards, including procedure-based skills. The milestones are the knowledge, skills, attitudes and other attributes for each of the ACGME competencies that monitor resident performance throughout the residency and range from less to more advanced levels. Goal-directed focused ultrasound is one of twenty-three specific milestones that will be measured during emergency medicine training. Discussion will focus on how to teach focused goaldirected pelvic ultrasound based on the five levels within this milestone.

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Pitfalls in First-Trimester Bleeding

Cited by 10 publications

References 36 publications

Clinical Approach to Pregnancy-Related Bleeding

Clinical Approach to Pregnancy-Related Bleeding

Clinical applications of bedside ultrasonography in internal and emergency medicine

Obstetrics and Gynecology Ultrasound Topics in Emergency Medicine Resident Training

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