Care of women;miscarriage and ectopic pregnancy
|
|
- Hester Webb
- 7 years ago
- Views:
Transcription
1 Care of women;miscarriage and ectopic pregnancy Belinda Champion- Gynae Oncology Clinical Nurse Specialist and Clinical Nurse Lead in Sexual Health Lewisham & Greenwich NHS TRUST May
2 Overview Increase awareness of the extended role of the Nurse Sonographer within the emergency gynae setting Describe some of the emerging trends in the management of miscarriage and ectopic pregnancy Discuss the implications of the NICE guidance on ectopic pregnancy and miscarriage management and how these guidelines impact upon current local and national practice.
3 Nurse Sonographer-Advanced role Making a difference (NHS Plan, 1999) proposed a new career framework for nurses to incorporate newly developed roles CNO key roles for nurses; To manage patient caseloads To run clinics
4 The Scope of the Nurse Sonographer s Role Clinical expert in gynaecology and ultrasound practice Act autonomously and within the MDT Develop innovative ways to improve the patients journey Contribute to meeting government targets Nurse led care is safe and effective as well as cost effective Provide expert advise, training and support to trainee sonographers and doctors
5 Improving women s experience Dedicated practitioner Rapid diagnosis and reasurrance Improve access to care Continuity of care Evidence-based care Shorter waiting times More information, more choice
6 Impact on services Higher turnover of patient s Efficient patient throughput Reduced length of stay Reduced emergency admissions Delivery of cost-effective, efficient services leading to cost reduction
7 Nurse Sonographer-The way forward The role of the NURSE SONOGRAPHER will CHAMPION benefits to the patients journey making it more accessible and seamless
8 Miscarriage ultrasound diagnosis RCOG Revised Guidelines(October 2011) Delayed miscarriage ( TV scan in all cases) Ultrasound diagnosis of a miscarriage should only be considered with a mean sac diameter >/=25mm (with no obvious yolk sac), or With a fetal pole with crown rump length >/=7mm (without fetal heart activity)
9 30 yr old woman G1P0 Case 1 10 weeks by gestational age Noticed an episode of brown pv spotting 1/52 ago and mild crampy pains NT scan due in 1/52
10 Delayed Miscarriage 10weeks by dates 7+5/40 by Scan
11 Empty gestation sac >25mm
12 NICE Guidelines- Diagnosis and initial management of ectopic pregnancy and miscarriage ( Dec, 2012) Summary of key points: NICE say 2 operators are required to diagnose a miscarriage on TVS the same day or the same clinician 7days later. If TA rescan in 14days. In practice, we routinely offer second opinion for the diagnosis of miscarriage and document clearly if this is declined on the ultrasound report
13 TVS- one scan fits all? Is there a gestational cut-off for TVS? Is TVS appropriate for all women? Why are we performing an intimate examination for all women? Are we taking into account women s choice? How are we implementing the guidance locally?
14 Management of Miscarriage-current options Expectant management- wait & see Medical management Surgical management- ERPC
15 New Developments management of miscarriage Manual Vacuum Aspiration
16 Manual Vacuum Aspiration (MVA) ERPC under LA. Default option in some trusts Performed under ultrasound guidance CRL up to 23mm or RPOC up to 5cm Not suitable for post natal, post STOP, suspected molar or complex uterine structure ie fibroids
17 MVA Cervical priming with misoprostol 400mcg sublingually 3hrs pre procedure If under 25yrs old screen for chlamydia or azithromycin stat dose offered PR diclofenac self administered 1hr pre procedure Anaesthetic gel and local anaesthetic injection to the cervix Reassure throughout the procedure
18 MVA 15minute obs for the first half hour then half hourly To be observed in hospital for 2hours post procedure Anti-D if rhesus negative POC sent to histology No follow up routinely booked To return if prolonged pvb (>2weeks) or signs of infection
19 Why do women choose MVA? Available sooner than GA Avoiding a GA Feel more in control Quicker recovery Recommended by friends and family
20 Patient Satisfaction Survey-Women s positive experiences of MVA All nurses and the consultant have all been extremely friendly, professional and kind throughout my stay. A special thank you to the Romanian nurse. Thank you to the staff at EPAGU I was made to feel comfortable and felt as though I had the support and kindness shown through this time. The medical team was very supportive. Lumi showed absolute concern and care. She is just wonderful. The other nurses and consultant were also fantastic. They made my healing/recovery process faster!!!
21 Medical Management- A change in practice NICE recommend that mifepristone is no longer offered as a treatment for delayed or incomplete miscarriages
22 Huge! Impact on Women? Anecdotally-women are walking with their feet Offers more flexibility in terms of taking time off work Reduced number of follow up visits Women want their care closer to home
23 Management of PUL s and ectopic pregnancies
24 Ectopic Gestation- management options Ultrasound diagnosis with a clinically useful report will aid in the decision making process of the following management options: Expectant management ( wait and see) Medical management ( methotrexate) Surgical ( laparoscopy/laparotomy)
25 27 yr old woman Case 2 G3P1+1 ( SVD) and previous STOP 7 weeks by gestational age. Irregular cycle varies- 5 to 6wks 2/7 history of slight dark brown spotting and pain in LIF Past history of PID in the past and previous Appendicetomy
26 Case 2-ultrasound appearances
27 Expectant management of Ectopic Wait and see approach: Pregnancy Lead Consultant decision only Less than 10% of all ectopic gestations can be safely managed through close observation Initial BHCG < 1000 and decreasing No blood in pelvis on USS
28 Expectant Management - NICE do not recommend expectant management of ectopic pregnancy Locally, our unit have good supporting data to continue with expectant miscarriage
29 Thank you!
30 Acknowledgements My Husband, Jon and my Daughter Georgina for their patience and encouragement Debbie Holloway, Nurse Consultant in Gynaecology, Guy s and St Thomas NHS Foundation Trust Joanne Fletcher, Nurse Consultant in Gynaecology, Sheffield Shirley Bogle, Sister, colleague and friend, Early Pregnancy unit at Lewisham Hospital Dr Judith Hamilton, Consultant Gynaecologist and Lead for EPAGU
PREGNANCY OF UNKNOWN LOCATION (PUL) - CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline
PREGNANCY OF UNKNOWN LOCATION (PUL) - CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline All clinical staff working in the Division of women, children & sexual health to provide evidence based guidance
More informationPatient information leaflet for Termination of Pregnancy (TOP) / Abortion
Patient information leaflet for Termination of Pregnancy (TOP) / Abortion Families Division Options available If you d like a large print, audio, Braille or a translated version of this leaflet then please
More informationEarly Pregnancy Assessment Unit EPAU
Early Pregnancy Assessment Unit EPAU Introduction Miscarriage occurs in 20 30% of clinical pregnancies and accounts for 55,000 couples experiencing early pregnancy loss each year in Australia. With the
More informationInformation for you Abortion care
Information for you Abortion care Published in February 2012 This information is for you if you are considering having an abortion. It tells you: how you can access abortion services the care you can expect
More informationAcute pelvic inflammatory disease: tests and treatment
Acute pelvic inflammatory disease: tests and treatment Information for you Information for you Published August 2010 Published in August 2010 (next review date: 2014) Acute What is pelvic inflammatory
More informationPain and bleeding in early pregnancy: assessment and initial management of ectopic pregnancy and miscarriage in the first trimester
Pain and bleeding in early pregnancy: assessment and initial management of ectopic pregnancy and miscarriage in the first trimester National Collaborating Centre for Women s and Children s Health Commissioned
More informationGynaecology Service. Saint Mary s Hospital. The Whitworth Clinic. Information for patients
Gynaecology Service Saint Mary s Hospital The Whitworth Clinic Information for patients Welcome to the Whitworth Clinic at Saint Mary s Hospital This leaflet will give you information about the service,
More informationabortion abortion abortion abortion abortion abortion abortion on abortio abortion ortion abortion abortion abortion abortion abortio
Abortion Your questions answered abortio bortion ion ortion on abortio 2 Are you pregnant but not sure you want to have the baby? Do you need more information about your pregnancy choices? Unplanned pregnancy
More informationUniversity College Hospital. Miscarriage Women s Health
University College Hospital Miscarriage Women s Health 2 Introduction The purpose of this leafl et is to: Describe what a miscarriage is and why it happens What it means for your health What treatment
More informationEARLY PREGNANCY LOSS A Patient Guide to Treatment
EARLY PREGNANCY LOSS A Patient Guide to Treatment You have a pregnancy that has stopped growing, or you have started to miscarry and the process has not completed. If so, there are four ways to manage
More informationEctopic pregnancy and miscarriage
Ectopic pregnancy and miscarriage Diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage Issued: December 2012 NICE clinical guideline 154 guidance.nice.org.uk/cg154 NHS
More informationFacts for Women Termination of pregnancy, abortion, or miscarriage management
Patient Education Facts for Women Termination of pregnancy, abortion, or miscarriage management This handout answers common questions about miscarriage management and the termination of a pregnancy, also
More informationWomen s Health Laparoscopy Information for patients
Women s Health Laparoscopy Information for patients This leaflet is for women who have been advised to have a laparoscopy. It outlines the common reasons doctors recommend this operation, what will happen
More informationPolycystic ovary syndrome: what it means for your long-term health
Polycystic ovary syndrome: what it means for your long-term health Information for you Published in February 2005, minor amendments in June 2005 Revised 2009 What is polycystic ovary syndrome? Polycystic
More informationDepartment of Gynaecology Early medically induced termination of pregnancy. Information for patients
Department of Gynaecology Early medically induced termination of pregnancy Information for patients Medically induced termination of pregnancy In this procedure the termination of pregnancy is brought
More informationabortion your questions answered
abortion your questions answered About Marie Stopes International Marie Stopes International is a specialist reproductive healthcare organisation and a registered charity working in both the UK and overseas.
More informationbpas.ie I just wanted to say thank you. Your staff showed both kindness and professionalism and this definitely helped me get through the day...
I just wanted to say thank you. Your staff showed both kindness and professionalism and this definitely helped me get through the day... bpas client bpas provides balanced counselling for unplanned pregnancy
More informationWomen, Children and Sexual Health Division Maternity Services. Guideline: Anti D- Prophylaxis
Women, Children and Sexual Health Division Maternity Services Guideline: Anti D- Prophylaxis 1. Introduction The National Institute for Clinical Excellence recommend routine antenatal anti-d prophylaxis
More informationTERMINATION OF PREGNANCY- MEDICAL
TERMINATION OF PREGNANCY- MEDICAL Information Leaflet Your Health. Our Priority. Page 2 of 8 You have been offered a medical termination of pregnancy using mifepristone. You will have been given some verbal
More informationModule 3 Unplanned Pregnancy and Abortion Care
Module 3 Unplanned Pregnancy and Abortion Care CSRH Module 3: Unplanned Pregnancy and Abortion Care Learning Outcomes: Develop a non-judgemental approach towards unplanned pregnancy and abortion care Have
More informationThe quadruple test screening for Down s syndrome and spina bifida
The quadruple test screening for Down s syndrome and spina bifida This leaflet provides information about a blood test to check for Down s syndrome and spina bifida. This test is available to you between
More informationAbnormal Uterine Bleeding
Abnormal Uterine Bleeding WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and has
More informationAssessment and management of miscarriage
Assessment and management of miscarriage Dawn Miller is a Senior Lecturer in Women s Health at the Dunedin School of Medicine, University of Otago. She is also a doctor at Family Planning, Dunedin, and
More informationNORTHAMPTONSHIRE INTEGRATED SEXUAL HEALTH SERVICES IUD/IUS PROTOCOL
NORTHAMPTONSHIRE INTEGRATED SEXUAL HEALTH SERVICES IUD/IUS PROTOCOL Policy Details NHFT document reference MMPr005 Version Final Date Ratified 19.01.16 Ratified by Medicines Management Committee Implementation
More informationClinical Interruption of Pregnancy (Medical/Surgical Abortion)
Clinical Interruption of Pregnancy (Medical/Surgical Abortion) Approximately one fifth of all pregnancies in the United States end in abortion (Ventura et al., 2009). According to the CDC (2011a), there
More informationHysterosalpingography
Scan for mobile link. Hysterosalpingography Hysterosalpingography uses a real-time form of x-ray called fluoroscopy to examine the uterus and fallopian tubes of a woman who is having difficulty becoming
More informationAbortion in Practice. A guide for GPs
Abortion in Practice A guide for GPs contents introduction four By British Pregnancy Advisory Service (BPAS) Medical Director part one pre-abortion five Who can be referred to BPAS? How to refer Other
More informationNational Hospital for Neurology and Neurosurgery
National Hospital for Neurology and Neurosurgery Botulinum toxin injections for the bladder Department of Uro-Neurology If you would like this document in another language or format, or require the services
More informationMedical criteria for IUCD s Based on the WHO MEC (2004- Annexure 3) system a woman s eligibility for IUCD insertion falls in 4 categories. These categ
CLIENT ASSESSMENT Ensure that the woman is not pregnant Determine the length and direction of uterus. Ensure that she does not have gonorrhea and chlamydia, and is not a high risk case of STI s Identify
More informationProblems in Early Pregnancy
Problems in Early Pregnancy Exceptional healthcare, personally delivered This information answers queries about issues that may arise in early pregnancy. Not all of these issues will apply to you. It provides
More informationWhy your weight matters during pregnancy and after birth
Information for you Published in November 2011 (next review date: 2015) Why your weight matters during pregnancy and after birth Most women who are overweight have a straightforward pregnancy and birth
More informationIMAP Statement on Safe Abortion
International Planned Parenthood Federation IMAP Statement on Safe Abortion Key points: When performed early in pregnancy by trained health personnel in adequate facilities, abortion is a very safe procedure
More informationK Raja/N Varol FPA 2013. FPA Sydney August 31 2013
FPA Sydney August 31 2013 Ms wilson 32 year old woman Presents with worsening, heavy menstrual and intermenstrual bleeding and pain for 6 months. Ms Wilson What is the differential diagnosis What are the
More informationInformation on. Abortion Services. www.sandyford.org. Telephone 0141 211 8130 1
Information on Abortion Services www.sandyford.org Telephone 0141 211 8130 1 Contents 1. First Steps... Page 3 2. The Assessment Clinic... Page 4 3. Medical Abortion... Page 6 4. Surgical Abortion... Page
More informationCopper intra-uterine device (IUD)
Oxford University Hospitals NHS Trust Copper intra-uterine device (IUD) Page What is an inter-uterine device? 3 How does it work? 4 Would an IUD be suitable for me? 5 Are there any risks or complications?
More informationTranscervical Resection of the Endometrium (TCRE)
Oxford University Hospitals NHS Trust Women s Centre Transcervical Resection of the Endometrium (TCRE) Information for women This leaflet is for women who have been advised to have a transcervical resection
More informationAssessment of Fetal Growth
Assessment of Fetal Growth Unit / Trust: 1. INTRODUCTION The aim of this guideline template is to outline the methods used to assess fetal growth and the referral pathways utilising customised antenatal
More informationArtificial insemination with donor sperm
Artificial insemination with donor sperm Ref. 123 / 2009 Reproductive Medicine Unit Servicio de Medicina de la Reproducción Gran Vía Carlos III 71-75 08028 Barcelona Tel. (+34) 93 227 47 00 Fax. (+34)
More informationCornual ruptured pregnancy with placenta increta CORNUAL RUPTURED PREGNANCY WITH PLACENTA INCRETA A RARE CASE
142 CORNUAL RUPTURED PREGNANCY WITH PLACENTA INCRETA A RARE CASE Agarwal NR 1, Rani A 1 *, Batra S 1 1. Department of Obststetrics and Gynaecology, Institute of Medical Sciences, Banares Hindu Univarsity.
More informationCLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC)
CLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC) 1. Aim/Purpose of this Guideline 1.1. Due to a rise in the caesarean section rate there are increasing numbers of pregnant women who
More informationTermination of pregnancy. A resource for health professionals. November 2005. Excellence in women s health
Termination of pregnancy A resource for health professionals November 2005 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Excellence in women s health This is a publication
More informationOutpatient hysteroscopy
Women s & Children s Outpatient hysteroscopy Information for patients Welcome to King s gynaecology service. The doctor who saw you in the outpatient clinic recently has recommended that you have a procedure
More informationOUTPATIENT HYSTEROSCOPY SERVICES JASMINE SUITE
OUTPATIENT HYSTEROSCOPY SERVICES JASMINE SUITE Information Leaflet Your Health. Our Priority. Page 2 of 6 This information is for patients having a hysteroscopy (diagnostic or operative). It explains what
More informationInformation for you Treatment of venous thrombosis in pregnancy and after birth. What are the symptoms of a DVT during pregnancy?
Information for you Treatment of venous thrombosis in pregnancy and after birth Published in September 2011 What is venous thrombosis? Thrombosis is a blood clot in a blood vessel (a vein or an artery).
More informationSupport information for women, their partners and families. Early Pregnancy Loss (Miscarriage)
Support information for women, their partners and families Early Pregnancy Loss (Miscarriage) The experience of early pregnancy loss can bring about a mix of thoughts and feelings. You are welcome to speak
More informationAbout the Cervical Stitch
About the Cervical Stitch You are probably reading this leaflet because you have experienced a late miscarriage or very premature birth. Your doctor may have told you that s/he suspects that this happened
More informationVaginal hysterectomy and vaginal repair
Women s Service Vaginal hysterectomy and vaginal repair Information for patients Vaginal hysterectomy and vaginal repair This leaflet is for women who have been advised to have a vaginal hysterectomy.
More informationComparison of oral versus vaginal misoprostol & continued use of misoprostol after mifepristone for early medical abortion
Indian J Med Res 122, August 2005, pp 132-136 Comparison of oral versus vaginal misoprostol & continued use of misoprostol after mifepristone for early medical abortion Suneeta Mittal, Sonika Agarwal,
More informationFact sheet 9. Screening for ovarian cancer
Fact sheet 9 Screening for ovarian cancer Ovacome is a national charity providing advice and support to women with ovarian cancer. We give information about symptoms, diagnosis, treatment, research and
More informationName of procedure: Laparoscopic (key-hole) ovarian surgery. Left/ Right unilateral salpingo-oophorectomy* (removal of one fallopian tube and ovary)
For staff use only: Patient Details: Surname: First names: Date of birth: Hospital no: Female: (Use hospital identification label) Gynaecology Patient agreement to treatment Name of procedure: Laparoscopic
More informationHigh quality follow up support and care
High quality follow up support and care How do you think the benefits of high quality follow up care? Client satisfaction Safe and effective continuation of the method What are the tasks involved in routine
More informationNew approaches to management of early pregnancy loss (miscarriage) Larry Leeman MD MPH UNM MCH Resident School September 5, 2012
New approaches to management of early pregnancy loss (miscarriage) Larry Leeman MD MPH UNM MCH Resident School September 5, 2012 Disclosure Statement No conflicts of interest Misoprostol is not FDA approved
More informationPrenatal screening and diagnostic tests
Prenatal screening and diagnostic tests Contents Introduction 3 First trimester routine tests in the mother 3 Testing for health conditions in the baby 4 Why would you have a prenatal test? 6 What are
More informationOut-patient hysteroscopy. Information for patients
Out-patient hysteroscopy Information for patients Important If there is any chance you may be pregnant please tell a member of the team immediately. We will not be able to perform a hysteroscopy if you
More informationChickenpox in pregnancy: what you need to know
Chickenpox in pregnancy: what you need to know First published December 2003 Revised edition published November 2008 What is chickenpox? Chickenpox is a very infectious illness caused by a virus called
More informationInformation on termination of pregnancy (abortion) A series of information leaflets on termination of pregnancy services in Greater Glasgow & Clyde
Information on termination of pregnancy (abortion) A series of information leaflets on termination of pregnancy services in Greater Glasgow & Clyde Your first doctors appointment The assessment clinic
More informationNURSE LED SERVICES IN CARDIFF AND VALE NHS TRUST. Sandra Smith Senior Nurse Manager Cardiff and Vale NHS Trust 28 th June 2007
NURSE LED SERVICES IN CARDIFF AND VALE NHS TRUST Sandra Smith Senior Nurse Manager Cardiff and Vale NHS Trust 28 th June 2007 Reasons for increasing Nurse Led Services The advent of HIV and the dramatic
More informationNormal Pregnancy and Pain Management Case Study
Normal Pregnancy and Pain Management Case Study Time: 1845 Heather Morris, RN, has just arrived to work her evening shift in Labor & Delivery. This is her 5th year as an RN in the unit. While waiting for
More informationA patient and public guide to the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis
A patient and public guide to the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis 1st Annual Report 2015 (Data collection: 1 February 2014 30 April 2015) 2 Contents Background Who
More informationFirst Trimester Screening for Down Syndrome
First Trimester Screening for Down Syndrome What is first trimester risk assessment for Down syndrome? First trimester screening for Down syndrome, also known as nuchal translucency screening, is a test
More informationMaternity Renal Pelvis Dilation (RPD)
Maternity Renal Pelvis Dilation (RPD) Fetal Medicine Unit Your baby has been found to have more fluid in its kidneys than normal. This leaflet will explain what this means for your baby. First of all,
More informationStocktake of access to general practice in England
Report by the Comptroller and Auditor General Department of Health and NHS England Stocktake of access to general practice in England HC 605 SESSION 2015-16 27 NOVEMBER 2015 4 Key facts Stocktake of access
More informationSaint Mary s Hospital Tests for you and your baby during pregnancy
Maternity Service Saint Mary s Hospital Tests for you and your baby during pregnancy Contents Page What is this leaflet about? 3 Routine blood tests for the mother 4 Anaemia 4 Blood group 4 German measles
More informationThe Scottish Public Services Ombudsman Act 2002
Scottish Public Services Ombudsman The Scottish Public Services Ombudsman Act 2002 Investigation Report UNDER SECTION 15(1)(a) SPSO 4 Melville Street Edinburgh EH3 7NS Tel 0800 377 7330 SPSO Information
More informationScreening for ovarian cancer Page 1 of 5 Ovacome
Fact sheet 9 Screening for ovarian cancer Ovacome is a national charity providing advice and support to women with ovarian cancer. We give information about symptoms, diagnosis, treatment, research and
More informationHeavy periods (menstrual bleeding)
Heavy periods (menstrual bleeding) This information sheet has been given to you to help answer some of the questions you may have about heavy periods and the treatments that are available. This leaflet
More informationNHS Cervical Screening Having a colposcopy
NHS Cervical Screening Having a colposcopy What is a colposcopy? 1 Why do I need a colposcopy? 1 What does a colposcopy involve? 2 Colposcopy results 4 Treatment to remove abnormal cells in the cervix
More informationThe link between cervical cancer and HPV (human papillomavirus)
The link between cervical cancer and HPV (human papillomavirus) The link between cervical cancer and HPV Key facts: HPV is a virus (the human papillomavirus). Almost all abnormal Pap smear results are
More informationGuy s, King s and St Thomas Cancer Centre The Cancer Outpatient Clinic Central venous catheter: Peripherally inserted central catheter
Guy s, King s and St Thomas Cancer Centre The Cancer Outpatient Clinic Central venous catheter: Peripherally inserted central catheter This information leaflet aims to help answer some of the questions
More informationLaparoscopic Hysterectomy
Any further questions? Please contact the matron for Women s Health on 020 7288 5161 (answerphone) Monday - Thursday 9am - 5pm. For more information: Royal College of Obstetrics and Gynaecology Recovering
More informationLaparoscopic Nephrectomy
Laparoscopic Nephrectomy Information for Patients This leaflet explains: What is a Nephrectomy?... 2 Why do I need a nephrectomy?... 3 What are the risks and side effects of laparoscopic nephrectomy?...
More informationInformation for you A low-lying placenta (placenta praevia) after 20 weeks
Information for you A low-lying placenta (placenta praevia) after 20 weeks Published in December 2011 Who is this information for? This information is intended to help you if you have, or have been told
More informationGuideline on the use of Anti-D Prophylaxis for Rhesus Negative Women
Guideline on the use of Anti-D Prophylaxis for Rhesus Negative Women This guidance does not override the individual responsibility of health professionals to make appropriate decision according to the
More informationIUD training principles 2013
IUD training principles 2013 Introduction These principles were developed in 2011 2012 by representatives and members of the following organisations: Sexual Health and Family Planning Australia (SHFPA)
More informationMolar pregnancy. (hydatidiform mole)
Molar pregnancy (hydatidiform mole) We have written this leaflet for women and their partners who have been affected by a molar pregnancy (also called a hydatidiform mole). 1 You may never have heard of
More informationTransobturator tape sling Female sling system
Transobturator tape sling Female sling system Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationThe following chapter is called "Follow-ups with a Positive or a Negative Pregnancy Test".
Slide 1 Welcome to chapter 7. The following chapter is called "Follow-ups with a Positive or a Negative Pregnancy Test". The author is Professor Pasquale Patrizio. Slide 2 This chapter has the following
More informationTrust Guideline for the use of the Modified Early Obstetric Warning Score (MEOWS) in detecting the seriously ill and deteriorating woman.
A clinical guideline recommended for use In: By: For: Key words: Written by: Supported by: Maternity Services. Obstetricians, Midwives and Midwifery Care Assistants. All women receiving care from maternity
More informationDa Vinci Robotic Hysterectomy and removal of ovaries (oophorectomy) with discharge information
Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Da Vinci Robotic Hysterectomy and removal of ovaries (oophorectomy) with discharge information Royal Surrey County Hospital
More informationFrequently Asked Questions (FAQ) for Medical Abortion
Frequently Asked Questions (FAQ) for Medical Abortion 1. What is medical abortion (MA)? MA is the use of one or more medications to terminate or end a pregnancy. Medical abortion is most effective when
More informationDepartment of Health. Maternity and Neonatal Clinical Guideline. Early pregnancy loss
Department of Health Maternity and Neonatal Clinical Guideline Early pregnancy loss Document title: Early pregnancy loss Publication date: September 2011 Document number: Document supplement: Amendments:
More informationimplant contraceptiv contraceptive contraceptive raceptiv contraceptive implant contraceptive contraceptive ontraceptive implant ontraceptive im
your guide to the contraceptive implant Helping you choose the method of contraception that is best for you contra ontraceptive im contraceptive implant mpl ceptive contraceptive contracepti ntraceptive
More informationda Vinci Myomectomy Changing the Experience of Surgery Are you a candidate for the latest treatment option for uterine fibroids?
da Vinci Myomectomy Changing the Experience of Surgery Are you a candidate for the latest treatment option for uterine fibroids? Your doctor may be able to offer you a new, minimally invasive surgical
More informationFemoral Hernia Repair
Femoral Hernia Repair WHAT IS A FEMORAL HERNIA REPAIR? 2 WHAT CAUSES A FEMORAL HERNIA? 2 WHAT DOES TREATMENT/ MANAGEMENT INVOLVE? 3 DAY SURGERY MANAGEMENT 3 SURGICAL REPAIR 4 WHAT ARE THE RISKS/COMPLICATIONS
More informationInterrupted Pregnancy Coding
Interrupted Pregnancy Coding American College of Obstetricians and Gynecologists Terry Tropin, RHIA, CPC, CCS-P, ACS-OB, PCS Content Development Expert, DecisionHealth ACOG Committee on Coding and Nomenclature
More informationCLINICAL PRACTICE GUIDELINE MANAGEMENT OF EARLY PREGNANCY MISCARRIAGE
CLINICAL PRACTICE GUIDELINE Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive Version 1.0
More informationDevelopment of Urgent Care in Halton
Development of Urgent Care in Halton Simon Wright Chief Operating Officer/Deputy Chief Executive Warrington and Halton Hospitals NHS Foundation Trust Urgent Care Review (2012/13) carried out by Halton
More informationBreast Screening Explained. We can supply this information in other languages, in large print, on audio or in Braille.
Breast Screening Explained We can supply this information in other languages, in large print, on audio or in Braille. Breast Screening Explained This leaflet tells you about free breast screening. Breast
More informationHow to Deal with Rumors and Misconceptions about IUDs
How to Deal with Rumors and Misconceptions about IUDs Rumors are unconfirmed stories that are transferred from one person to another by word of mouth. In general, rumors arise when: an issue or information
More informationHysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?
ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is
More informationOut-patient management of medical abortion
Saint Mary s Hospital Gynaecology Service Whitworth Clinic Out-patient management of medical abortion Please attend: 1st stage on at 2nd stage on at Follow up on at 2 Contents page Welcome... 4 First stage...
More informationHPV and the Future of Cervical Screening
HPV and the Future of Cervical Screening John Tidy, Professor of Gynaecological Oncology Chair, National Colposcopy QA Committee, Sheffield What is HPV? Small ds DNA virus Over 140 genotypes described
More informationFacing Hysterectomy? Learn why da Vinci Surgery may be your best treatment option for a benign gynecologic condition
Facing Hysterectomy? Learn why da Vinci Surgery may be your best treatment option for a benign gynecologic condition The Condition(s): Chronic Pain, Heavy Bleeding, Fibroids, Endometriosis and/or Prolapse
More informationI will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too?
What is node-positive breast cancer? Node-positive breast cancer means that cancer cells from the tumour in the breast have been found in the lymph nodes (sometimes called glands ) in the armpit area.
More informationAbnormal Uterine Bleeding FAQ Sheet
Abnormal Uterine Bleeding FAQ Sheet What is abnormal uterine bleeding? Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period. Bleeding that occurs between
More informationBlood Pressure Management and Your Pregnancy
Patient Education Blood Pressure Management and Your Pregnancy This handout explains: How your blood pressure is checked during pregnancy. What preeclampsia is, including risk factors, treatments, and
More informationPOST MENOPAUSAL BLEEDING CHECKLIST. Ultrasound. Information folder given to patient. Booking form faxed/emailed
POST MENOPAUSAL BLEEDING CHECKLIST Ultrasound Information folder given to patient Booking form faxed/emailed 1 BOOKING FORM - HYSTEROSCOPY FOR POST MENOPAUSAL BLEEDING Patient s Name: Surname: DOB: / /
More informationConfirmed Deep Vein Thrombosis (DVT)
Confirmed Deep Vein Thrombosis (DVT) Information for patients What is deep vein thrombosis? Blood clotting provides us with essential protection against severe loss of blood from an injury to a vein or
More informationm e d i c a l a b o r t i o n
providing m e d i c a l a b o r t i o n in l o w-resource settings An Introductory guidebook Second Edition p r o v i d i n g me d i c a l ab o r t i o n in l o w-re s o u r c e settings: an introductory
More informationSurgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place.
What is an abdominal myomectomy? Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place. When is this surgery used? Treatment
More information