Spontaneous abortion: Management. Grand Rounds 5/15/13 Jamie Peregrine, R2 WCGME OB/GYN
|
|
|
- Drusilla Sanders
- 7 years ago
- Views:
Transcription
1 Spontaneous abortion: Management Grand Rounds 5/15/13 Jamie Peregrine, R2 WCGME OB/GYN
2 Objectives Differentiate between abnormal pregnancies: ectopic vs missed/incomplete/complete abortion. Know where to look for management of spontaneous abortions Review management of threatened and incomplete abortions Discuss birth control options after abortion
3 Common presentations of abnormal pregnancies 9w0d by LMP, VBx4d, no IUP by TVS, UPREG+ quant 20,000; 48 hours later 18,000 9w0d by LMP, VB x4d, live IUP measures 8w5d by TVS w/ subchorionic hemorrhage >50% 9w0d by LMP, VBx4d, abd pn & back cramps, live IUP 8w5d by TVS, cervix 2cm w/ bleeding 11w0d by LMP, routine PNC, absent cardiac activity IUP 8w5d by TVS, cervix closed
4 Resources Williams OB 23 rd edition Ch 9 Abortion pp Creasy MFM 6 th edition Ch 33 Embryonic and Fetal Demise pp paragraph
5 Resources continued UpToDate ACOG practice bulletins No. 94 Medical management of ectopic pregnancy No. 67 Medical management of abortion RCOG NICE clinical guideline Diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage Dec 2012 (281 pp)
6
7 Threatened abortion Bleeding through a closed cervical os, first ½ of pregnancy, +/- pain 20-25% of early pregnancies 50% of all threatened abs end in abortion, but 90-96% of pregnancies with fetal cardiac activity & VB at 7-11 weeks will result in ongoing pregnancy Managed expectantly until resolution, dx nonviable pregnancy, or progress to inevitable, incomplete, or complete Sab.
8 Threatened abortion management Cochrane reviewed RCTs and found insufficient evidence to recommend: Bedrest HCG Vitamin supplementation Tocolytics/beta-agonists
9 Threatened abortion management Meta-analysis showed lower miscarriage with progestin compared with placebo or none. (RR 0.53; 95% CI ) 4 studies, 2 oral 2 vaginal, 1 good study (the only one which did show significant difference by itself), vaginal subgroup analysis CI crossed 1 Regimens: PO dydrogesterone (Duphaston) 10 mg bid, continued until 1 week after bleeding stopped. PV 25 mg progesterone bid, cont until 14 d after bleeding stopped PV 90 mg progesterone (Crinone 8%) daily x 5d PO dydrogesterone 40 mg then 10 mg bid, treatment cont until 16 weeks RCOG guidelines find it probably cost effective to treat, but find insufficient evidence to treat based on quality of data, lack of long-term safety data. Dydrogesterone not available in US?
10 Spontaneous abortion Non-induced loss of pregnancy before 20 weeks; <500 g (WHO). 8-20% of clinically recognized pregnancies 13-36% of all pregnancies
11 Expectant vs active tx of Sab
12 Expectant vs active tx of Sab
13 Expectant vs active tx of Sab
14 Expectant vs active tx of Sab
15 Expectant vs active tx of Sab
16 Expectant vs active tx of Sab
17 Expectant vs active tx of Sab
18 Expectant vs active tx of Sab
19 Expectant vs active tx of Sab
20 Expectant vs active tx of Sab
21 Medical vs surgical tx of Sab
22 Medical vs surgical tx of Sab
23 Medical vs surgical tx of Sab
24 Medical vs surgical tx of Sab
25 Medical vs surgical tx of Sab
26 Medical vs surgical tx of Sab
27 Medical vs surgical tx of Sab Risk of Asherman s increases from 8% with 1 st or 2 nd D&C to 30% with 3 rd.
28 Medical vs surgical tx of Sab
29 Cytotec PV vs placebo: missed ab
30 Cytotec PV vs placebo: missed ab
31 RU-486 vs placebo: missed ab
32 Cytotec+RU-486 vs RU-486: missed ab
33 Cytotec Dose: missed ab
34 SL cyotec x1 or longer: missed ab
35 SL cyotec x1 or longer: missed ab
36 SL Cytotec x1 or more: missed ab
37 PO vs SL: missed ab
38 PO vs SL: missed ab
39 PO vs SL: missed ab
40 SL vs PV: missed ab
41 SL vs PV: missed ab
42 SL vs PV: missed ab
43 PO vs PV: missed ab
44 PO vs PV: missed ab
45 PO vs PV: missed ab
46 PO vs PV: missed ab
47 Cytotec PV vs placebo: incomplete
48 Dose of PO cytotec: incomplete
49 Dose of PO cytotec: incomplete
50 Dose of PO cytotec: incomplete
51 Cytotec PO vs PV: incomplete
52 Cytotec PO vs PV: incomplete
53 Cytotec PO vs SL: incomplete
54 Cytotec PO vs SL: incomplete
55 Rhogam Sab: yes, as many as 5% become isoimmunized without it Threatened abortion: controversial
56 Contraception post-sab Gaffield ME, Kapp N, Ravi A. Use of combined oral contraceptives post abortion. Contraception Oct;80(4): doi: /j.contraception Epub 2009 Jun 4. Systematic review: 7 articles identified, 1 involving spontaneous ab. Quality of data not great. Immediate COCs didn t increase bleeding after induced abortion in 1 st trimester. Coagulation parameters increased compared to copper IUD control. Clinical significance unknown. Increase VTE not reported. WHO and CDC Medical Eligibility Criteria for Contraceptive Use COCs, Depo, IUDs: no restriction after induced abortion IUD no restriction after 1 st trimester induced or spontaneous abortion Non-IUD methods no restriction in GTN (decreasing or persistently elevated HCG) Otherwise doesn t specify safety of contraception immediately post- Sab
57 Use single dose of 800 mcg dose vaginally or sublingually
Ultrasound in the First Trimester of Pregnancy. Elizabeth Lipson, HMS III
Ultrasound in the First Trimester of Pregnancy Elizabeth Lipson, HMS III First Trimester Sonography Localization of Gestational Sac Intrauterine vs. ectopic Identification of abnormalities Embryonic demise
Family Planning Curriculum
Family Planning Curriculum University of Alabama at Birmingham Department of Obstetrics and Gynecology Module 1: Introduction Incidence of unintended pregnancy and abortion Safety of abortion, morbidity
New 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
Early 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
Emergency contraception, including ellaone (based on FSRH/CEU Guidance)
Emergency contraception, including ellaone (based on FSRH/CEU Guidance) Dr Lynsey Dunckley Associate Specialist SRH Southampton Solent Sexual Health Conference Friday 25 th January 2013 Quiz! Which is
Reduced Ovarian Reserve Is there any hope for a bad egg?
Reduced Ovarian Reserve Is there any hope for a bad egg? Dr. Phil Boyle Galway Clinic, 19 th March 2014 For more information on Low AMH see www.napro.ie Anti Mullerian Hormone AMH levels are commonly measured
6.1 Contraceptive Knowledge and Practices of Women Requesting Medical Termination of Pregnancy
6. UNSAFE ABORTIONS Complications from unsafe abortions if untreated, could lead to morbidity or death. The best way to prevent unsafe abortions is to reduce the unmet need for contraception and make safe
Nowrosjee Wadia Maternity Hospital
6. UNSAFE ABORTIONS The family planning programme of India is targeting towards providing a wide range of contraceptive choices to eligible couples with the ultimate objective of decreasing the unwanted
Update on Medical Abortion. P.C. Ho Department of O&G University of Hong Kong IWAC 2013 Bangkok
Update on Medical Abortion P.C. Ho Department of O&G University of Hong Kong IWAC 2013 Bangkok Mifepristone (RU486) Orally active progesterone antagonist at receptor level 97-98% bound to albumin and alpha-1
MHRI IUD Protocol. Migraine with aura Current DVT or PE History of or current breast cancer Active viral hepatitis Severe cirrhosis or liver tumors
Table of Contents A. Indications B. Contraindications C. Prior to Insertion D. Insertion E. Follow-Up Visit F. Removal G. Re-Insertion H. Complications/Side Effects I. Appendices MHRI IUD Protocol A. Indications
Outpatient Management of Early Pregnancy Loss
Outpatient Management of Early Pregnancy Loss Linda Prine, MD Associate Clinical Professor of Family Medicine Beth Israel & Harlem Family Medicine Residency Institute for Family Health Sarah Pickle, MD
Assessment 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
Disclosure. Objectives 2/21/2016
Recurrent Pregnancy Loss: The myths, the controversies and the evidence Mamie McLean, MD Assistant Professor Reproductive Endocrinology and Infertility University of Alabama at Birmingham Disclosure I
Up to 25% of all women in the early stages of. Vaginal bleeding in the early stages of pregnancy CME CE
feature n Learning objectives: n complete the posttest: Page xx n additional CME/: Pages xx Turn to page 27 for additional information on this month s CME/ courses. Kimberly D. Walker; Kathy Dexter, MLS,
The 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
Use of Ultrasound in the Provision of Abortion. Juan E. Vargas, MD Assistant Professor of Clinical Obstetrics and Gynecology and Radiology, UCSF
Use of Ultrasound in the Provision of Abortion Juan E. Vargas, MD Assistant Professor of Clinical Obstetrics and Gynecology and Radiology, UCSF Overview Uses and indications of ultrasound in the provision
Lecture 12a: Complications of Pregnancy
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Medical 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
Clinical 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
ALTERNATIVE TREATMENT PLAN AND CONSENT FOR MEDICAL ABORTION WITH MIFEPREX (MIFEPRISTONE) AND MISOPROSTOL
ALTERNATIVE TREATMENT PLAN AND CONSENT FOR MEDICAL ABORTION WITH MIFEPREX (MIFEPRISTONE) AND MISOPROSTOL The FDA gave its approval status to Mifepristone in 1996 based on research up to that time. Extensive
Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook
Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook MISOPROSTOL FOR TREATMENT OF INCOMPLETE ABORTION: AN INTRODUCTORY GUIDEBOOK CONTRIBUTORS: JENNIFER BLUM, JILLIAN BYNUM, RASHA
The position of hysteroscopy in current fertility practice is under debate.
The position of hysteroscopy in current fertility practice is under debate. The procedure is well tolerated. No consensus on effectiveness of HSC in improving prognosis of subfertile women. systematic
Patient 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
Annotated Bibliography on Misoprostol Alone for Early Abortion
Annotated Bibliography on Misoprostol Alone for Early Abortion 1. Carbonell JL, Rodriguez J, Velazco A, Tanda R, Sanchez C, Barambio S, Chami S, Valero F, Mari J, de Vargas F, Salvador I. Oral and vaginal
Information 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
Maj Alison Baum. R3, Nellis FMR
Maj Alison Baum R3, Nellis FMR What are some of your thoughts about birth plans? http://www.youtube.com/watch?v=hh62v0c xf04 Labor: Pain management wishes Doulas Episiotomy Intermittent fetal monitoring
m 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
CODING GUIDELINES FOR CONTRACEPTIVES. Updated for ICD-10 CM (post October 1, 2015)
CODING GUIDELINES FOR CONTRACEPTIVES Updated for ICD-10 CM (post October 1, 2015) TABLE OF CONTENTS ICD-10 CM Diagnosis Codes: Encounter for contraception page 2 LARC: Coding for IUD Insertion and Removal
Menopause Guidance on management and prescribing HRT for GPs based on NICE guidance 2015
PRIMARY CARE WOMEN S HEALTH FORUM GUIDELINES Menopause Guidance on management and prescribing HRT for GPs based on NICE guidance 2015 Written by Dr Imogen Shaw This guidance is designed to support you
Frequently 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
South Dakota Task Force to Study Abortion Pierre, South Dakota September 21, 2005
South Dakota Task Force to Study Abortion Pierre, South Dakota September 21, 2005 Section III. : The review and exposition of the body of medical, psychological, and sociological knowledge that has accumulated
Effective long-lasting strategy to prevent unintended pregnancy. The intrauterine system for contraception after abortion.
Effective long-lasting strategy to prevent unintended pregnancy. The intrauterine system for contraception after abortion. After the abortion I started re-thinking my birth control method. I am looking
Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women
Objectives Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women Provide a framework to evaluate abnormal uterine bleeding (AUB) Review medical and surgical management options
Best practice in comprehensive abortion care
Best practice in comprehensive abortion care Best Practice Paper No. 2 June 2015 Published by the Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent s Park, London NW1 4RG www.rcog.org.uk
Abigail R. Proffer, M.D. October 4, 2013
Abigail R. Proffer, M.D. October 4, 2013 Topics Human Papillomavirus (HPV) Vaccines Pap smears Colposcopy Contraception Polycystic Ovary Syndrome (PCOS) Can I get pregnant? Miscarriage Abnormal Uterine
Interrupted 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
Online Cytotechnology Degree Programs
Online Cytotechnology Degree Programs cytotec cost at walmart how to take cytotec tablets for abortion cytotec tablet price cytotec misoprostol 200 mcg via oral misoprostol cytotec generic cytotec 200
High 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
Management of Abnormal PAP Smears. K Chacko, MD, FACP 2010 GIM Conference
Management of Abnormal PAP Smears K Chacko, MD, FACP 2010 GIM Conference Scope of the Problem About 7-10% 7 of PAPs will come back abnormal 3.5 to 4 million in the US each year Approximate 4000 deaths
Frequently Asked Questions
Frequently Asked Questions What is Medabon? Medabon is a combination therapy for medical abortion. Medical abortion refers to the process of ending a pregnancy by taking medication, rather than through
the abortion pill by David Hager, M.D.
the abortion pill by David Hager, M.D. A positive pregnancy test is one of the most life-changing moments for a woman. Never is it more important to base your decisions on accurate information. Try to
1 st Trimester OB Ultrasound
Indications/Goals: 1 st Trimester OB Ultrasound Geoffrey E. Hayden, MD Director of Emergency Ultrasonography Vanderbilt Emergency Medicine Primary objective is to identify an intrauterine pregnancy Secondary
CONFIDENT CODING FOR OB/GYN CONFIDENT CODING FOR OB/GYN
Arlene J. Smith, CPC AAPC National Advisory Board 2007-2009 1 So when exactly does the global period start? Unraveling the confusion in antepartum care coding Correct coding for multiple gestations! Vaginal
Teens and Birth Control. The Latest in Contraceptive Counseling for Teenagers
Teens and Birth Control The Latest in Contraceptive Counseling for Teenagers A brief history of modern birth control in the US 1960- The first oral contraceptive is marketed in the US 1965- The Supreme
MEDICAL abortion is the use of pills to
www.rhm-elsevier.com A 2005 Reproductive Health Matters. All rights reserved. Reproductive Health Matters 2005;13(26):20 24 0968-8080/05 $ see front matter PII: S0968-8080(05)26212-2 FEATURES Medical Abortion:
Antibiotic prophylaxis during obstetric and gynaecology surgery in adults: background information
Antibiotic prophylaxis during obstetric and gynaecology surgery in adults: background information Pages 1 to 3 provide available evidence and references to support the surgical prophylaxis recommendations.
OB/GYN. Clerkship Learning Objectives. Office for Clinical Affairs Department of OB/GYN (515) 271-1629 (515) 271-1421 FAX (515) 271-1727
OB/GYN Clerkship Learning Objectives Rebecca Shaw, MD, FACOG Office for Clinical Affairs Department of OB/GYN (515) 271-1629 (515) 271-1421 FAX (515) 271-1727 General Description Required Rotation This
Keywords: Efficacy, Misoprostol Vaginal Administration, Pregnancy
A COMPARISON OF EFFICACY AND SIDE-EFFECTS OF TWO METHODS OF VAGINAL MISOPROSTOL ADMINISTRATION IN THE FIRST TRIMESTER OF PREGNANCY TERMINATION FOR PATIENTS OF BANDARABAS HOSPITAL LOCATED IN IRAN *Azadeaskari,
National Clinical Guideline. Diagnosis, staging and Treatment of Gestational Trophoblastic Disease. Literature Search Strategies
National Clinical Guideline Diagnosis, staging and Treatment of Gestational Trophoblastic Disease Literature Search Strategies NCCP 1 Diagnosis Question 1 Clinical Question Should all women undergoing
New Oral Anticoagulants Increase Risk for Gastrointestinal Bleeding - A Systematic Review and Meta-Analysis
New Oral Anticoagulants Increase Risk for Gastrointestinal Bleeding - A Systematic Review and Meta-Analysis Holster IL, Valkhoff VE, Kuipers EJ, Tjwa ET Departments of Gastroenterology and Hepatology,
Insurance Reimbursement for Post-Pregnancy Long-Acting Reversible Contraception (LARC) Background Benefits of LARC
Insurance Reimbursement for Post-Pregnancy Long-Acting Reversible Contraception (LARC) Shandhini Raidoo MD, Bliss Kaneshiro MD, MPH, Mary Tschann MPH, Reni Soon MD, MPH, Emmakate Friedlander MD, Jennifer
ABORTIONS: CAUSES AND MANAGEMENT. Dr J S DOHBIT OBS & GYN H G O P Y YAOUNDE
ABORTIONS: CAUSES AND MANAGEMENT Dr J S DOHBIT OBS & GYN H G O P Y YAOUNDE Postgraduate Training in Reproductive Health Research Faculty of Medicine, University of Yaoundé 2007 PLAN INTRODUCTION BURDEN
BUTTE COUNTY PUBLIC HEALTH DEPARTMENT POLICY & PROCEDURE
BUTTE COUNTY PUBLIC HEALTH DEPARTMENT POLICY & PROCEDURE SUBJECT: Pregnancy Testing and Counseling Protocol P&P # APPROVED BY: EFFECTIVE DATE: Mark Lundberg MD Health Officer REVISION DATE: 2/20/2010 Phyllis
Preterm Labor, the Cervix, and Progesterone. The Cervix. The Cervix. Disclosure of Conflict of Interest. 2nd Trimester Cervical Length
Disclosure of Conflict of Interest Preterm Labor, the Cervix, and Progesterone John C. Hobbins, M.D. Professor of Obstetrics and Gynecology University of Colorado Health Sciences Center Denver, CO Dr.
Termination 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
Chapter 10. When Abortion Fails
Chapter 10 When Abortion Fails Occasionally abortion fails, especially when it is drug induced. When this happens, either a second D&C or a more serious surgery may be attempted. The other alternative
To provide safe and standardized nursing care for the patient requiring induction or augmentation of labor.
Policy: Guidelines for the Management of Patients Undergoing Induction or Labor & Delivery Effective Date May 2012 Approval Date May 2012 Supersedes September 2011 Applicable to VUH Children s Hospital
Pain 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
This is Jaydess. Patient Information. What is Jaydess? How does Jaydess work?
, Patient Information This is Jaydess We hope that this brochure will answer your questions and concerns about Jaydess. What is Jaydess? Jaydess is an intrauterine device consisting of a hormone capsule
Copper 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?
CHLAMYDIA SCREENING IN WOMEN
CHLAMYDIA SCREENING IN WOMEN APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE What screening should be done? NCQA ACCEPTED CODES DOCUMENTATION
THE DIFFERENCE BETWEEN THE MORNING-AFTER PILL AND THE ABORTION PILL
THE DIFFERENCE BETWEEN THE MORNING-AFTER PILL AND There has been considerable public confusion about the difference between the morning-after pill and the abortion pill because of misinformation disseminated
Safe abortion: technical and policy guidance for health systems. Second edition
Safe abortion: technical and policy guidance for health systems Second edition Safe abortion: technical and policy guidance for health systems Second edition Acknowledgements WHO is grateful for the technical
Intrauterine Device (IUD) THE FACTS
Intrauterine Device (IUD) Quick Facts Effectiveness in Preventing Pregnancy: Use: Of 100 women using IUDs for a year, about one may become pregnant. IUDs are better at preventing pregnancy than condoms,
Clinical Practice Guidance for the Assessment of Young Women aged 20-24 with Abnormal Vaginal Bleeding
Clinical Practice Guidance for the Assessment of Young Women aged 20-24 with Abnormal Vaginal Bleeding Clinical Practice Guidance for the Assessment of Young Women aged 20-24 with Abnormal Vaginal Bleeding
OFFICE OF TREATMENT SERVICES OFFICE OF INMATE HEALTH SERVICES
OFFICE OF TREATMENT SERVICES OFFICE OF INMATE HEALTH SERVICES PREGNANCY MANAGEMENT MANUAL Date Issued: 01/07/2008 Dates 07/15/2008 Reviewed: 09/28/2009 All Policies and Procedures will be reviewed, at
Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions
Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in * (MBChB, FICMS, CABOG) **Sawsan Talib Salman (MBChB, FICMS, CABOG) ***Huda Khaleel Ibrahim (MBChB) Abstract Background: - Although
IUD Troubles: Best Practices for Difficult Insertions, Removals, and Malpositioned Devices
IUD Troubles: Best Practices for Difficult Insertions, Removals, and Malpositioned Devices Larry Leeman MD, MPH Nicole Yonke MD, MPH Joanna Hooper MD Disclaimer No conflicts of interests Use of misoprostol
Birth Control Options
1 of 5 6/2/2014 9:46 AM Return to Web version Birth Control Options What is contraception? Contraception means preventing pregnancy, also called birth control. Most people know about options such as birth
Abnormal 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
EARLY 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
Quality of Birth Certificate Data. Daniela Nitcheva, PhD Division of Biostatistics PHSIS
Quality of Birth Certificate Data Daniela Nitcheva, PhD Division of Biostatistics PHSIS Data Quality SC State Law requires that you file the birth certificate within 5 days of a child s birth. Data needs
Abortion 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
The Challenges, Risks, and Benefits of Oral Contraceptives
The Challenges, Risks, and Benefits of Oral Contraceptives Learning Objectives After participating in this educational activity, participants should be better able to: 1. Identify the currently available
ORIGINAL RESEARCH ARTICLE. Introduction Medical abortion using mifepristone combined
ORIGINAL RESEARCH ARTICLE Low-Dose Mifepristone 200 mg and Vaginal Misoprostol for Abortion Eric A. Schaff,* Steven H. Eisinger,* Lisa S. Stadalius, Peter Franks,* Bernard Z.Gore, and Suzanne Poppema The
Diagnosis Codes for Pregnancy and Complications of Pregnancy
This list is for informational purposes only and is not a binding or definitive list of covered conditions. It is not a guarantee of coverage; coverage depends on the available benefits and eligibility
STANDARD APRN PROTOCOL FOR IUD INSERTION: Levonorgestrel (LNG) Releasing Intrauterine System
STANDARD APRN PROTOCOL FOR IUD INSERTION: Levonorgestrel (LNG) Releasing Intrauterine System DEFINITION The LNG-releasing intrauterine systems (Mirena, Liletta and Skyla ) are on the market. The LNG-releasing
Clinical Scenarios CODING AND BILLING 101. Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting
Clinical Scenarios CODING AND BILLING 101 Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting 1 Always remember Follow coding guidelines If you didn t write it down, it didn t happen The
Department of Veterans Affairs VHA HANDBOOK 1330.03. Washington, DC 20420 October 5, 2012 MATERNITY HEALTH CARE AND COORDINATION
Department of Veterans Affairs VHA HANDBOOK 1330.03 Veterans Health Administration Transmittal Sheet Washington, DC 20420 October 5, 2012 MATERNITY HEALTH CARE AND COORDINATION 1. REASON FOR ISSUE. This
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
Comparison 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,
Procedure Based Coding
Procedure Based Coding Jon K. Hathaway Objectives Review Global definition Review common modifiers Procedure plus E&M codes 2013 MSACOG Snow Meeting 1 Vacuum assisted Vaginal Delivery was first reported
Facts 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
Induced Abortion. Dr. Anan Sacdpraseuth Mahosot Hospital
Induced Abortion Dr. Anan Sacdpraseuth Mahosot Hospital GFMER - WHO - UNFPA - LAO PDR Training Course in Reproductive Health Research Vientiane, 26 November 2009 Induced Abortion Introduction 40 to 60
THE BREASTFEEDING ANSWER BOOK CONTRACEPTION. To download electronic version. llli.org/babupdate
THE BREASTFEEDING ANSWER BOOK 12 CONTRACEPTION March 2012 Update To download electronic version llli.org/babupdate World Health Organization recommendations Theoretically hormonal contraceptive use could
Prognosis of Very Large First-Trimester Hematomas
Case Series Prognosis of Very Large First-Trimester Hematomas Juliana Leite, MD, Pamela Ross, RDMS, RDCS, A. Cristina Rossi, MD, Philippe Jeanty, MD, PhD Objective. The aim of this study was to evaluate
OBGYN Orientation & Billing Guide 9/22/2014
OBGYN Orientation & Billing Guide 2014 Welcome to Magnolia Health! We thank you for being part of or considering Magnolia s network of participating providers, hospitals, and other healthcare professionals.
Abnormal 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
Review of Non-VKA Oral AntiCoagulants (NOACs) and their use in Great Britain
Review of Non-VKA Oral AntiCoagulants (NOACs) and their use in Great Britain Dr Alexander (Ander) Cohen Guy s and St Thomas Hospitals, King s College London, UK Pavia Spring Meeting 13 June 2014 Overview
Prenatal 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
PROTOCOL RECOMMENDATIONS FOR USE OF METHOTREXATE AND MISOPROSTOL IN EARLY ABORTION
PROTOCOL RECOMMENDATIONS FOR USE OF METHOTREXATE AND MISOPROSTOL IN EARLY ABORTION INTRODUCTION: Both methotrexate and misoprostol have been approved by the U.S. Food and Drug Administration (FDA) for
Thapaliya Kailash et al. Int. Res. J. Pharm. 2015, 6 (6) INTERNATIONAL RESEARCH JOURNAL OF PHARMACY
INTERNATIONAL RESEARCH JOURNAL OF PHARMACY www.irjponline.com ISSN 2230 8407 Research Article USE OF MIFEPRISTONE AND MISOPROSTOL COMBINATION ON ABORTION IN FIRST TRIMESTER PREGNANCY AT GOVERNMENT HOSPITAL
Prepared by Father Tom Knoblach, Consultant for Healthcare Ethics, Diocese of Saint Cloud
Prepared by Father Tom Knoblach, Consultant for Healthcare Ethics, Diocese of Saint Cloud History Prior to 1967, abortion was prohibited in all 50 states except when the mother's life was in danger. Between
bpas.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
Support 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
Provider Notification Obstetrical Billing
Provider Notification Obstetrical Billing Date of Notification September 1, 20 Revision Date September 17, 2015 Plans Affected Mercy Care Plan and Mercy Care Long Term Care Plan Referrals As outlined in
abortion 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.
Women, 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
Strategies for the Prevention of Prematurity Progesterone. Cervical Screening, Cerclage, and Pessaries
Strategies for the Prevention of Prematurity Progesterone. Cervical Screening, Cerclage, and Pessaries Thomas J. Garite, M.D. Professor Emeritus, University of CA Irvine Editor Emeritus, American Journal
Safe & Unsafe. abortion
Safe & Unsafe Facts About abortion WHAT IS THE DIFFERENCE BETWEEN UNSAFE AND SAFE ABORTION? What is unsafe abortion? Unsafe abortion is a procedure for terminating an unplanned pregnancy either by a person