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6 results

  • Chapter 16 - Induction of Labor at Term

  • from Section 2 - Labor and Delivery
  • Edited by Amira El-Messidi, McGill University, Montréal, Alan D. Cameron, University of Glasgow
  • Book:
    OSCEs in Obstetrics and Maternal-Fetal Medicine
    Published online:
    23 February 2023
    Print publication:
    16 February 2023, pp 228-243

  • Summary

    You are covering the obstetric practice of a colleague who just left on a two-month leave. A 28-year-old primigravida with a spontaneous singleton at 35+1 weeks’ gestation presents for a routine prenatal visit. Pregnancy dating was confirmed by first-trimester sonography. Your trainee informs you the patient is normotensive, fundal height is appropriate for gestation, and she does not have clinical complaints. Fetal activity has been normal. The patient wishes to discuss labor management with you at this visit.

  • Chapter 11 - The Role of Early Pregnancy Loss Care in Ensuring Competence in Uterine Evacuation

  • from Section II - Integration of Abortion into Graduate Medical Education
  • Edited by Uta Landy, University of California, San Francisco, Philip D Darney, University of California, San Francisco, Jody Steinauer, University of California, San Francisco
  • Book:
    Advancing Women's Health Through Medical Education
    Published online:
    30 July 2021
    Print publication:
    19 August 2021, pp 123-129

  • Summary

    Abortion. The phrase “uterine evacuation” can create tension and line people up on opposite sides of the abortion issue, with no recognition of its safety, commonplace occurrence and health or life-saving capabilities. Due to the dichotomized and politicized nature of abortion, in some places it is difficult to teach health care providers how to empty a uterus, even in a life-threatening situation.Early pregnancy loss (EPL) management can provide an entry point for this education, as well as a way to destigmatize the uterine aspiration procedure and medical treatment because, although management is the same as for “elective abortion” the indication is different; with an abortion, a pregnancy is terminated that would otherwise likely continue, while with EPL, the pregnancy has ceased to be viable. This difference is subtle, yet concrete and profound for many.

  • Chapter 13 - Ultrasonography of the cervix

  • from Section 2: - Ultrasonography in infertility
  • Edited by Botros R. M. B. Rizk, University of South Alabama
  • Book:
    Ultrasonography in Reproductive Medicine and Infertility
    Published online:
    07 September 2011
    Print publication:
    25 March 2010, pp 103-112

  • Summary

    In 1869, a hemorrhagic uterine growth was diagnosed and cauterized with silver nitrate, thus qualifying the procedure to be the first operative hysteroscopy during direct visualization of endometrial cavity. The pressure required to separate the walls of a normal-sized uterine cavity (with saline) is less than 50mmHg. A solution containing 35% dextran 70 (molecular weight 70,000 kDa) was introduced as a distending medium for hysteroscopy. Compared with placebo, use of misoprostol among premenopausal women before hysteroscopy was found to result in fewer cervical lacerations, most probably secondary to a reduced need for cervical dilation. Despite the increasing adoption of hysteroscopy as an ambulatory procedure, protocols for local anesthesia and/or analgesia remain far from uniform. In a flexible hysteroscope, fiberoptic bundles (flexible) transmit the image to the eyepiece or the camera. Pregnancy and genital tract infections are obvious contraindications to hysteroscopy.

  • 14 - Diagnosis and management of miscarriage

  • Edited by Davor Jurkovic, Lil Valentin, Sanjay Vyas
  • Book:
    Gynaecological Ultrasound in Clinical Practice
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 159-178

  • Summary

    Miscarriage occurs if there is a failure of embryonic growth or if a viable fetus dies. An incomplete miscarriage is diagnosed by history of bleeding, pain, passage of products of conception and an open internal cervical os on examination. Traditional clinical methods of diagnosing miscarriage have been largely replaced by ultrasound diagnosis. Early pregnancy units have been developed to streamline the diagnosis of abnormal early pregnancy. The Royal College of Radiologists and the Royal College of Obstetricians and Gynaecologists (RCR/RCOG) issued joint guidelines on the ultrasound diagnosis of early pregnancy loss. Low levels of progesterone have long been associated with early pregnancy failure. Treatment regimens include the use of the antiprogesterone, mifepristone and a prostaglandin analogue, the most commonly used of which is misoprostol. These regimens were initially devised for the management of first-trimester therapeutic abortion.

  • Treatment of Shock Resulting from Abortion Using Misoprostol: A Case Report

  • Zhang Lin
  • Journal:
    Prehospital and Disaster Medicine / Volume 16 / Issue S1 / June 2001
    Published online by Cambridge University Press:
    28 June 2012, p. S90
    Print publication:
    June 2001
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