Dr hina aamir

Gynae sho

Ask about the LMP

Amount of bleeding

Abdopelvis pain

Past obstetric history

Any contraception

Any past ho miscarriages ,ectopic pregnancy

Those with a H/O a positive pregnancy test and:

Vaginal bleeding or abdominal pain

Previous ectopic pregnancy

Previous tubal surgury

Previous miscarriage

Iucd in situ

Persistant bleeding post evacuation of the ERCP were there is a suspicion of the problems

Other clinical conditions as stated in the hospital protocol

Viable intrauterine pregnancy

Pregnancy of uncertain viability

Early pregnancy loss

Incomplete miscarriage

Complete miscarriage

Pregnancy of

FETAL FACTORS

Chromosomal abnormalities

autosomal trisomies -52%

Monosomy X -30%

CONGENITAL ANMOLIES

TRAUMA

MATERNAL FACTORS

Advanced maternal age

RISK FACTORS

PV BLEEDING WITH DELAYED PERIODS Common in pregnancy 20-40% with a normal outcome Ask about amount of bleed, color , any passage of clots

or tissues ABDOPELVIS PAIN Incidental findings on US In cases of ectopic preg Breast tenderness Gi syptoms Urinary symptoms Shoulder tip pain Dizziness, light headedness Rectal pain or pain on defecation

GENERAL PHYSICAL EXAM Pallor ,tachycardia, Abdo exam Tenderness on palpation Guarding or rigidity ,enlarged uterus Shock collapse

PER SPECULUM EXAM Source of bleeding Amount of bleeding, cervix dilated or any products of

conception