EBCOG P1 – 3 Month- Early pregnancy-Day 5 EMQ

EMQ

 

A.Repeat UPT after a week

B.Methotrexate

C.Pelvic Ultrasound

D.Repeat medical management

E.Surgical management

F.F.UPT after 3 weeks

G.G.Expectant management 1-2 weeks

H.Medical management

I.Repeat Transvaginal scan after 1 week

J.Transvaginal scan after 2 weeks

K.take opinion of second sonographer

L.Register with trophoblastic centre

M.Counsel various management options

 

 

The following Scenarios shows various women presenting to early pregnancy clinic .please choose from above options regarding their follow up and management .

 

 

Missed miscarriage – medical management done. UPT done at 3 weeks is positive. What should be the next step/ appropriate step ?

1. Xavier, 32 year old woman , primigravida now 6weeks pregnant. Her transvaginal scan  shows a right adnexa mass of 36x25x30mm with fetal cardiac activity present . Her beta hcg is 1570IU/L. She is asymptomatic and hemodynamically stable .She underwent laparoscopy and  because of a healthy contralateral tube .

Salpingectomy done.when is the follow  up  for this patient ?

2.Mrs. X is 32 year old primigravida 7 pregnant.she is here  for dating scan Trans abdominal scan shows gestational sac   pole measuring 22mm

No fetal pole.noted   When is the Follow up advised ?

3.Mrs, Rubina is into 9 weeks pregnancy . TVS –  shows CRL 6.5mm and no cardiac activity. When do u  advise follow up

4.Mrs. Ruby , has undergone evacuation for Missed miscarriage . Evacuation done and HPE of products of conception showed molar pregnancy .

Follow up advised .

5. 9 weeks pregnancy . TVS – CRL 9 mm and no cardiac activity. This was confirmed by 2nd sonographer, what is the best advise ?

A.Preimplantation genetic diagnosis

B.11 + 2 to 13+6

C.14 + 1 to 20 + 0

D.18 + 0 to 20 + 6

E.24-28w

F.32w

G.36w

H.41w

 

 Instructions For each of the clinical scenarios listed, select the SINGLE most appropriate gestation when the screening test should be performed.

 

6.Optimal gestational age to accurately determine chorionicity of multiple Pregnancies

7. Quadruple test or integrated (combined and quadruple test) screening tests for Down syndrome

8.Screening that prevents the risk of single gene defect disorders such as Huntington disease

9. Optimal gestational age to accurately determine chorionicity of multiple Pregnancies

10. Quadruple test or integrated (combined and quadruple test) screening tests for Down syndrome

11. Screening that prevents the risk of single gene defect disorders such as Huntington disease