Miscarriage Consent Advice

Option List:
A.       Call the consultant
B.      Reassurance
C.       Antibiotics and Discharge after 24 hrs
D.      Laparoscopy and repair
E.      Laparotomy and repair
F.        Antibiotics and Discharge when stable
Choose the most appropriate management for the scenarios given below. Each option can be used once or more than once.

1. 27 year old P2L2, delivered 8 months back, is for  Copper coil insertion. During the procedure, while Introducing a uterine sound, the ST3 felt that there is a loss of resistance. The consultant was informed regarding the suspicion of uterine perforation and the coppercoil insertion was abandoned and observed for bleeding. Bleeding was normal. The management options include
2. 30 year old,P3L3, had a miscarriage at 12 weeks and underwent surgical evacuation under the direct supervision of the consultant. During evacuation, loss of resistance was felt and perforation of uterus was suspected and there was significant vaginal bleeding . The appropriate management plan for her would be