By Geoffrey Chamberlain

(BMJ booklet) textual content has been up to date all through and redesigned within the present ABC structure. Covers association of care, general antenatal administration, fetal health, paintings in being pregnant, raised blood strain, preterm exertions, a number of being pregnant, audit of beginning, and extra. prior version: c1993. Softcover.

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Lesions of the cervix or vagina may cause bleeding in early pregnancy. References 1 Westergaard J, Teisner B, Sinosich M et al. Ultrasound and biochemical tests in the prediction of early pregnancy failure. Br J Obstet Gynaec 1985;92:77–83. 2 Cacciatore B, Stenman U, Yostalo P. Diagnosis of ectopic pregnancy. Br J Obstet Gynaec 1990;97:904–8. Recommended reading ● ● ● ● ● Aukum W. Diagnosing suspected ectopic pregnancy. Br Med J 2000;321:1235–60. Hejenius P. Interventions for tubal ectopic pregnancy.

Labour force survey 1984–2000. London: ONS, 2001. 35 7 Vaginal bleeding in early pregnancy Bleeding drives patients to their general practitioner swiftly. Vaginal bleeding early in pregnancy makes the woman think that she may be miscarrying, so this brings her even more promptly; the practitioner thence has the opportunity to diagnose the cause and start management. 1). In addition, bleeding may occur for no apparent reason in a large number of cases. In early pregnancy such cases are commonly categorised as threatened miscarriage, but this is fudging the issue for in many cases the conceptus and its future placental system are not involved; doctors should be honest and say that they do not know the cause rather than mislabel it.

The degree of shock usually relates to the amount of blood loss from the body and the degree of cervical dilatation. The differential diagnosis includes ectopic pregnancy and salpingitis. Management Threatened miscarriage A woman with a threatened miscarriage is best removed from an active environment. If the practitioner tells her to go to bed to rest for 48 hours she may feel happier but there is no real evidence that bedrest makes any difference to the incidence of miscarriage. Some 5% of women who deliver safely report vaginal bleeding in the same pregnancy; the effectiveness of specific treatments is difficult to assess.

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