Me and You

Pelvic examination of threatened miscarriage reveals :

• Bleeding through external os

• Soft uterus & cervix

• Closed external os

• Dilated internal os

Missed miscarriage :

• Brownish intermittent vaginal bleeding

• Opened cervical os

• Uterus smaller than date

• Vaginal evacuation done for uterus <12w

'Blighted ovum' in missed miscarriage is defined as :

• Loss of definition of gestation sac

• Smaller diameter

• Absent fet echoes

• Absent fetal cardiac movement

Placental abruption :

• Low implantation of placenta occupies lower uterine segment

• Premature separation of placenta

• Present of 'couvelaire uterus'

• After 28 weeks POG

Vaso previa :

• Rare, emergency

• Vessels crossing cervix -angiogram

• Umbilical cord vessel without whartn's jelly

• Immediate C-section

Non-placental causes of antepartum hemorrhage (APH) :

• Cervicitis

• Cervical erosion/carcinoma

• Vasa previa

• Vaginal trauma

Placenta previa summary :

• Bleeding from placenta covering the cervical os

• Soft, non-tender abdomen

• No fetal distress

• Normal CTG

• Not associated with pre-eclampsia

• Halah biasa jer

• Hensem sikit

• Hensem banyak