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Second trimester miscarriage managementFrom: Rafael Haciski (haciski@earthlink.net)Tue Apr 5 14:31:25 2005
Query to the group (as I have rare opportunity to handle this and have gotten several diferent suggestions) Unregistered ~14 week pregnant patient Seen in another ER yestereday, dx spontaneous ROM, sent home to bedrest. Rolls in today to our ER with nausea pain and bleeding No FHT, found to be contracting q3-5, cervix at 4 cm, small parts presenting, bleeding not excessive, Temp 100.2, WBC 22,000 Questions: ... would you or would you not cover her with antibiotics (and which) while she aborts ... would you allow spontaneous process to proceed and for how long, or would you add pitocin, methergine, prostaglandin, or other? (some suggested surgical extraction which at this point I disagree with) ... where would you manage her (ER, floor, OB suite?)
-- Rafael C. Haciski MD FACOG Bradenton FL
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