Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First-Trimester Pregnancy

2018 ◽  
Vol 37 (8) ◽  
pp. 1965-1975 ◽  
Author(s):  
Nova Panebianco ◽  
Frances Shofer ◽  
Katie O'Conor ◽  
Tristan Wihbey ◽  
Lakeisha Mulugeta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Transvaginal Ultrasound ◽  
Emergency Department Patient ◽  
First Trimester ◽  
Patient Perceptions ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

The utility of transvaginal ultrasound in the ED evaluation of complications of first trimester pregnancy

2015 ◽  
Vol 33 (6) ◽  
pp. 743-748 ◽  
Author(s):  
Nova L. Panebianco ◽  
Frances Shofer ◽  
J. Matthew Fields ◽  
Kenton Anderson ◽  
Alessandro Mangili ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

scholarly journals Pitfalls in Emergency Department Focused Bedside Sonography of First Trimester Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Kerri Layman ◽  
Michael Antonis ◽  
Jonathan E. Davis
Keyword(s):  
Emergency Department ◽  
Clinical Decision Making ◽  
Case Reports ◽  
Clinical Decision ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Diagnostic Modality ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
First Trimester Of Pregnancy

Background. Bedside sonography performed by emergency physicians is frequently utilized for real-time clinical decision-making in the emergency department (ED) setting. This includes the sonographic evaluation of pain or bleeding in the first trimester of pregnancy. The detection of intrauterine pregnancy (IUP) or life-threatening conditions, including ectopic pregnancy, is critical.Objectives. This paper will review several important pearls and avoidable pitfalls of this diagnostic modality by brief presentation of illustrative cases followed by discussion of key principles.Case Reports. Three patients evaluated in the ED for bleeding or pain occurring during the first trimester of pregnancy will be presented.Conclusions. When conducting emergency bedside ultrasound for the evaluation of first trimester pregnancy, it is important to avoid common pitfalls that can place your patient at risk.

scholarly journals P107: Does the use of bedside ultrasound to identify intrauterine pregnancy in the emergency department shorten the length of stay of patients presenting with 1st trimester vaginal bleeding or pelvic pain?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S114-S114
Author(s):  
M. Ravichandiran ◽  
S. Ramkissoon
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Point Of Care ◽  
First Trimester ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Intrauterine Pregnancy ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Experimental Group

Introduction: The use of point of care ultrasound (POCUS) has increased rapidly in the emergency department (ED) over the last 10 years. This study seeks to determine whether the use of POCUS to identify intrauterine pregnancy in the ED shortens the length of stay of patients presenting with first trimester pregnancy-related complaints at The Scarborough Hospital (TSH). Methods: A prospective chart review of women seen at TSH ED for first trimester pregnancy-related complaints was conducted from March 1, 2014 to December 30, 2014. ED physicians were asked to record the names of patients assessed using POCUS in the ED along with their findings during the study period (experimental group). Health Records data was used to find all patients seen in the emergency department during the study period with the chief triage complaint of “Pregnancy Issues < 20 weeks” (control group). Results: A total of 378 patients were identified in the control group and 61 patients were recorded in the experimental group. The outliers were removed from both groups. The POCUS identified an intra-uterine pregnancy (POS IUP) in 47.5% and no definite intrauterine pregnancy (NDIUP) in 52.5%.In the control group, 82.0% proceeded to obtain a formal ultrasound (FUS) after the POCUS. Patients found to have a POS IUP on the POCUS spent 141.48±100.95 minutes in hospital, while patients found to have NDIUP spent 197.10±132.48 minutes in hospital (p=0.07). The POS IUP group spent statistically significantly less time in hospital when compared to the control group (p=0.001). In the POCUS group, patients seen between 1700 and 0800 (i.e. when FUS is not available) spent significantly less time (p=0.02) in hospital (113.13±118.07 minutes, n=24) when compared to patients seen between 0800 and 1700 (208.28±106.35 minutes, n=36). Conclusion: For first-trimester pregnancy-related complaints, POCUS has been shown to be effective in reducing the time that patients spend in hospital at TSH. This difference was especially apparent when POCUS was used at times when FUS was not available. Despite the apparent reluctance of many ED physicians to discharge patients without a FUS, even after identifying a POS IUP on the POCUS, it was evident that this technology was saving time for both physicians and patients.

scholarly journals Medical Abortion of a First-Trimester Pregnancy with Large Multiple Uterine Leiomyomata

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Somsook Santibenchakul ◽  
Unnop Jaisamrarn
Keyword(s):  
Transvaginal Ultrasound ◽  
Medical Abortion ◽  
First Trimester ◽  
Termination Of Pregnancy ◽  
Combination Regimen ◽  
Uterine Leiomyomata ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Successful Termination ◽  
Normal Menstrual Cycle

Introduction. Termination of pregnancy in a patient with huge uterine leiomyomata poses significant challenges to clinicians. In this study, we report the successful termination of pregnancy in a patient with large multiple uterine leiomyomata using a combined regimen of drugs for medical abortion. Case. A 42-year-old woman, 6 weeks pregnant, presented to the Family Planning Clinic with an unintended pregnancy. She had a large, irregular abdominal midline mass, equivalent in size to 30-32 weeks of pregnancy. Abdominal and transvaginal ultrasound examinations revealed a small intrauterine gestational sac with a yolk sac and multiple large uterine leiomyomata. Treatment with mifepristone (200 mg) was initiated at the clinic. In addition, she was instructed to sublingually take 800 μg of misoprostol after 24–48 h. Two weeks later, at the follow-up visit, the patient complained of continued light bleeding. A pelvic examination showed that her cervix was dilated by 1 cm. In addition, abdominal and transvaginal ultrasound revealed a thick, inhomogeneous endometrium. Owing to light bleeding and no anemia or infection, the patient received two additional doses of 800 μg misoprostol vaginally. Her bleeding subsided for 61 days, and she resumed her normal menstrual cycle. Conclusion. A first-trimester pregnancy with large multiple uterine leiomyomata can be safely terminated using a combination regimen of drugs for medical abortion. However, an additional dose of misoprostol is required for the successful termination of pregnancy.

The distance between the embryo and yolk sac associated with inhibin A in the first-trimester pregnancy – which is the novelty?

2019 ◽  
Vol 1 (67) ◽  
pp. 13
Author(s):  
Carmen Elena Bucuri ◽  
Răzvan  Ciortea ◽  
Andrei Mihai Malutan ◽  
Cristian Iuhaș ◽  
Maria Rada ◽  
...  
Keyword(s):  
First Trimester ◽  
Yolk Sac ◽  
Inhibin A ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy
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