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Patient has complaints of missed periods (LMP) with amenorrhea for the last 4 months. On examination, cervical os is open with profuse discharge per vagina. State likely diagnosis and management list.
Patient has complaints of missed periods (LMP) with amenorrhea for the last 4 months. On examination, cervical os is open with profuse discharge per vagina. State likely diagnosis and management list.
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more than 4 weeks ago
Likely diagnosis: Pregnancy
Management: 1. Confirm pregnancy with a urine or blood pregnancy test. 2. Provide counseling on options for pregnancy continuation or termination. 3. Refer to an obstetrician/gynecologist for further evaluation and prenatal care if the patient chooses to continue the pregnancy. 4. Offer contraceptive counseling and options for future family planning.
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Google Gemini AI
more than 4 weeks ago
Likely Diagnosis: Incomplete abortion
Management List:
- Emergency measures: - Ensure airway, breathing, and circulation (ABCs). - Establish intravenous (IV) access for fluid resuscitation and medication administration. - Monitor vital signs (pulse, blood pressure, temperature). - Control bleeding with IV fluids or blood transfusion if necessary.
- Medical management: - Uterotonic agents: Administer oxytocin or misoprostol to stimulate uterine contractions and expel the remaining fetal tissue. - Antibiotic prophylaxis: Prescribe antibiotics to prevent infection. - Anti-D immunoglobulin: Administer anti-D immunoglobulin to Rh-negative women to prevent Rh sensitization if fetal tissue is present.
- Surgical management: - Manual vacuum aspiration (MVA): Suction out the remaining fetal tissue using a suction curette under local anesthesia. - Cervical dilation and evacuation (D&E): Dilate the cervix and remove the fetal tissue using forceps or curettes.
- Follow-up: - Schedule a follow-up appointment to ensure complete evacuation and assess recovery. - Order lab tests to monitor hemoglobin levels and pregnancy hormone levels. - Provide counseling and support to the patient.