ABC of Antenatal Care by Geoffrey Chamberlain

By Geoffrey Chamberlain

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

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Ectopic pregnancy should always be considered in any cases of lower abdominal pain because an unruptured ectopic pregnancy, leaking a little blood over the course of some days, is hard to diagnose. A negative routine pregnancy test is not exclusive; it is usually positive. 8 The most common ectopic pregnancies are in the fallopian tube. (A) Those at the medial end rupture. 2 Symptoms and signs of ectopic pregnancy Unruptured Ruptured Symptoms Gradual onset Dull ache over days Signs No shock Vague suprapubic tenderness No great cervical tenderness Vague mass often felt Sudden onset Severe pain over minutes Commonly shocked Rigid abdomen with rebound tenderness Extreme tenderness on cervical movement Too tender to palpate Management The management of a woman with a ruptured ectopic pregnancy is straightforward.

This is particularly important when a woman has had a previous ectopic pregnancy and one fallopian tube has already been removed. A leaking tubal pregnancy is harder to diagnose, such cases being usually referred to outpatient departments in a more leisurely fashion. 2 At laparoscopy the swollen area of the tube can usually be seen and little blood may come from the lateral end. Under ultrasound guidance, injections of fetotoxic agents such as methotrexate or potassium chloride are given. Alternatively, some, having made a firm diagnosis of ectopic pregnancy by a raised hCG, an empty uterus, and ultrasound evidence of fluid in the pouch of Douglas, will treat the woman conservatively if the ectopic is unruptured.

When the woman becomes pregnant she receives maternity benefits, but these are poor compared with those in other European countries and income will be reduced. Every woman is entitled to 18 weeks of maternity leave. 20, going up to £75 per week in 2002 and £100 in 2003, hence the total standard maternity pay is for 18 weeks for those who have worked before pregnancy. Maternity allowance is separate and may be claimed. 20 a week for women who are employed in pregnancy. There are no deductions for tax or National Insurance contributions.

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