Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with vaginal bleeding and pelvic cramping following a known or suspected pregnancy. Reports passage of tissue per vagina. Quantify bleeding (number of pads/hr), presence of clots, and severity of pain. Denies fever, chills, or foul-smelling discharge. LMP: [Date]. Gestational age: [Weeks].
Clinical Examination Findings
Vitals: Stable/Unstable. Abdominal exam: Soft, non-distended, mild suprapubic tenderness, no rebound or guarding. Pelvic exam: Speculum reveals blood/tissue at the external os. Bimanual exam: Uterus is smaller than expected for gestational age, firm, slightly tender; cervical os is open. Adnexa: Non-tender, no masses palpated.
Treatment Protocol
Plan: 1. Confirm diagnosis via transvaginal ultrasound (retained products of conception). 2. CBC, Rh typing, and blood type. 3. Management options: Expectant management, medical evacuation (Misoprostol), or surgical evacuation (D&C/MVA). 4. Administer Rho(D) immune globulin if Rh-negative. 5. Antibiotic prophylaxis if indicated.