O&G Cases · Gynae-surgery — early pregnancy and abortion care
Septic miscarriage — emergency management station
Team-based emergency station: septic miscarriage with haemodynamic compromise. Tests the sepsis six, source control by evacuation, antibiotic choice, anti-D, and the decision to operate after rather than during resuscitation. Includes assessor key and marking domains.
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Station brief
Format. Emergency management station, approximately 12 minutes. You are the gynaecology registrar in the emergency department. A nurse and a junior doctor are with you; the consultant is 15 minutes away and has been called. The assessor runs the clock and feeds new observations. [1]
Candidate instruction. Lead the resuscitation and source control of septic miscarriage. Verbalise your actions, your drug orders with doses, your escalation triggers, and your communication with the team, the consultant and the woman. [1][2]
References4ShowHide
- [1]Coomarasamy A, Gallos ID, Papadopoulou A, et al. Sporadic miscarriage: evidence to provide effective care Lancet, 2021.PMID 33915095
- [2]Lissauer D, Wilson A, Hewitt CA, et al. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery N Engl J Med, 2019.PMID 30865795
- [3]Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn Transfus Med, 2014.PMID 25121158
- [4]H Al Wattar B, Murugesu N, Tobias A, et al. Management of first-trimester miscarriage: a systematic review and network meta-analysis Hum Reprod Update, 2019.PMID 30753490