O127 Scar Pregnancies: Early Diagnosis Allows Conservative Non Surgical Management (original) (raw)

International Journal of Gynecology & Obstetrics, 2012

Abstract

ABSTRACT S305 health for stabilizing patient before transfer to higher facility, they noted lack of knowledge to give the intervention, fear attitude recognizing the side effects of MgSO4, and lack of effort by midwife and the stakeholders to improve their skill competency to use the medicine as mentioned in the institutional guidelines. Care had barriers of limited drugs and availability of equipment and the efforts from health department to review the feasibility of the midwife practice were not been completely considered. The influence of social factors also contributed to the delay of management to transfer patient and the difficulty of midwife to make a clinical decision making. Conclusions: The case study highlights the complexities of barriers to optimize the utilization of MgSO4 in referral case from midwife in private practice to higher facilities. A better understanding of midwife clinical competency and standard obstetrics practice to facilitate management of preeeclampsia should be the main focus intervention by stakeholders to improve the midwife capacity in translation the evidence of clinical practice. Objectives: Scar pregnancy is an ectopic pregnancy with a peculiar localization of placenta on/in previous hysterotomy site. Scar pregnancy could be cause of placenta accreta, uterine rupture, massive hemorrhage and so on. Early diagnosis of abnormal localization could preserve the woman from dangerous and life-threatening complications and her fertility as well. Transvaginal sonography performed in first trimester can identify scar pregnancies. Materials: Between 2009 and 2011 we diagnosed 16 scar pregnancies by transvaginal and transabdominal sonography, all of these patients had at least 1 previous caesarean section. Methods: Diagnostic criteria we look for are (fig. 1): an intrauterine gestational sac with localization on the anterior uterine wall, at internal orifice, thinnening of myometrial layer, defect of decidua basalis between placenta and myometrium and abnormal placental vascularization. Our purpose was to identify as soon as possible scar pregnancies in order to reduce maternal morbidity and mortality. Figure 1.

Laura Giambanco hasn't uploaded this paper.

Let Laura know you want this paper to be uploaded.

Ask for this paper to be uploaded.