Summary Writer: Jessica Tong
Editor: James Edwards
Interviewee: Neil Campbell
James talks to Dr Neil Campbell about bleeding in early pregnancy.
Neil is a part time Staff Specialist at Royal Prince Alfred Hospital and Visiting Medical Officer at the Mater hospital and North Shore Private Hospital in Sydney. He practices both Obstetrics and Gynaecology but completed a two year additional Fellowship in minimally invasive Gynaecological surgery. Neil is involved with a number of clinics at Royal Prince Alfred Hospital including the Early Pregnancy service and also runs the Abnormal Uterine Bleeding clinic specialising in the management of menstrual disorders and fibroids.
With Dr Neil Campbell, Staff Specialist in Obstetrics & Gynaecology at Royal Prince Alfred Hospital, New South Wales, Australia
Case – 30 year old woman presents to the ED 6 weeks gestation with PV bleeding
If haemodynamically unstable, move the patient to the resuscitation bay, stabilise and implement resuscitative measuresGet IV access and order bloods including group & hold ± cross-match, FBC, β-hCG, progesterone.
If haemodynamically stable, take a thorough history and perform a clinical examination, before ordering relevant investigations and contacting the appropriate personnel.
*If uncertain with performing a speculum examination, it would be advisable to ask a more senior medical officer to supervise.
Ultrasound is a good initial screening tool when combined with a β-hCG level and clinical suspicion for an ectopic pregnancy.
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