Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:57

1204 Pregnancy Complications for the Internist Pressure Ulcers

➣Cornual ectopic: cornual resection vs hysterectomy+/– metho-

trexate prior

➣Ovarian ectopic: partial vs complete oophorectomy

➣Cervical ectopic: cone of cervix vs hysterectomy; uterine artery

embolization or methotrexate prior to surgery possible

➣Abdominal pregnancy: 10% fetal salvage rate, placenta can be

removed later, after cessation of function by beta-HCG

➣Preeclampsia, preterm labor or preterm membrane rupture –

Seek specialized obstetrical consultation

specific therapy

n/a

follow-up

■Rh (–) with (–) antibody screen:

➣50 mcg RhoGAM IM for ectopic and <12 wks gestation

➣300 mcg RhoGAM IM I >12 wks

complications and prognosis

■Persistent GTN requires chemotherapy

■Infertility in ectopic pregnancies, infectious complications

PRESSURE ULCERS

JEFFREY P. CALLEN, MD

history & physical

History

■Also known as decubitus ulcer

■Due to pressure often associated with bedridden or wheelchair-

bound patient

■Friction, moisture may contribute.

Signs & Symptoms

■Ulceration over the sacrum, coccygeal, ischial tuberosities or greater

trochanter

■Begins as an erythematous, induration

■Ulcer may be very deep.

tests

■Basic tests: none needed

■Imaging studies – Radiographs to rule out osteomyelitis