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Paps , abortion, and vacuum delivery

Paps , abortion, and vacuum delivery. Katie ostrom. Pap smears. Start age 21 20’s: every 3 years 30’s: every 5 years + HPV screen Hysterectomy or >65: may stop unless history of CIN 2, 3, CIS or vaginal cancer. Abnormal pap results. Abnormal pap results.

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Paps , abortion, and vacuum delivery

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  1. Paps, abortion,and vacuum delivery Katie ostrom

  2. Pap smears • Start age 21 • 20’s: every 3 years • 30’s: every 5 years + HPV screen • Hysterectomy or >65: may stop unless history of CIN 2, 3, CIS or vaginal cancer

  3. Abnormal pap results

  4. Abnormal pap results *LEEP is Loop Electrical Excisional Procedure. 1 is OK but >1 or a Cold Knife Cone biopsy should have a cervical cerclage with future pregnancies.

  5. Paps in Pregnancy *Endocervicalcurrettage

  6. Abortion types • Threatened: bleeding + cramping • Cervix closed, + FHT, + bleeding • Inevitable: bleeding + cramping + cervix dilated • Cervix open, +/- FHT, + bleeding • Incomplete: cervix open, +/- FHT, + bleeding • Missed: cervix closed, - FHT, - bleeding

  7. Abortion testing • Blood type and Rh* • HCG: going up or down? • Progesterone level • Low with abnormal placentation • High may be OK *Major blood type incompatibilities between A, B, and O produce antibodies, as does Rh (+/- D protein on surface of RBCs). However, antibodies against D interact only with the surface antigens of fetal RBCs, and not all fetal tissue as in A, B, and O antibodies, thus causing much more damage and fetal anemia. RHOGAM is available to treat this.

  8. Abortion management *Mifepristone (anti-progesterone) + Misoprostol (prostaglandin) ** D&C using sonogram guidance and suction with sharp steel curettage at the end.

  9. Vacuum delivery If chin-posterior presentation, do C-section immediately.

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