Gynae – Induction

A 25-year old woman presents to the emergency department 3 days after a termination of pregnancy feeling unwell. On assessment by the triage nurse she is found to be hypotensive (BP 90/60 mmHg) and bradycardic (HR of 40 bpm), with continued vaginal bleeding. The patient is moved into resus as she appears grey and clammy with mottling of her hands and feet and a significantly prolonged peripheral capillary refill time. Once there, she receives a bolus of IV fluid, followed by O negative blood. After 30-minutes there is still no improvement. What diagnosis needs to be considered here?

A 28-year old woman presents to the ED. She is 20 weeks pregnant and has a 2-day history of vague lower and right sided abdominal pain. She has had some vomiting and has felt hot. There has been no PV bleeding or discharge. There have been no bowel or urinary symptoms. Her observations are 38.6, HR 110, BP 96/56, RR 20, Sats 98% on air. On examination there is diffuse lower abdominal pain which is worse on the right.  With some slight tenderness in the right upper quadrant. There is also a gravid uterus present. What diagnosis/diagnoses should be considered here?

A 31- year old woman who is 8 weeks pregnant, presents to the ED with 1 day of persistent vomiting (over 20 episodes). She is normally fit and well, and this is her first pregnancy. Her observations are normal. Other than the continued vomiting, her examination is unremarkable.  What tests are important to do in the ED to see if referral is warranted?

A 31- year old woman who is 8 weeks pregnant presents to the ED with a 1 day of persistent vomiting (over 20 episodes). This is her first pregnancy  and she is normally fit and well. She has +2 of Ketones in her urine, with a normal blood sugar level. You are keen to give her an antiemetic whilst she is awaiting her bed in the early pregnancy ward. She has not received any other medications for her vomiting and has no allergies.

Which of the following antiemetics can be considered as a first line option?