See rationale. This is my best attempt at a fix. Please lmk if I’m missing something regarding methylergonovine being the appropriate answer here! @AnKing-Maintainers
support, couldn’t find any specific discussion on Amboss but Uptodate agrees, assuming it is due to uterine atony
yes, but the card implies that it’s given prophylactically which is wrong.
@mohannadkh10 I did some research and completely agree. I changed “complete” to “incomplete or inevitable”. What do you think of the current formulation?
Changing:
- Drug to drug class
- Complete to incomplete
- And Methylergonovine to Uterotonic agents
Changes every aspect making it an entirely new card. I don’t this this is the right way to go about it.
True, definitely overhauls the whole thing. What would you suggest be the best way to go about it? Delete?
Also, while I do agree it changes the card significantly, I think that the spirit of the original card (that, in certain cases of spontaneous abortion, you can give uterotonic prophylaxis to decrease risk of hemorrhage), is preserved.
The card is wrong on so many levels that I’m struggling to think of a way to “right” the card without making significant changes.
@AnKing-Maintainers this card needs to change, one way or another. If anyone can think of a better/less invasive way to fix this card, I’m all ears!
I think these cards with relatively few cards are newer, sourced form BnB Step 2 - would see if we can try to find source to see what this was really getting at
Good idea! In the B&B video, Dr. Ryan says:
“A complete spontaneous abortion occurs when a woman has a documented intrauterine pregnancy and then develops bleeding and cramping, the cervical os has to be closed and there have to be no products of conception evident by ultrasound, even though the woman earlier had a documented intrauterine pregnancy. And then in addition to these items, there can’t be any evidence of ectopic pregnancy. So if a woman meets all of these criteria, then she is said to have had a complete spontaneous abortion. And the management in these cases is generally just supportive care. Sometimes antibiotics are given to prevent endometritis or infection. There’s a drug called methylergonovine which can be used. It causes uterine contractions, and this can lower the risk of small amounts of retained tissue or infection and so this is sometimes also administered.”
I guess this sheds some light on the issue. We could have the card read:
What drug can be given after a complete spontaneous abortion to decrease retained tissue and infection risk?
{{c1::Methylergonovine}}
Still though, this info from Dr. Ryan does not seem to be corroborated by UpToDate or AMBOSS…
Really appreciate you looking into this! Think that is a much better solution (and tbh very few people are ever seeing this card based on the way it is tagged)
Why not just delete the card? I understand it’s complicated, but since there are very few tags, why not either transform it into a more HY one or delete it entirely?
I think I agree with Mohannad here