Threatened Abortion 
                                =================== 
þ Cervical Length
 - In late pregnancy, cervical length should be > 3 cm
 - < 2.5 cm is indication of likely preterm labor
 - can do US specifically to measure just cervical length
 - can also see thinning of cervix on US, another sign of preterm labor

þ Placenta Previa
 - leading cause of second- (14-26 weeks) and third-trimester bleeding
 - significant cause of mortality and morbidity
 - associated with older maternal age, multips
 - may self-correct if in early preganancy
 - recommendation is for no pelvic (OR rectal) in ED if known
   placenta previa; do exams in OR with double-setup (ready for
   c-section
 - in early pregnancy: pelvic rest until OB says it's OK.

þ Obtain:
 - Quantitative HCG
 - Blood Type (or document patient's type on chart)

þ General:
 - For any bleeding in pregnancy, threatened abortion, ectopic pregnancy,
   miscarriage, check Rh blood type.  If Rh-: give RhoGam 300 mcg. if second
   or third trimester. give "miniGam" (50 mcg.) if in first trimester. [but,
   note that the company has changed the packaging in about 2000 so that you
   can't give "miniGam" any more, so give full dose.]
 - 20% of bleeding episodes that occur during late pregnancy are
   caused by placenta previa.  A pelvic exam should not be
   performed in these cases until placenta previa is ruled out.
   If the condition is present, profuse bleeding can occur from
   the pelvic exam. Ref: Tintinalli 3rd ed. p 412.
 - Bleeding will occur in twenty to twenty-five percent of pregnancies.  Fifty
   percent of those patients will miscarry. Ref: Rosen 3rd ed. p 1975