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Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience  arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number.  To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Retained Products of Conception (RPOC) (677)

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The term retained products of conception (RPOC) refers to placental and/or fetal tissue that remains in the uterus after a spontaneous pregnancy loss (miscarriage), planned pregnancy termination or preterm/term delivery. The presence of RPOC after a spontaneous pregnancy loss distinguishes a complete from an incomplete miscarriage.

Signs of RPOC

The characteristic clinical manifestations of RPOC may include heavy or prolonged uterine bleeding and pelvic pain. Signs of infected RPOC can commonly include pyrexia, offensive discharge or uterine tenderness.

Diagnosis

RPOC are diagnosed by ultrasound. Patients should have a transvaginal scan to assess RPOC unless the patient declines. On scan, the presence of hyperechoic material within the endometrium is suggestive of evidence of RPOC. A thickened endometrium alone is not a predictor of RPOC.

Management

Any patient haemodynamically unstable or clinically unwell requires urgent medical review.

Perform speculum examination to assess bleeding and look for RPOC where there is moderate or heavy bleeding.

NICE Guidelines recommend that if bleeding is not heavy and women are clinically stable, all women wait 7 days and rescan undertaken before undergoing active treatment, if previous scan has identified an intrauterine pregnancy.

Patient to call EPAS if:

  • Bleeding fails to settle after 3 complete weeks from being diagnosed, even if pregnancy test negative. (Requires rescan)
  • If pregnancy test remains positive after 3 weeks. (Requires rescan + HCG)
  • If signs of infection present e.g. raised temperature, foul smelling discharge, generally feeling unwell. (Requires rescan and infection screening)

Antibiotics should not routinely be prescribed unless there are signs of infection (offensive vaginal discharge / pyrexia / raised WCC/CRP).

It is also important to use the flow-chart as a guide Other factors such as amount of bleeding, time-frame, etc. must also be taken into account with individualised care plans be made for some patients.

Editorial Information

Last reviewed: 01/08/2019

Next review date: 31/03/2024

Author(s): Emily Smith.

Approved By: Gynaecology Clinical Governance Group

Document Id: 677