As EM physicians, we receive training in obstetrics. While most of us don't walk into a shift *hoping* for a delivery, we are trained to handle these cases if the present. Postpartum hemorrhage can be a complication of even a "normal" delivery. Read on below for some pearles regarding how to manage a postpartum hemorrhage.
You're working in your new hospital without ObGyn coverage and your triage nurse informs you that "there is a woman bleeding up front...she looks pregnant." You begin to run a differential through your head of what that problem could be. Read on below for diagnoses to consider.
A 29-year-old woman presents for heavy vaginal bleeding. She is hemodynamically stable. She had an uncomplicated vaginal delivery of a full-term baby 1 week ago. She denies fever or pain. There is active bleeding from the os. No cervical motion tenderness or signs of trauma or foul-smelling discharge. What is the most likely diagnosis?
A. Uterine Atony
B. Retained products of conception
C. Cervical Trauma
A very gravid patient arrives in your ED after sudden cardiac arrest. You begin to panic as you wonder what differences you need to consider for a pregnant patient in cardiac arrest. Lucky for you, you are an avid EM Daily reader!