Obstetrics/Gynecology

Board Review: OB/GYN

A 26 year old female at 40 weeks gestation presents to your emergency department in labor.  During the delivery you notice retraction of the fetal head against the maternal perineum and are unable to deliver either shoulder.  Which of the following steps below should be performed first?

  1. Suprapubic pressure with flexion of hips 
  2. Episiotomy 
  3. Rotate mother to prone position 
  4. Cephalic replacement 
  5. Intentional clavicle fracture 
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Advanced Practice: Vaginal Cuff Dehiscence and Evisceration

Vaginal Cuff Dehiscence and Evisceration After Total Hysterectomy

Incidence of vaginal cuff dehiscence after hysterectomy ranges from 0.14-4.1%.

Risk factors include post-operative infection, radiotherapy, chemotherapy, early return to sexual intercourse, constipation

Surgical emergency with risk of bowel necrosis.

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Back to Basics: Postpartum Hemorrhage

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.

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Back to Basics: Vaginal Bleeding in Late Pregnancy

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.

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Board Review: OB/GYN

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

D. Endometritis 

 

 

 

 

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Advanced Practice: Supportive Management of Critical Illness in Pregnancy

The nurse calls you to the room of a 34 year old crashing patient....and she happens to be pregnant.  Here are the pearls for resuscitation and management of the critically ill pregnant patient. 

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