Archive for category: Ob/Gyn

D-Dimer in Pregnancy: Limiting Radiation with Pre-test Probability

29 Nov
November 29, 2018

Background: Pulmonary embolism is the leading cause of death in pregnancy and the puerperium – accounting for nearly 20% of maternal deaths in the United States – making rapid and accurate diagnosis critically important for emergency physicians, OB/GYNs, and all who take care of these women on a regular basis. Diagnosis is made more difficult […]

Is Macrobid Safe in 1st Trimester Pregnancy?

23 Jul
July 23, 2018

Background: In 2011, the American College of Obstetricians and Gynecologists (ACOG) released a committee opinion warning against the use of nitrofurantoin (Macrobid) during the first trimester of pregnancy due to the perceived risk of an increased rate of congenital abnormalities with its use (Committee Opinion 2017). While the committee continued to recommend that nitrofurantoin be […]

D-Dimer and Pregnancy: The DiPEP Study

19 Mar
March 19, 2018

Background: Pulmonary embolism is the leading cause of death in pregnancy and the puerperium – accounting for nearly 20% of maternal deaths in the United States – making rapid and accurate diagnosis critically important for emergency physicians, OB/GYNs, and all who take care of these women on a regular basis. Unfortunately, typical diagnostic pathways and […]

Post-Partum Hemorrhage

15 Jan
January 15, 2018

Definition: Blood loss > 500 ml after a delivery (or > 250 ml after an abortion). The management of post-abortion hemorrhage is similar to that of post-partum hemorrhage (PPH). Causes Uterine atony (~ 50% of cases) Retained products of conception (POCs) Cervical lacerations Uterine perforation Uterine Inversion Abnormal placentation (accreta, increta, percreta) Coagulopathy Background: Occurs […]

It’s Time for Tranexamic Acid (TXA) in Massive Hemorrhage

20 Nov
November 20, 2017

Background: Bleeding from massive hemorrhage in trauma and post-partum are a major cause of death worldwide. There have been two large randomized controlled trials, in trauma and post-partum hemorrhage that have shown administration of TXA within 3 hrs of bleeding onset reduces death due to bleeding. The current meta-analysis that we are going to best […]