Archive for category: Ob/Gyn

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 review […]

Usefulness of the Pelvic Examination in 1st Trimester Vaginal Bleeding

16 Oct
October 16, 2017

Background: First trimester vaginal bleeding is a common complaint seen in the emergency department.  Patients are obviously stressed about the possibility of miscarriage while providers are stressed about missing diagnoses such as ectopic pregnancies.  There have been multiple studies questioning the interrater reliability of the pelvic examination. A more important question however, is does the […]

The WOMAN Trial: Early TXA in Post-Partum Hemorrhage

22 May
May 22, 2017

Background: Post-partum hemorrhage (PPH) is the leading cause of maternal death worldwide. It is typically defined as > 500 ml of blood loss within 24 hours of giving birth. However, PPH encompasses a broad spectrum of disease from mild oozing over hours to rapid exsanguination and death. The burden of mortality from PPH is shouldered […]

Post Intubation Sedation for Pregnant Patients

10 Aug
August 10, 2015

You have just intubated a seizing eclamptic woman who is 34 weeks pregnant. As she is being prepped for transfer to the OB unit for an emergent C-section your nurse asks you what medications you would like for post intubation analgesia and sedation. You have limited recollection of whether Propofol crosses the placenta, and have […]

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