Archive for category: Ob/Gyn

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 […]

Is Pelvic Exam in the Emergency Department Useful?

30 Jan
January 30, 2014

Women with undifferentiated abdominal pain and/or vaginal bleeding commonly present to the emergency department.  Many textbooks advocate for the pelvic exam as an essential part of the history and physical exam. Performance of this portion of the exam is time consuming to the physician and uncomfortable for the patient. It is with great regularity that […]

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