OBGYN

How can you use POCUS to evaluate for retained products of conception?

 A 22-year-old female presents with three days of vaginal bleeding. She has soaked through multiple pads and has passed clots. She endorses some lightheadedness but no syncope. Her last period was two weeks ago. She has no known past medical history, does not use hormonal contraception, and is sexually active with one male partner. On exam, she is stable, and her abdomen is soft and non-tender. The speculum exam reveals blood in the vaginal vault that appears to be coming from the cervical os. Her urine pregnancy test is negative. What is your next step in evaluation and treatment?

What do you need to know about hysterectomy complications?

The emDOCs podcast is back! This week we cover ovarian torsion and several myths.

A 36-year-old female presents to the ED with vaginal pain. She initially noticed a small bump one week ago that was only painful with sexual intercourse, but it has grown and now causes discomfort even when walking. Her temperature is 98.9oF, heart rate 78, and blood pressure 126/84. On exam she has a large, soft mass protruding at the 8 o’clock position of the vaginal opening that is painful and fluctuant to touch. There is some induration around the mass, but no vaginal discharge is noted on the pelvic exam. What is most likely causing this woman’s pain? How would you manage this diagnosis to provide some relief?

Today’s emDOCs cast is the second in a series on post abortion complications. This podcast looks at incomplete abortion and retained products of conception, complications of medical abortion, trauma and perforation, drug toxicity, and amniotic air embolism.

Today the emDOCs cast covers the first in a series on post abortion complications. Today’s podcast looks at abortion categorization, epidemiology, bleeding, and infection.

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER) Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed. This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy! Case 1: A 25-year-old female presents 4 days after vaginal delivery saying she has felt unwell. When asked further, she has experienced nausea, myalgias, and fever. On abdominal examination, she has significant periumbilical and suprapubic tenderness.   Case 2: A 33-year-old female presents 2 days after C-section with fever.  She is tachycardic, tachypneic, hypotensive, and febrile.   Considerations: What are the causes of postpartum fever? What is the approach to identifying the source of postpartum fever? What are the risk factors for endometritis? How do patients with endometritis present? What is the ED evaluation? What is the ED management?   Suggested Resources: Articles emDocs Radiopaedia WikEM Journal Articles EM Clinics North America Stat Pearls

This week’s podcast with Tim Montrief and Brit Long covers a complication of assisted reproductive technology: ovarian hyperstimulation syndrome.

This week’s podcast covers pearls and pitfalls of ectopic pregnancy.