OBGYN

A 24-year-old female G4P1 who is 9 weeks pregnant presents with abdominal pain and vaginal bleeding for 3 days. Vital signs include HR 115, BP 100/76, T 38.7, RR 13, SpO2 99% on RA. She is ill-appearing and has tenderness to palpation of the bilateral lower quadrants and suprapubic region. Pelvic exam reveals blood in the vaginal vault and foul-smelling discharge from the cervix with no other abnormalities. What is the likely diagnosis?

We’re back with myths and misconceptions in ectopic pregnancy testing, focusing on urine and serum β-hCG and ultrasound.

This podcast evaluates myths and misconceptions in ectopic pregnancy, focusing on risk factors, history, and exam. 

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.