Imaging for Appendicitis in Pregnancy

Imaging for Appendicitis in Pregnancy

In a pregnant patient presenting with abdominal pain and suspected appendicitis, an initial ultrasound should be performed to exclude obstetric causes for abdominal pain. MRI may be a reasonable next study if it is immediately accessible and radiologists with expertise in MRI interpretation are available. Otherwise, CT should be utilized.

New IDSA Guideline on Asymptomatic Bacteriuria

New IDSA Guideline on Asymptomatic Bacteriuria

The IDSA now only recommends screening for and treating asymptomatic bacteriuria (ASB) in pregnant women and those undergoing an invasive urologic procedure.

Can We Use Ondansetron In Pregnancy?

Can We Use Ondansetron In Pregnancy?

In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).

Forget the Blood Patch? A Medical Option That Works

Forget the Blood Patch? A Medical Option That Works

Administration of neostigmine and atropine vs placebo, in addition to usual care for post-dural puncture headache (PDPH), was highly effective in this RCT involving healthy postpartum women.

What Is a Normal Platelet Count In Pregnancy?

What Is a Normal Platelet Count In Pregnancy?

There is a normal drop in platelet count during pregnancy.  In the first trimester, the normal count is around 250,000 and decreases to about 225,000 at delivery.  Platelet counts <100,000 were rarely encountered in normal, uncomplicated pregnancies and should not generally be considered a physiologic change.

Acetaminophen 3rd Trimester and Ductal Closure

Acetaminophen 3rd Trimester and Ductal Closure

Acetaminophen use during late pregnancy was associated with premature ductus arteriosus closure in these two cases.

Better Medical Miscarriage Treatment

Better Medical Miscarriage Treatment

In women with confirmed first trimester pregnancy loss, the combination of mifepristone 200mg orally and misoprostol 800μg vaginally at 24 hours vs misoprostol 800μg alone resulted in improved complete expulsion at day 8 (NNT = 6) and decreased need for surgery: 9% vs 24%.

Low-Dose Perfusion or CTPA for PE in Pregnancy?

Low-Dose Perfusion or CTPA for PE in Pregnancy?

Low dose perfusion-only (LDQ) nuclear scan (the "Q" of the V/Q scan) or CTPA are the imaging studies of choice to diagnose PE in pregnant women.  LDQ (using one-third the normal technetium) had high accuracy and lower radiation dose and may be preferred over CTPA, assuming the CXR is normal.

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