OB/GYN – Page 2 – JournalFeed

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Postpartum hemorrhage is defined as ≥1000mL of blood loss irrespective of the delivery route, with associated shock. Remember the four “T’s”: tone (uterine atony), trauma (lacerations, uterine rupture), tissue (retained placenta, clots) and thrombin (coagulopathies). Manage the ABCs (especially two large bore IV’s for massive transfusion) and tailor treatment to the specific cause. Recommendations for balanced transfusion are derived from the trauma literature, but it is important to administer cryoprecipitate earlier to maintain a higher fibrinogen level (at term the normal level is >350mg/dL).

May 10 2021

New Treatment for PID – Should We Add Metronidazole?

Infectious Disease, OB/GYN, Pharmacy/Pharmacology

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Adding metronidazole to the current IDSA regimen of ceftriaxone (CTX) and doxycycline for outpatient pelvic inflammatory disease treatment is generally well tolerated and associated with less-frequent recovery of anaerobic organisms and improved clinical response compared to CTX and doxy.

Jan 7 2021

New Regimen for Gonorrhea and Chlamydia

Infectious Disease, OB/GYN

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The new regimen for treating gonorrhea is ceftriaxone 500mg IM, and in patients with unknown chlamydia status, add doxycycline 100mg po bid x 7 days.

Jun 16 2020

Fluconazole During Pregnancy – Is It Safe?

OB/GYN, Pediatrics, Pharmacy/Pharmacology

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Even at the usual low dose for vulvovaginal candidiasis, fluconazole was associated with an increased risk of musculoskeletal malformations when given in the first trimester. Higher doses were associated with an even greater risk.

May 15 2020

Should We Rethink Pregnancy-Adapted YEARS Criteria?

Hematology/Oncology, OB/GYN, Venous Thromboembolism

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Had the pregnancy-adapted YEARS algorithm been applied in the DiPEP population, it would have missed a significant number of PEs. But there are several limitations to this study.

Jan 24 2020

A New Way to Do Lumbar Puncture?

OB/GYN, Pain/Sedation/Procedure

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style=”white-space:pre-wrap;”>The SAIL technique* was superior to the usual landmark using the intercristal line to find the L4-L5 interspace in pregnant patients.

Aug 16 2019

Imaging for Appendicitis in Pregnancy

Imaging, OB/GYN, Surgery

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.

May 20 2019

New IDSA Guideline on Asymptomatic Bacteriuria

Hematology/Oncology, Infectious Disease, Medicine/Geriatrics, OB/GYN, Pediatrics, Pharmacy/Pharmacology, Renal, Urology

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

May 10 2019

Counterpoint: Pelvic Exam Is Necessary

Infectious Disease, OB/GYN, Pediatrics, Retail/Urgent Care

This letter to the editor presents compelling reasons why a pelvic exam is needed to diagnose cervicitis or pelvic inflammatory disease.

May 3 2019

PE in Pregnancy – YEARS Algorithm

Imaging, Landmark, OB/GYN, Venous Thromboembolism

The Pregnancy-Adapted YEARS Algorithm safely and accurately ruled out pulmonary embolism (PE) for pregnant patients and reduced the rate of CT pulmonary angiography (CTPA) across all trimesters.