Dangers we cannot miss if we see a pregnant woman (>20 weeks) with vaginal bleeding!

A 34-year-old woman at 32 weeks gestation presents to the emergency department with cough, dyspnea and hypoxemia. She rapidly progresses to severe ARDS despite lung protective ventilation, paralysis and inhaled epoprostenol. P/F ratio is 99 mm Hg. Is prone positioning safe to perform in pregnant patients with severe ARDS? If so, are modifications necessary to offload the abdomen and monitor the fetus? A recently published review in Obstetrics and Gynecology discusses this important topic. 

A 36-year-old woman presented to urgent care with cough, dyspnea and hypoxemia. She was transported to the ED where she rapidly progressed to severe ARDS despite lung protective ventilation, paralysis and inhaled epoprostenol. Post-intubation, it was determined that she was pregnant with ultrasound revealing a fetus at 23 weeks, 6 days gestational age. She underwent cannulation for venovenous ECMO. What is the role of ECMO in the pregnant patient? A recently published analysis of the ELSO registry for peripartum patients supported with ECMO demonstrates a 70 percent survival rate. 

Postpartum hemorrhage is the leading cause of maternal death worldwide.  Here is a great review for management by the ED doc by Stacy Marshall, MD.

The nurse calls you to the room of a 34 year old crashing patient....and she happens to be pregnant.  Here are the pearls for resuscitation and management of the critically ill pregnant patient. 

Not quite seeing that crisp yolk sac on traditional trans-abdominal ultrasound imaging with the curvilinear probe? Click ahead for a cool trick to avoid breaking out the trans-vaginal probe!

A pregnant female presents with "damp" underwear upon awakening.  How do you know if she has ruptured her membranes?

Delivering a baby in the emergency department is far from ideal and although all usually goes well, you need to be prepared in case it doesn’t. Shoulder dystocia gets a lot of hype because of those fancy corkscrew maneuvers, so instead of that we’re going to talk about another dreaded complication, post-partum hemorrhage.