Dr. Nowlan, M.D., discusses which type treatment is most effective for first trimester pregnancy loss. 

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

A 28 year old woman comes into your community rural ED, only medical history is she had a baby 15 days ago.  Says she’s been feeling unwell for the past week and begins to seize - what do you do? 

A 32 year old female G3P2002 at 25 weeks gestation presents to the ED with progressively worsening dyspnea associated with pleuritic chest pain. You are concerned that this patient has a pulmonary embolism. All of the following may be appropriate diagnostic studies for this patient with the exception of:

A 21 year old female presents to the ED with vaginal bleeding. She reports that a home pregnancy test was positive this morning. A beta hcg quant level is drawn and pending. On ultrasound you identify an extrauterine gestational sac without an IUP.

A 28 year old female G2P0010 at 9wga by LMP presents to the ED with nausea and vomiting for the past 3 weeks. She reports that since she found out she was pregnant she has felt nauseated nearly every day. She comes to the ED today because she has begun vomiting and is unable to eat or drink much for the past week.

A 19 year old female presents to the ED with abnormal vaginal discharge for 5 days. She is sexually active with a new male partner and does not consistently use protection. A pelvic  exam reveals cervicitis. A vaginal GC swab is sent to the lab. Her urine hcg is negative. After discussing your concerns with the patient, she agrees to be empirically treated for GC infection today. She weighs 55 kg. What treatment regimen do you order?

A young female presents in your ED waiting area in active labor. What steps are you going to take to safely delivery the baby and prevent fetal and maternal complications? 

Dr. Manganiello covers the pearls regarding ovarian torsion.

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.