Ob/Gyn

Critical Care Transport: Blunt Polytrauma in Pregnancy

Emma Rolf^*, Samuel Kefer, MD^{^}, Jennifer Quinn, BSN, RN^†, Ryan Newberry, DO^{^}^†, Andrew Cathers, MD^{^}^†, Craig Tschautscher, MD^{^} and Brittney Bernardoni, MD^{^}^†

DOI: https://doi.org/10.21980/J81366 Issue 10:3 No ratings yet.

At the completion of this simulation participants will be able to 1) perform primary and secondary trauma surveys, 2) assess the neurovascular status of a tibia/fibula fracture, 3) appreciate anatomic and physiologic differences in pregnancy, 4) appropriately order analgesia and imaging, 5) recognize and treat hemorrhagic shock, 6) perform an extended focused assessment with sonography in trauma exam (eFAST) in undifferentiated hemorrhage, 7) identify a displaced pelvic fracture and properly apply a pelvic binder, and 8) obtain and interpret fetal heart rate using ultrasound.

Posterior Reversible Encephalopathy Syndrome and Eclampsia

Kristina Jacomino, MD^*, Kevin Tomecsek, MD^*, Andrew Little, DO^* and Mary Mclean, MD^*

DOI: https://doi.org/10.21980/J8H64T Issue 10:3 No ratings yet.

At the end of this oral boards session, examinees will be able to: 1) demonstrate familiarity with the structured interview oral board format and case play; 2) recognize the history and exam features concerning for PRES and eclampsia; 3) order appropriate diagnostic workup for postpartum and hypertensive emergencies including eclampsia and PRES; 4) understand treatment options for the management of eclampsia (intravenous [IV] magnesium sulfate, IV antihypertensive therapy, and emergent consultation with an obstetrician [OB/GYN]); 5) understand threshold for taking control of airway in patients with eclampsia; 6) understand indications for ordering brain imaging in patients with eclampsia and altered mental status; and 7) demonstrate effective communication with treatment team/family members as well as correct disposition of the patient to a higher level of care (intensive care unit [ICU]).

Current Issue Neurology Ob/Gyn Oral Boards

Vulvar Hematoma. CT Coronal Unannotated. JETem 2024

Computed Tomography Findings in Non-Obstetric Vulvar Hematoma: A Case Report

Eleanor M Birch, MD, MPH^*, Theodore McClean, MD^* and Scott Szymanski, MD^*

DOI: https://doi.org/10.21980/J8194H Issue 9:4 No ratings yet.

Bedside ultrasound was first used to evaluate for evidence of abscess or cyst formation. Ultrasound demonstrated a hypoechoic area within the right labia without evidence of a cyst or abscess wall. Based on these findings, an angiogram CT of the pelvis was obtained which revealed a vulvar hematoma with evidence of active arterial extravasation. In both the coronal and axial view, there is an asymmetric area of isodensity in the right labia representing a hematoma (blue circled area). Angiography may show areas of active extravasation, which appears as hyperdensity within the area of hematoma (see red arrow in coronal plane).

Visual EM Ob/Gyn

High-Fidelity Simulation with Transvaginal Ultrasound in the Emergency Department

Levi Filler, DO^* and Katrina Lettang, MD^*

DOI: https://doi.org/10.21980/J8606Q Issue 9:3 No ratings yet.

By the end of the session, learners should be able to 1) recognize the clinical indications for transvaginal ultrasound in the ED, 2) practice the insertion, orientation, and sweeping motions used to perform a TVPOCUS study, 3) interpret transvaginal ultrasound images showing an IUP or alternative pathologies, and 4) understand proper barrier, disinfection, and storage techniques for endocavitary probes.

Ob/Gyn Procedures Simulation

Septic Abortion Complicated by Disseminated Intravascular Coagulation

Lauren Moore, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8GH1G Issue 9:2 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) Obtain a relevant focused history including pregnancy history, medication use, and past medical history. 2) Develop a differential for fever and vaginal bleeding in a pregnant patient. 3) Discuss management of septic abortion, including empiric broad-spectrum antibiotics and obstetric consultation for source control with dilation and curettage (D&C). 4) Discuss expected laboratory findings of disseminated intravascular coagulation (DIC). 5) Discuss management of DIC, including identification of underlying etiology and supportive resuscitation with blood products. 6) Review the components of blood products. 7) Identify appropriate disposition of the patient to the intensive care unit (ICU).

Hematology/Oncology Infectious Disease Ob/Gyn Simulation

Iatrogenic Uterine Perforation. US Unannotated. JETem 2024

Vaginal Bleeding Due to Iatrogenic Uterine Perforation – A Case Report

John Costumbrado, MD^{*^}, Leah Snyder, MD^{^}, Sassan Ghassemzadeh, MD^{*^} and Daniel Ng, MD^{*^}

DOI: https://doi.org/10.21980/J83643Issue 9:2 No ratings yet.

The bedside transabdominal US of the pelvis showed a heterogeneous mixture of hypoechoic and hyperechoic endometrial thickening extending to the lower uterine segment (blue arrow), which was thought to represent active hemorrhage. Computed tomography of the abdomen and pelvis showed evidence of a large amount of endometrial hyperdensity (red arrow) suggestive of hemorrhagic contents within a grossly enlarged uterus. There was relative decreased enhancement of the uterine body and fundus, concerning for devascularization. There was also active extravasation along the left lateral uterus (yellow arrow).

Visual EM Ob/Gyn

A Homemade, Cost-Effective, Realistic Pelvic Exam Model

Jessie Godsey, MD^*, Ilya Kott, MD^*, Adrienne Payden^* and Patricia Ward^*

DOI: https://doi.org/10.21980/J8HM0F Issue 8:3 No ratings yet.

After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy.

Procedures Innovations Ob/Gyn

Peripartum Cardiomyopathy

Victoria L Morris, MD^*, Carolina Mendoza, MD^*, Gowri S Stevens, MD^*, Jessica L Wilson, MD^*and Adeola A Kosoko, MD^*

DOI: https://doi.org/10.21980/J8ZS9M Issue 8:2 No ratings yet.

By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy.

Cardiology/Vascular Ob/Gyn Simulation

Point-of-Care Ultrasound to Diagnose Molar Pregnancy: A Case Report

Katherine Wietecha, MD^*, Caitlin A Williams, MS^{^}and Valori Slane, MD^*

DOI: https://doi.org/10.21980/J82W7T Issue 7:2 No ratings yet.

A transabdominal point-of-care ultrasound (POCUS) was initiated to determine whether an abnormality to the pregnancy could be identified. Curvilinear probe was used. Our transabdominal POCUS, in the transverse plane, showed a heterogenous mass with multiple anechoic areas in the uterus. The white arrow on the ultrasound identifies these findings. The classic “snowstorm” appearance was concerning for molar pregnancy.

Ob/Gyn Visual EM

Syncope Due to a Ruptured Ectopic Pregnancy

Derek JC Hunt, DO^*, Kevin McLendon, DO^* and Jodi Conrad, DO^*

DOI: https://doi.org/10.21980/J86M0N Issue 7:1 No ratings yet.

At the conclusion of this simulation, the learner will be able to: 1) review the initial management of syncope; 2) utilize laboratory and imaging techniques to diagnose a ruptured ectopic pregnancy; and 3) demonstrate the ability to resuscitate and disposition an unstable ruptured ectopic pregnancy.

Ob/Gyn Simulation