Article

Critical Obstetric and Gynecologic Procedures in the Emergency Department

Research Section, Department of Emergency Medicine, University of Puerto Rico, San Juan, PR, USA. Electronic address: .
Emergency medicine clinics of North America (Impact Factor: 0.78). 02/2013; 31(1):207-36. DOI: 10.1016/j.emc.2012.09.005
Source: PubMed

ABSTRACT

Obstetric and gynecologic emergencies are common reasons for emergency department visits. Therefore, emergency physicians must be proficient in the management and treatment of these emergencies. This article reviews critical procedures and provides an overview of each procedure and the indications, contraindications, technique, and potential complications.

0 Followers
 · 
16 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nurse practitioners (NPs) rarely undertake gynaecological histories or female genital examinations yet, by doing so, they can broaden their scope of practice. This article discusses what NPs should ask women about their gynaecological histories and how to undertake pelvic examinations, and reviews common gynaecological symptoms. Further articles will cover different aspects of the pelvic examination and potential differential diagnoses.
    No preview · Article · Sep 2013 · Emergency nurse: the journal of the RCN Accident and Emergency Nursing Association
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cysts and abscesses of the Bartholin glands are a common occurrence in gynecologic or general practice. Little is known about restrictions in patient's daily life and sexual activity during treatment of Bartholin's cysts in general and especially with the Word catheter. This study is to assess the Quality of Life and Sexual Activity during treatment of Bartholin cyst's and abscesses with the Word-catheter. Between March 2013 and May 2014 30 women were included in the study. Pain before treatment and during catheter insertion and removal was assed using a standardized VAS scale. Health-related quality of life was assessed with the Short-Form-12-Health-Survey. Fallowfield's Sexual Activity Questionnaire was administered to investigate sexual limitations. During treatment patient self-reported to a pain-diary (VAS 0-10). Pain levels decreased from a 3 [0-10] on day 1 to 0 [0-6] on day 6 with the median staying at 0 for the remaining treatment period. Discomfort and pain during sexual activity decreased significantly from initial presentation to end of treatment. The mental component summary score of the SF 12 increased significantly from 46.94±10.23 before treatment to 50.58±7.16 after treatment (p=0.016); the physical component summary score did not change significantly. The Word catheter is well tolerated for the treatment of Bartholin's cysts and abscesses with few and no serious side effects and little impingement of sexual health. A more relevant informed consent ahead of treatment, specifically with regard to pain in the first few days after catheter placement, might further increase acceptance of the catheter and adjust patient expectations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Mar 2015 · European journal of obstetrics, gynecology, and reproductive biology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objetivo: hacer una revisión de la literatura orientada a describir la anatomía quirúrgica, el diagnóstico y el manejo de las lesiones vulvares y perineales secundarias a trauma genital y perineal de alto impacto.Materiales y métodos: se presenta el caso de una adolescente de 15 años de edad, que presentó fractura inestable de pelvis, desgarro rectal y trauma vulvar, con destrucción de la anatomía del piso pélvico, atendida en una clínica privada de referencia de la cuidad de Bogotá (Colombia). Se realizó reconstrucción del piso pélvico por parte del servicio de ginecología de forma inmediata y manejo conjunto de las otras lesiones con cirugía general y ortopedia. Se hizo una revisión de la literatura registrada con los siguientes términos MeSH: heridas y traumatismos, vulva, genitales femeninos, lesiones y ginecología, en las bases de datos Medline vía PubMed, desde el año 1940 hasta el 2015; además, en EBSCO y Lilacs se buscaron artículos de revisión y reportes de caso publicados en inglés y español.Resultados: inicialmente se seleccionaron 20 estudios, de los cuales se descartaron 6 artículos en los que el principal objetivo era el manejo del trauma obstétrico, trauma por prolapso o trauma con mayor compromiso abdominal; quedaron 14 estudios. Tres de los casos reportados se describen en pacientes prepúberes, 9 en mujeres en edad reproductiva y 2 en posmenopáusicas por diferentes mecanismos de trauma. El diagnóstico se basa en la historia clínica y la exploración física. Las imágenes diagnósticas podrían ayudar a establecer la magnitud del daño pélvico. Se considera una emergencia quirúrgica; se debe hacer reparación de los músculos y nervios, y ligadura de vasos sangrantes, además de determinar la necesidad de derivación intestinal o urinaria.Conclusión: el trauma vulvar es una urgencia quirúrgica por las consecuencias de funcionalidad del tracto genitourinario y riesgo de contaminación o pérdida de tejido. La intervención debe ser oportuna y el manejo multidisciplinario. El abordaje que se realice va a depender de los hallazgos encontrados en el momento de la valoración y de las condiciones médicas asociadas.
    Preview · Article · Dec 2015 · Revista colombiana de obstetricia y ginecología