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EM@3AM: Endometritis

EMDocs

A) Administer ceftriaxone 500 mg IM and doxycycline 100 mg PO B) Consult OB/GYN for incision and drainage C) Establish IV access and administer clindamycin and gentamicin D) Prescribe doxycycline with metronidazole and ensure close OB/GYN follow-up Answer: C Most postpartum infections are identified after hospital discharge.

OB/GYN 64
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What's best: breast milk, bottle or a mix of both

Sensible Medicine

There is no credible evidence exclusive breast feeding improves ~ all long term health outcomes. Hospitals that use breastfeeding as a quality metric for OB/GYN are making an error. There is no credible evidence breast feeding improves IQ (even the one RCT that *spuriously* claimed this lost that claim in follow up).

OB/GYN 65
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Why Transplant Surgery?

SheMD

I grew up in Zimbabwe and when I was around 7 years old, a group from Loma Linda came to Zimbabwe to do pediatric congenital heart surgeries at Parirenyatwa Hospital. There are so many research opportunities in transplant- including basic science research, immunology, or studying outcomes. Becoming a surgeon was my ultimate dream.

OB/GYN 52
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Hysterectomy Complications

EMDocs

Operative complications requiring surgical intervention or hospitalization occur in about 3-6% of all hysterectomies (5). Once diagnosed the patient should be treated with broad-spectrum antibiotics and referred to OB/GYN for operative repair (6). Morbidity outcomes of 78,577 hysterectomies for benign reasons over 23 years.

OB/GYN 67
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SAEM Clinical Images Series: Unidentified Intrauterine Object

ALiEM

The risk of pregnancy with an IUD in place is <1%; according to a database of 18 million hospital deliveries, the reports of retained IUD at birth was 12 per 100,000 births. Pregnancy outcome in women with an intrauterine contraceptive device. For pregnancies with an IUD in place, the rate of ectopic pregnancy is higher.