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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

One of my mentors likens transplant surgery to OB/GYN because these are the only specialties where patients are happy to come to the hospital, our unpredictable hours are similar, and we get to witness new life. There are so many research opportunities in transplant- including basic science research, immunology, or studying outcomes.

OB/GYN 52
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Visually Guided Uterine Biopsies in Physician’s Office: Interview with Allison London Brown, CEO of LUMINELLE

Medagadget

This leads to suboptimal outcomes, and the frequent need to repeat the biopsy procedure because the first attempt did not yield an adequate sample. And this blind approach results in flawed outcomes. Again, this blind approach results in flawed outcomes. A suction curette can only sample 4% of the uterus. scissors, graspers).

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Hysterectomy Complications

EMDocs

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. If the top of the pouch is opening at any point this is concerning for dehiscence. 2020 Sep;127(10):1269-1279.

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

ALiEM

Pregnancy outcome in women with an intrauterine contraceptive device. References ACOG Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol. 2011 Jul;118(1):184-196. doi: 10.1097/ AOG.0b013e318227f05e. 0b013e318227f05e. PMID: 21691183. Ganer H, Levy A, Ohel I, Sheiner E.