Managing Postpartum Complications in the Emergency Department

Show Notes

• Why is this an important topic in EM? 
• Hemorrhage etiologies and definition
• Headache etiologies, both common and the more dangerous (ICH)
• Fever and infection
  • Mastitis
  • Endometritis
• Preeclampsia/eclampsia
  • Definition, diagnosis, risk factors (Table 1)
• HELLP syndrome
  • Definition, diagnosis (Table 2)
• Peripartum cardiomyopathy
  • Time of onset, how to make the diagnosis, risks (Table 3)
• Prehospital care
  • IV fluids
  • TXA
  • AMS evaluation
  • Chest pain
  • Fever/hypotension 
• ED evaluation
  • History (what kind of things should we remember to ask?) 
  • Physical exam (what should we be paying attention to?) 
• Diagnostic studies
  • Hemorrhage (exam, vitals, labs, US)
  • Headache (labs, imaging – what type?)
  • Fever and infection (labs, imaging – US or CT, antibiotics)
  • Cardiopulmonary complaints (labs, imaging, ECG)
• Treatment
  • Hemorrhage 
  • Headache (CVT)
  • Infection (mastitis, endometritis, wound Infection)
  • Preeclampsia, eclampsia, HELLP, seizures
  • Cardiomyopathy
• What about breastfeeding mothers? 
• Controversies and cutting edge
  • Endovascular therapy
  • Thromboelastography