Obstetrics Gynecology

A

• Abnormal Uterine Bleeding — Acute Hemodynamic Management

  Stabilize with IV access and tranexamic acid when appropriate, give high dose hormonal therapy if not contraindicated, and arrange gynecologic consultation; consider procedures for refractory bleeding.
• Adenomyosis — Diagnosis & Treatment

  Consider in heavy/painful menses and enlarged tender uterus. Diagnose with TVUS/MRI; treat with LNG‑IUD or other hormonal suppression; definitive therapy is hysterectomy when childbearing complete.
• Amenorrhea — Primary vs Secondary Workup

  Differentiate primary vs secondary amenorrhea; rule out pregnancy first; use targeted endocrine and anatomic evaluation to guide therapy.

C

• Cervical Insufficiency — Cerclage Indications

  Cerclage indicated for history of mid‑trimester losses, ultrasound‑documented short cervix with prior preterm birth, or physical exam dilation; choose history‑, ultrasound‑, or exam‑indicated cerclage accordingly.

E

• Eclampsia and Severe Preeclampsia — Magnesium, Blood Pressure Control, and Delivery

  New-onset seizures in pregnancy/postpartum (eclampsia) or preeclampsia with severe features. Stabilize airway/breathing, give magnesium sulfate for seizure control and prophylaxis, control blood pressure (labetalol, hydralazine, or nifedipine), and expedite delivery once maternal stabilized; manage HELLP and monitor fetus.
• Eclampsia — Seizure Control and Blood Pressure

  Pregnancy related seizures require magnesium sulfate for seizure control, blood pressure management, and urgent obstetric delivery planning.
• Eclampsia — Seizure Control, BP Targets, and Delivery

  New-onset generalized seizures in pregnancy or postpartum related to preeclampsia; secure airway, give magnesium sulfate, control severe BP, and proceed to delivery after maternal stabilization.
• Ectopic Pregnancy — Diagnosis & Management

  Consider in any reproductive age patient with abdominal pain or bleeding; use TVUS and serial hCG; methotrexate for selected stable cases; surgery for instability, rupture, or contraindications to methotrexate.
• Ectopic Pregnancy — hCG Algorithm, Methotrexate vs Surgery, and Rh Prophylaxis

  Suspect with abdominal pain, vaginal bleeding, and positive pregnancy test. Use transvaginal ultrasound and quantitative hCG trends; manage with single- or multi-dose methotrexate for stable, appropriate candidates or laparoscopic surgery for rupture/contraindications. Administer Rh immunoglobulin to Rh-negative patients.
• Ectopic Pregnancy — β‑hCG/Ultrasound Algorithm, Methotrexate Criteria, and Surgical Management

  Suspect ectopic with abdominal pain, vaginal bleeding, and positive pregnancy test. Use β‑hCG and transvaginal ultrasound to determine location; select methotrexate for stable, reliable patients meeting criteria; otherwise proceed to laparoscopic salpingostomy/salpingectomy. Rhogam for Rh‑negative patients.
• Endometriosis — Diagnosis & Medical/Surgical Management

  Clinical diagnosis with empiric therapy is often appropriate; laparoscopy for definitive diagnosis or when infertility/surgical management indicated; combine hormonal suppression and pain strategies with fertility planning.

H

• Hyperemesis Gravidarum — ED Care

  Severe pregnancy related nausea and vomiting with weight loss and ketonuria; restore volume, correct electrolytes, give antiemetics from safe classes, and consider thiamine before dextrose.

I

• Infertility — Initial Evaluation & When to Refer

  Time‑based definition by age; evaluate both partners; begin with ovulation, tubal patency, and semen analysis; refer early for complex factors or advanced reproductive techniques.
• IUD Complications — Malposition, Expulsion & Perforation

  Evaluate IUD strings and symptoms; use ultrasound for localization when strings not visualized; manage malposition, partial expulsion, or perforation based on device type and reproductive plans.

O

• Ovarian Torsion — Clinical Suspicion, Ultrasound, and Laparoscopic Detorsion

  Sudden unilateral pelvic pain with nausea/vomiting in reproductive‑age or pregnant patients suggests torsion. Obtain transvaginal ultrasound with Doppler, but do not delay gynecologic consultation; prioritize ovary‑sparing laparoscopic detorsion when viable.
• Ovarian Torsion — Urgent Diagnosis and Detorsion

  Consider in acute pelvic pain with nausea; do not exclude with normal Doppler; urgent gynecologic consultation for diagnostic laparoscopy and detorsion to preserve ovary.

P

• Pelvic Inflammatory Disease — ED Treatment

  Clinical diagnosis in sexually active patients with pelvic pain and cervical motion, uterine, or adnexal tenderness; treat empirically and ensure partner therapy and follow up.
• Placenta Accreta Spectrum — Antenatal Planning & Delivery

  PAS requires antenatal diagnosis with targeted ultrasound ± MRI, delivery planning at Level III/IV center, and multidisciplinary approach; cesarean hysterectomy with placenta in situ is standard for accreta/increta/percreta.
• Postpartum Hemorrhage — Acute Management

  Leading cause of maternal morbidity; identify Four Ts (Tone, Trauma, Tissue, Thrombin), activate massive transfusion, give uterotonics and tranexamic acid, and escalate to procedural control.
• Postpartum Hemorrhage — Initial Management

  Recognize early, activate massive hemorrhage protocol, perform uterine massage, give uterotonics, and escalate with tranexamic acid, balloon tamponade, and surgical control.
• Postpartum Hemorrhage — Uterotonics, Tranexamic Acid, and Balloon Tamponade

  PPH is blood loss ≥1000 mL or bleeding with signs of hypovolemia within 24 h of birth. Manage with uterine massage, first‑line uterotonics, early tranexamic acid, and stepwise escalation to balloon tamponade and surgical interventions with massive transfusion protocols.
• Postpartum Hemorrhage — Uterotonics, TXA, Balloon Tamponade, and Stepwise Escalation

  PPH is blood loss ≥1000 mL or bleeding with signs of hypovolemia within 24 h of birth. Activate PPH protocol: fundal massage and uterotonics (oxytocin first-line), add tranexamic acid within 3 hours, perform uterine balloon tamponade, and escalate to uterine artery embolization or surgical interventions (B-Lynch, hysterectomy) if refractory.
• Postpartum Hypertension — Recognition & Treatment

  Postpartum hypertension/preeclampsia can occur de novo. Treat severe BP promptly, give magnesium sulfate for eclampsia prophylaxis with severe features, and arrange early follow‑up.
• Preeclampsia and Eclampsia — ED Stabilization

  Hypertensive obstetric emergency: control BP, give magnesium sulfate for seizure prevention or control, evaluate for severe features, and coordinate timely delivery with obstetrics.
• Preterm Labor — Tocolytics, Steroids, and MgSO₄

  Diagnose preterm labor clinically; use antenatal corticosteroids and magnesium sulfate for neuroprotection; tocolytics for short‑term pregnancy prolongation to allow steroid/transfer window.

S

• Septic Abortion — ED Resuscitation and Antibiotics

  Postabortion uterine infection with fever, abdominal pain, and foul discharge; begin sepsis resuscitation, give broad spectrum antibiotics with anaerobic coverage, and arrange urgent uterine evacuation with obstetrics.

T

• TOLAC/VBAC — Counseling & Risk Assessment

  Offer TOLAC to most with one prior low‑transverse cesarean; assess individualized success probability and uterine rupture risk; deliver in facility capable of emergent cesarean.