Skip to main content

Abstract

In these 15 paragraphs, we have gathered the available knowledge in the medical literature about urgencies and emergencies that doctors, midwifves, and nurses may encounter in the daily management of obstetric and gynecological cases. The style is practical: the text is correlated with illustrations and algorithms, so that the reader can get the most benefit, with the least effort. The main assumption is that clinical practice integrates with theoretical knowledge, allowing the physician to adequately and timely address all the major pathological conditions and their complications.

Every day, 800 women die in the world, from causes related to pregnancy and childbirth, 99% of them live in low-income countries, and the vast majority of deaths are preventable with low-level healthcare interventions. The authors acknowledge that the basis of every correct medical performance is the culture of professionals, the wealth of scientific knowledge and experience. We have examined in 15 short paragraphs the most frequent urgencies and emergencies that the practitioner meets in obstetrical-gynecological daily practice. The text was designed to be also used for non-specialist in obstetrics and gynecology. The text is designed to be also used by specialist out of Ob-Gyn.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McWilliams GD, Hill MJ, Dietrich CS III. Gynecologic emergencies. Surg Clin North Am. 2008;88:265.

    PubMed  Google Scholar 

  2. Schrager J, Robles G, Platz T. Isolated fallopian tube torsion: a rare entity in a premenarcheal female. Am Surg. 2012;78:118.

    PubMed  Google Scholar 

  3. Bouguizane S, Bibi H, Farhat Y, et al. [Adnexal torsion: a report of 135 cases]. J Gynecol Obstet Biol Reprod (Paris). 2003;32:535.

    Google Scholar 

  4. Varras M, Tsikini A, Polyzos D, et al. Uterine adnexal torsion: pathologic and grayscale ultrasonographic findings. Clin Exp Obstet Gynecol. 2004;31:34.

    CAS  PubMed  Google Scholar 

  5. Houry D, Abbott JT. Ovarian torsion: a fifteen year review. Ann Emerg Med. 2001;38:156.

    CAS  PubMed  Google Scholar 

  6. White M, Stella J. Ovarian torsion: 10 year perspective. Emerg Med Australas. 2005;17:231.

    PubMed  Google Scholar 

  7. Oltmann SC, Fischer A, Barber R, et al. Cannot exclude torsion a - 15year review. J Pediatr Surg. 2009;44:1212.

    PubMed  Google Scholar 

  8. Tsafrir Z, Hasson J, Levin I, et al. Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence. Eur J Obstet Gynecol Reprod Biol. 2012;162:203.

    PubMed  Google Scholar 

  9. Kokoska ER, Keller MS, Weber TR. Acute ovarian torsion in children. Am J Surg. 2000;180:462.

    CAS  PubMed  Google Scholar 

  10. Rousseau V, Massicot R, Darwish AA, et al. Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases. J Pediatr Adolesc Gynecol. 2008;21:201.

    CAS  PubMed  Google Scholar 

  11. Anthony EY, Caserta MP, Singh J, Chen MY. Adnexal masses in female pediatric patients. AJR Am J Roentgenol. 2012;198:W426.

    PubMed  Google Scholar 

  12. Wilkinson C, Sanderson A. Adnexal torsion a multimodality imaging review. Clin Radiol. 2012;67:476.

    CAS  PubMed  Google Scholar 

  13. Valsky DV, EshBroder E, Cohen SM, et al. Added value of the grayscale whirlpool sign in the diagnosis of adnexal torsion. Ultrasound Obstet Gynecol. 2010;36:630.

    CAS  PubMed  Google Scholar 

  14. Vijayaraghavan SB, Senthil S. Isolated torsion of the fallopian tube: the sonographic whirlpool sign. J Ultrasound Med. 2009;28:657.

    PubMed  Google Scholar 

  15. Albayram F, Hamper UM. Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med. 2001;20:1083.

    CAS  PubMed  Google Scholar 

  16. BenAmi M, Perlitz Y, Haddad S. The effectiveness of spectral and color Doppler in predicting ovarian torsion. A prospective study. Eur J Obstet Gynecol Reprod Biol. 2002;104:64.

    Google Scholar 

  17. Lee EJ, Kwon HC, Joo HJ, et al. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med. 1998;17:83.

    CAS  PubMed  Google Scholar 

  18. Taskin O, Birincioglu M, Aydin A, et al. The effects of twisted ischaemic adnexa managed by detorsion on ovarian viability and histology: an ischaemic are perfusion rodent model. Hum Reprod. 1998;13:2823.

    CAS  PubMed  Google Scholar 

  19. Jones HW, Jones GS. Novak textbook of gynecology. 10th ed. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins; 1981. p. 471.

    Google Scholar 

  20. Mathevet P, Nessah K, Dargent D, Mellier G. Laparoscopic management of adnexal masses in pregnancy: a case series. Eur J Obstet Gynecol Reprod Biol. 2003;108:217.

    PubMed  Google Scholar 

  21. Bottomley C, Bourne T. Diagnosis and management of ovarian cyst accidents. Best Pract Res Clin Obstet Gynaecol. 2009;23:711.

    PubMed  Google Scholar 

  22. Kim JH, Lee SM, Lee JH, et al. Successful conservative management of ruptured ovarian cysts with hemoperitoneum in healthy women. PLoS One. 2014;9:e91171.

    PubMed  PubMed Central  Google Scholar 

  23. Teng SW, Tseng JY, Chang CK, et al. Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum. J Am Assoc Gynecol Laparosc. 2003;10:474.

    PubMed  Google Scholar 

  24. Reif P, Schöll W, Klaritsch P, Lang U. Rupture of endometriotic ovarian cyst causes acute hemoperitoneum in twin pregnancy. Fertil Steril. 2011;95:2125.e1.

    Google Scholar 

  25. Viswanathan M, Hartmann K, McKoy N, Stuart G, Rankins N, Thieda P, Lux LJ, Lohr KN. Management of uterine fibroids: an update of the evidence. Evid Rep Technol Assess (Full Rep). 2007;(154):1–122.

    Google Scholar 

  26. Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. Am Fam Physician. 2007;75(10):1503–8.

    PubMed  Google Scholar 

  27. Vollenhoven B. Introduction: the epidemiology of uterine leiomyomas. Baillieres Clin Obstet Gynaecol. 1998;12(2):169–76.

    CAS  PubMed  Google Scholar 

  28. Greenberg MD, Kazamel TI. Medical and socioeconomic impact of uterine fibroids. Obstet Gynecol Clin North Am. 1995;22(4):625–36.

    CAS  PubMed  Google Scholar 

  29. Tropeano G, Amoroso S, Scambia G. Non-surgical management of uterine fibroids. Hum Reprod Update. 2008;14(3):259–74.

    PubMed  Google Scholar 

  30. Downes E, Sikirica V, Gilabert-Estelles J, Bolge SC, Dodd SL, Maroulis C, et al. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):96–102.

    PubMed  Google Scholar 

  31. Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372(17):1646–55.

    CAS  PubMed  Google Scholar 

  32. Munro MG, Critchley HO, Fraser IS. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95(7):2204–8.

    PubMed  Google Scholar 

  33. Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynecol Clin North Am. 2006;33(1):153–69.

    PubMed  Google Scholar 

  34. Pérez-López FR, Ornat L, Ceausu I, Depypere H, Erel CT, Lambrinoudaki I, et al. EMAS position statement: management of uterine fibroids. Maturitas. 2014;79(1):106–16.

    PubMed  Google Scholar 

  35. Wiesenfeld HC, Sweet RL, Ness RB, et al. Comparison of acute and subclinical pelvic inflammatory disease. Sex Transm Dis. 2005;32:400–5.

    PubMed  Google Scholar 

  36. Ness RB, Kip KE, Hillier SL, et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am J Epidemiol. 2005;162:585–90.

    PubMed  Google Scholar 

  37. Cohen CR, Mugo NR, Astete SG, et al. Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis. Sex Transm Infect. 2005;81:463–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Haggerty CL, Totten PA, Astete SG, et al. Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease. Infect Dis Obstet Gynecol. 2006;2006:30184.

    PubMed  PubMed Central  Google Scholar 

  39. Jurstrand M, Jensen JS, Magnuson A, et al. A serological study of the role of Mycoplasma genitalium in pelvic inflammatory disease and ectopic pregnancy. Sex Transm Infect. 2007;83:319–23.

    PubMed  PubMed Central  Google Scholar 

  40. Ross J, Judlin P, Jensen J, International Union Against Sexually Transmitted Infections. 2012 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2014;25(1):1–7. https://doi.org/10.1177/0956462413498714.. Epub 29 Aug 2013

    Article  PubMed  Google Scholar 

  41. Government of Western Australia. Department of Health Benign gynaecology acute pelvic inflammatory disease. Clinical guidelines gynaecology 2015.

    Google Scholar 

  42. European Guideline for the Management of Pelvic Inflammatory Disease UK National Guideline for the Management of Pelvic Inflammatory Disease 2011.

    Google Scholar 

  43. UK National Guideline for the Management of Pelvic Inflammatory Disease 2011.

    Google Scholar 

  44. CDC-Center for Disease Control and Prevention. Sexually transmitted disease treatment guidelines 2015.

    Google Scholar 

  45. Workowski KA. Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis. 2015;61(Suppl 8):S759–62. https://doi.org/10.1093/cid/civ771.

    Article  PubMed  Google Scholar 

  46. Maleckiene L, et al. Comparison of clinical and laparoscopic diagnoses of pelvic inflammatory disease. Int J Gynaecol Obstet. 2009;104(1):74–17.

    PubMed  Google Scholar 

  47. Ness RB, Trautmann G, Richter HE, et al. Effectiveness of treatment strategies of some women with pelvic inflammatory disease: a randomized trial. Obstet Gynecol. 2005;106(3):573–80.

    PubMed  Google Scholar 

  48. Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012;98(3):511–9.

    CAS  PubMed  Google Scholar 

  49. Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am. 1997;24(2):411–40.

    CAS  PubMed  Google Scholar 

  50. Avraham S, Seidman DS. Surgery versus pharmacological treatment for endometriosis. Future Med. 2014;10:161–6.

    CAS  Google Scholar 

  51. American College of Obstetricians and Gynecologists. Practice Bulletin 114. Management of Endometriosis. Obstet Gynecol. 2010;116(1):223–36.

    Google Scholar 

  52. Viganò P, Parazzini F, Somigliana E, Vercellini P. Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol. 2004;18(2):177–200.

    PubMed  Google Scholar 

  53. Nap AW, Groothuis PG, Demir AY, Evers JLH, Dunselman GAJ. Pathogenesis of endometriosis. Best Pract Res Clin Obstet Gynaecol. 2004;18(2):233–44.

    PubMed  Google Scholar 

  54. Signorile PG, Baldi A. Endometriosis: new concepts in the pathogenesis. Int J Biochem Cell Biol. 2010;42(6):778–80.

    CAS  PubMed  Google Scholar 

  55. Mathur S, Peress MR, Williamson HO, et al. Autoimmunity to endometrium and ovary in endometriosis. Clin Exp Immunol. 1982;50(2):259–66.

    CAS  PubMed  PubMed Central  Google Scholar 

  56. Suginami H. A reappraisal of the coelomic metaplasia theory by reviewing endometriosis occurring in unusual sites and instances. Am J Obstet Gynecol. 1991;165(1):214–8.

    CAS  PubMed  Google Scholar 

  57. Schrager S, Falleroni J, Edgoose J. Evaluation and treatment of endometriosis. Am Fam Physician. 2013;87(2):107–13.

    PubMed  Google Scholar 

  58. Kodaman PH. Current strategies for endometriosis management. Obstet Gynecol Clin North Am. 2015;42(1):87–101.

    PubMed  Google Scholar 

  59. Suzuki T, Izumi SI, Matsubayashi H, Awaji H, Yoshikata K, Makino T. Impact of ovarian endometrioma on oocytes and pregnancy outcome in in vitro fertilization. Fertil Steril. 2005;83(4):908–13.

    PubMed  Google Scholar 

  60. Reeve L, Lashen H, Pacey AA. Endometriosis affects sperm-endosalpingeal interactions. Hum Reprod. 2005;20(2):448–51.

    CAS  PubMed  Google Scholar 

  61. American Fertility Society. Revised American Fertility Society classification of endometriosis: 1985. Fertil Steril. 1985;43(3):351–2.

    Google Scholar 

  62. Allen C, Hopewell S, Prentice A, Gregory D. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis (Review). 2010;(2). www.cochranelibrary.com.

  63. Jacobson T, Duffy JMN, Barlow D, Konincks PR, Garry R. Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Libr. 2010;(11):1–21.

    Google Scholar 

  64. Jones KD, Sutton C. Patient satisfaction and changes in pain scores after ablative laparoscopic surgery for stage III-IV endometriosis and endometriotic cysts. Fertil Steril. 2003;79(5):1086–90.

    PubMed  Google Scholar 

  65. Munro MG, Critchley HOD, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynecol Obstet. 2011;113(1):3–13.

    Google Scholar 

  66. Lieng M, Istre O, Sandvik L, Qvigstad E. Prevalence, 1-Year regression rate, and clinical significance of asymptomatic endometrial polyps: cross-sectional study. J Minim Invasive Gynecol. 2009;16(4):465–71.

    PubMed  Google Scholar 

  67. Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA. Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol. 2000;21(2):180–3.

    CAS  PubMed  Google Scholar 

  68. Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol. 1993;82(5):736–40.

    CAS  PubMed  Google Scholar 

  69. Tavassoli FA, Devilee P. World Health Organization classification of tumors: pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press; 2003.

    Google Scholar 

  70. Dilley A, Drews C, Lally C, Austin H, Barnhart E, Evatt B. A survey of gynecologists concerning menorrhagia: perceptions of bleeding disorders as a possible cause. J Womens Health Gend Based Med. 2002;11(1):39–44.

    PubMed  Google Scholar 

  71. Byams VR, Anderson BL, Grant AM, Atrash H, Schulkin J. Evaluation of bleeding disorders in women with menorrhagia: a survey of obstetrician-gynecologists. Am J Obstet Gynecol. 2012;207(4):269.e1–5.

    Google Scholar 

  72. Gleeson NC. Cyclic changes in endometrial tissue plasminogen activator and plasminogen activator inhibitor type 1 in women with normal menstruation and essential menorrhagia. Am J Obstet Gynecol. 1994;171(1):178–83.

    CAS  PubMed  Google Scholar 

  73. Smith SK, Abel MH, Kelly RW, Baird DT. Prostaglandin synthesis in the endometrium of women with ovular dysfunctional uterine bleeding. Br J Obstet Gynaecol. 1981;88(4):434–42.

    CAS  PubMed  Google Scholar 

  74. Smith SK, Abel MH, Kelly RW, Baird DT. A role for prostacyclin (PGi2) in excessive menstrual bleeding. Lancet (London, England). 1981;1(8219):522–4.

    CAS  Google Scholar 

  75. Heatley MK. The association between clinical and pathological features in histologically identified chronic endometritis. J Obstet Gynaecol. 2004;24(7):801–3.

    CAS  PubMed  Google Scholar 

  76. Pitsos M, Skurnick J, Heller D. Association of pathologic diagnoses with clinical findings in chronic endometritis. J Reprod Med. 2009;54(6):373–7.

    PubMed  Google Scholar 

  77. Toth M, Patton DL, Esquenazi B, Shevchuk M, Thaler H, Divon M. Association between chlamydia trachomatis and abnormal uterine bleeding. Am J Reprod Immunol. 2007;57(5):361–6.

    PubMed  Google Scholar 

  78. Rosenberg MJ, Waugh MS, Stevens CM. Smoking and cycle control among oral contraceptive users. Am J Obstet Gynecol. 1996;174(2):628–32.

    CAS  PubMed  Google Scholar 

  79. Meijer WEE, Heerdink ER, Nolen WA, Herings RMC, Leufkens HGM, Egberts ACG. Association of risk of abnormal bleeding with degree of serotonin reuptake inhibition by antidepressants. Arch Intern Med. 2004;164(21):2367.

    PubMed  Google Scholar 

  80. Marzano DA, Haefner HK. The Bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004;8:195.

    PubMed  Google Scholar 

  81. Krissi H, Shmuely A, Aviram A, From A, Edward R, Peled Y. Acute Bartholin’s abscess: microbial spectrum, patient characteristics, clinical manifestation, and surgical outcomes. Eur J Clin Microbiol Infect Dis. 2016;35(3):443–6.

    CAS  PubMed  Google Scholar 

  82. Downs MC, Randall HW Jr. The ambulatory surgical management of Bartholin duct cysts. J Emerg Med. 1989;7:623–6.

    CAS  PubMed  Google Scholar 

  83. Cobellis PL, Stradella L, De Lucia E, et al. Alcohol sclerotherapy: a new method for Bartholin gland cyst treatment. Minerva Ginecol. 2006;58:245–8.

    CAS  PubMed  Google Scholar 

  84. Kafali H, Yurtseven S, Ozardali I. Aspiration and alcohol sclerotherapy: a novel method for management of Bartholin’s cyst or abscess. Eur J Obstet Gynecol Reprod Biol. 2004;112:98–101.

    PubMed  Google Scholar 

  85. Cheetham DR. Bartholin’s cyst: marsupialization or aspiration? Am J Obstet Gynecol. 1985;152:569–70.

    CAS  PubMed  Google Scholar 

  86. Gennis P, Li SF, Provataris J, et al. Jacobi ring catheter treatment of Bartholin’s abscesses. Am J Emerg Med. 2005;23:414–5.

    PubMed  Google Scholar 

  87. Andersen PG, Christensen S, Detlefsen GU, et al. Treatment of Bartholin’s abscess. Marsupialization versus incision, curettage and suture under antibiotic cover. A randomized study with 6 months’ follow up. Acta Obstet Gynecol Scand. 1992;71:59–62.

    CAS  PubMed  Google Scholar 

  88. Penna C, Fambrini M, Fallani MG. CO2 laser treatment for Bartholin’s gland cyst. Int J Gynaecol Obstet. 2002;76:79–80.

    CAS  PubMed  Google Scholar 

  89. Benedetti Panici P, Manci N, Bellati F, et al. CO2 laser therapy of the Bartholin’s gland cyst: surgical data and functional short- and long-term results. J Minim Invasive Gynecol. 2007;14:348–51.

    PubMed  Google Scholar 

  90. Fambrini M, Penna C, Pieralli A, et al. Carbon-dioxide laser vaporization of the Bartholin gland cyst: a retrospective analysis on 200 cases. J Minim Invasive Gynecol. 2008;15:327–31.

    PubMed  Google Scholar 

  91. World Health Organization. Guidelines for medico-legal care of victims of sexual violence, 2003.

    Google Scholar 

  92. Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C, WHO Multi-Country Study on Women’s Health and Domestic Violence Against Women Study Team. Intimate partner violence and women’s physical and mental health in the WHO multicountry study on women’s health and domestic violence: an observational study. Lancet. 2008;371(9619):1165–72. https://doi.org/10.1016/S0140-6736(08)60522-X.

  93. UK National Guidelines on the Management of Adult and Adolescent Complainants of Sexual Assault; 2011.

    Google Scholar 

  94. Ragusa A, Crescini C. URGENZE ED EMERGENZE IN SALA PARTO. Padova: Casa Editrice PICCIN Nuova Libreria; 2015. p. 197–211.

    Google Scholar 

  95. Oyelese Y, Ananth CV. Placental Abruptio. Obstet Gynecol. 2006;108(4):1005–16.

    PubMed  Google Scholar 

  96. Yeo L, Vintzleos A. Placenta Abruptio. Philadelphia: Lippincott, Williams & Wilkins; 2004.

    Google Scholar 

  97. Royal College of Obstetricians and Gynaecologists. Antepartum haemorrhage. RCOG 2011. Green-top guidelines N° 63.

    Google Scholar 

  98. Tikkanen M. Etiology, clinical manifestations, and prediction of placental abruption. Acta Obstet Gynecol Scand. 2010;89(6):732–40.

    PubMed  Google Scholar 

  99. Glantz C, Purnell L. Clinical utility of sonography in the diagnosis and treatment of placental abruption. J Ultrasound Med. 2002;21(8):837–40.

    PubMed  Google Scholar 

  100. Usui R, Matsubara S, Ohkuchi A, Kuwata T, Watanabe T, Izumi A, et al. Fetal heart pattern reflecting the severity of placental abruption. Arch Gynecol Obstet. 2008;277(3):249–53.

    PubMed  Google Scholar 

  101. Oyelese Y, Smulian JC. Placenta previa, placenta accreta and vasa previa. Obstet Gynecol. 2006;107(4):927–41.

    PubMed  Google Scholar 

  102. Royal College of Obstetricians and Gynaecologists. Placenta praevia, placenta praevia accreta and vasa praevia: diagnosis and management. RCOG 2011. Green-top guidelines N° 27.

    Google Scholar 

  103. WHO recommendations for the prevention and treatment of postpartum haemorrhage. 2012. http://apps.who.int/iris/bitstream/10665/75411/1/9789241548502_eng.pdf. Last accessed 06 Jun 2017.

  104. Royal College of Obstetricians and Gynaecologists (RCOG). Prevention and management of postpartum haemorrhage. Green-top Guideline N. 52. 2009. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg52/. Last accessed 06 Jun 2017.

  105. Mousa HA, Blum J, Abou El Senoun G, Shakur H, Alfirevic Z. Treatment for primary postpartum haemorrhage. Cochrane Database Syst Rev. 2014;(2):CD003249.

    Google Scholar 

  106. Mukherjee S, Sabaratnam A. Post-partum haemorrhage. Obstet Gynaecol Reprod Med. 2009;19:121–16.

    Google Scholar 

  107. Meir JY, Natale N, Arisi E, et al. Emorragia post-partum: linee guida per la prevenzione, Diagnosi e il trattamento. Linee guida AOGOI. I libri dell’AOGOI. Cento, Ferrara: Editeam; 2009. p. 23–49

    Google Scholar 

  108. Abdul-Kadir R, McLintock C, Ducloy AS, et al. Evaluation and management of postpartum hemorrhage: consensus from an international expert panel. Transfusion. 2014;54(7):1756–68.

    PubMed  Google Scholar 

  109. Pavord S, Maybury H. How I treat postpartum hemorrhage. Blood. 2015;125(18):2759–70.

    CAS  PubMed  Google Scholar 

  110. Ducloy-Bouthors AS, Jude B, Duhamel A, et al. High-dose tranexamic acid reduces blood loss in postpartum haemorrhage. Crit Care. 2011;15(2):R117.

    PubMed  PubMed Central  Google Scholar 

  111. Sentilhes L, Deneux-Tharaux C. Prophylactic tranexamic acid in addition to uterotonics may prevent blood loss for vaginal and caesarean deliveries. Evid Based Med. 2016;21(3):97.

    PubMed  Google Scholar 

  112. Butwick AJ. Postpartum hemorrhage and low fibrinogen levels: the past, present and future. Int J Obstet Anesth. 2013;22(2):87–91.

    CAS  PubMed  Google Scholar 

  113. Edwards P, Shakur H, Barnetson L, et al. Central and statistical data monitoring in the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2) trial. Clin Trials. 2014;11(3):336–43.

    PubMed  Google Scholar 

  114. Lalonde A, International Federation of Gynecology and Obstetrics. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2012;117(2):108–18.

    PubMed  Google Scholar 

  115. AIFA. Nota informativa importante concordata con l’EMA e l’AIFA: Restrizione d’uso di HES (medicinali contenenti amido idrossietilico). 2013. http://www.agenziafarmaco.gov.it/it/content/nota-informativa-importante-sulla-restrizione-d%E2%80%99uso-di-hes-medicinali-contenenti-amido-idros. Last accessed 06 Jun 2017.

  116. Charbit B, Mandelbrot L, Samain E, et al. The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage. J Thromb Haemost. 2007;5(2):266–73.

    CAS  PubMed  Google Scholar 

  117. Collins PW, Lilley G, Bruynseels D, et al. Fibrin-based clot formation an early and rapidly available biomarker for progression of postpartum hemorrhage: a prospective cohort study. Blood. 2014;124(11):1727–36.

    CAS  PubMed  Google Scholar 

  118. Kozek-Langenecker SA, Afshari A, Albaladejo P, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2013;30(6):270–382.

    PubMed  Google Scholar 

  119. Hofmeyr GJ, Abdel-Aleem H, Abdel-Aleem MA. Uterine massage for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2013;(7):CD006431.

    Google Scholar 

  120. Allam MS, B-Lynch C. The B-Lynch and other uterine compression suture techniques. Int J Gynecol Obstet. 2005;89(3):236–41.

    CAS  Google Scholar 

  121. B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104(3):372–5.

    CAS  PubMed  Google Scholar 

  122. Baskett TF. Uterine compression sutures for postpartum hemorrhage: efficacy, morbidity, and subsequent pregnancy. Obstet Gynecol. 2007;110(1):68–71.

    PubMed  Google Scholar 

  123. Price N, B-Lynch C. Technical description of the B-Lynch brace suture for treatment of massive postpartum hemorrhage and review of the published cases. Int J Fertil Womens Med. 2005;50(4):148–63.

    PubMed  Google Scholar 

  124. Hayman RG, Arulkumaran S, Steer PJ. Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol. 2002;99(3):502–6.

    CAS  PubMed  Google Scholar 

  125. Ghezzi F, Cromi A, Uccella S, Raio L, Bolis P, Surbek D. The Hayman technique: a simple method to treat postpartum haemorrhage. BJOG. 2007;114(3):362–5.

    CAS  PubMed  Google Scholar 

  126. Joshi VM, Otiv SR, Majumder R, Nikam YA, Shirivastava M. Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG. 2007;114(3):356–61.

    CAS  PubMed  Google Scholar 

  127. Lethaby A, Mukhopadhyay A, Naik R. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev. 2012;(4):CD004993.

    Google Scholar 

  128. Grady K, Howell C, Cox C. Uterine inversion - chapter23. In: The MOET coursemanual: managing obstetric emergencies and trauma. 2nd ed. London: RCOG Press; 2007.

    Google Scholar 

  129. Loeffler F. Postpartum haemorrhge and abnormalities of the third stage of labour. In: Chamberlain G, editor. Turnbull’s obstetrics. 2nd ed. Edinburgh: Churchill Livingstone; 1995. p. 729–34.

    Google Scholar 

  130. O’Sullivan J. Acute inversion of the uterus. Br Med J. 1945;2:282–3.

    PubMed  PubMed Central  Google Scholar 

  131. Ragusa A, Crescini C, et al. Uterine inversion- Chapter 11. In: Manuale di urgenze ed emergenze in sala parto. 2nd ed. Padova: Piccin Press; 2016.

    Google Scholar 

  132. Shah-Hosseini R, Evrard JR. Puerperal uterine inversion. Obstet Gynecol. 1989;73(4):567–70.

    CAS  PubMed  Google Scholar 

  133. Watson P, Besch N, Bowes WA Jr. Management of acute and subacute puerperal inversion of the uterus. Obstet Gynecol. 1980;55(1):12–6.

    CAS  PubMed  Google Scholar 

  134. Soleymani Majd H, Pilsniak A, Reginald PW. Recurrent uterine inversion: a novel treatment approach using SOS Bakri balloon. BJOG. 2009;116(7):999–1001.

    CAS  PubMed  Google Scholar 

  135. Huntington JL, Irving FC, Kellog FS. Abdominal reposition in acute inversion of the puerperal uterus. Am J Obstet Gynecol. 1928;15:34–40.

    Google Scholar 

  136. Boyle JJ, Katz VL. Umbilical cord prolapse in current obstetric practice. J Reprod Med. 2005;50(5):303–6.

    PubMed  Google Scholar 

  137. Draycott T, Winter C, Crofts J, et al., editors. Module 8. Cord prolapse in: PROMPT: practical obstetric multi professional training course manual. London: RCOG Press; 2008. p. 117–24.

    Google Scholar 

  138. Goswami K. Umbilical cord prolapse. In: Grady K, Howell C, Cox C, editors. Managing obstetric emergencies and trauma. The MOET course manual. 2nd ed. London: RCOG Press; 2007. p. 233–7.

    Google Scholar 

  139. Koonings PP, Paul RH, Campbell K. Umbilical cord prolapse. A contemporary look. J Reprod Med. 1990;35(7):690–2.

    CAS  PubMed  Google Scholar 

  140. Panter KR, Hannah ME. Umbilical cord prolapse: so far so good? Lancet. 1996;347(8994):74. Royal College of Obstetricians and Gynaecologists. Umbilical cord prolapse. Green-top Guideline No.50; April 2008.

    Google Scholar 

  141. Siassakos D, Crofts JF, Winter C, Weiner CP, Draycott TJ. The active components of effective training in obstetric emergencies. BJOG. 2009;116(8):1028–32.

    CAS  PubMed  Google Scholar 

  142. Usta IM, Mercer BM, Sibai BM. Current obstetrical practice and umbilical cord prolapse. Am J Perinatol. 1999;16(9):479–84.

    CAS  PubMed  Google Scholar 

  143. Murphy DJ, MacKenzie IZ. The mortality and morbidity associated with umbilical cord prolapse. Br J Obstet Gynaecol. 1995;102(10):826–30.

    CAS  PubMed  Google Scholar 

  144. Lin MG. Umbilical cord prolapse. Obstet Gynecol Surv. 2006;61(4):269–77.

    PubMed  Google Scholar 

  145. Katz Z, Shoham Z, Lancet M, Blickstein I, Mogilner BM, Zalel Y. Management of labor with umbilical cord prolapse: a 5-year study. Obstet Gynecol. 1988;72(2):278–81.

    CAS  PubMed  Google Scholar 

  146. Crofts JF, Ellis D, Draycott TJ, Winter C, Hunt LP, Akande VA. Change in knowledge of midwives and obstetricians following obstetric emergency training: a randomized controlled trial of local hospital, simulation centre and teamwork training. BJOG. 2007;114(12):1534–41.

    CAS  PubMed  Google Scholar 

  147. Siassakos D, Fox R, Draycott TJ. Umbilical cord prolapse [Green-top guideline no. 50]. London: RCOG Press; 2008.

    Google Scholar 

  148. Siassakos D, Hasafa Z, Sibanda T, Fox R, Donald F, Winter C, et al. Retrospective cohort study of diagnosis-delivery interval with umbilical cord prolapse: the effect of team training. BJOG. 2009;116(8):1089–96.

    CAS  PubMed  Google Scholar 

  149. Khandelwal A, Fasih N, Kielar A. Imaging of acute abdomen in pregnancy. Radiol Clin North Am. 2013;51:1005–22.

    PubMed  Google Scholar 

  150. Germain A, Brunaud L. Visceral surgery and pregnancy. J Visc Surg. 2010;147:e129–35.

    CAS  PubMed  Google Scholar 

  151. Gilo NB, Amini D, Landy HJ. Appendicitis and cholecystitis in pregnancy. Clin Obstet Gynecol. 2009;52:586–96.

    PubMed  Google Scholar 

  152. ACOG Committee on Obstetric Practice. ACOG Committee Opinion No. 474: Non obstetric surgery during pregnancy. Obstet Gynecol. 2011;117:420–1.

    Google Scholar 

  153. Evans SR, Sarani B, Bhanot P, Feldman E. Surgery in pregnancy. Curr Probl Surg. 2012;49:333–88.

    PubMed  Google Scholar 

  154. Knab LM, Boller AM, Mahvi DM. Cholecystitis. Surg Clin North Am. 2014;94:455–70.

    PubMed  Google Scholar 

  155. Kuhlmann RS, Cruikshank DP. Maternal trauma during pregnancy. Clin Obstet Gynecol. 1994;37(2):274–93.

    CAS  PubMed  Google Scholar 

  156. Petrone P, Talving P, Browder T, Teixeira PG, Fisher O, Lozornio A, et al. Abdominal injuries in pregnancy: a 155-month study at two level 1 trauma centers. Injury. 2011;42(1):47–9.

    PubMed  Google Scholar 

  157. Vikram K, Parul G, Ranjana K, Umamaheshwar K. Trauma in pregnancy - a review. Adv Res Gastroenterol Hepatol. 2016;2(1):555580.

    Google Scholar 

  158. Suresh MS, Wali A. Failed intubation in obstetrics: airway management strategies. Anesthesiol Clin North Am. 1998;16:477–98.

    Google Scholar 

  159. Ramsay G, Paglia M, Bourjeily G. When the heart stops: a review of cardiac arrest in pregnancy. J Intensive Care Med. 2013;28(4):204–14.

    PubMed  Google Scholar 

  160. Lockey DJ, Crewdson K, Lossius HM. Pre-hospital anaesthesia: the same but different. Br J Anaesth. 2014;113(2):211–9.

    CAS  PubMed  Google Scholar 

  161. Pearlman M, Faro S. Obstetric septic shock: a pathophysiologic basis for management. Clin Obstet Gynecol. 1990;33(3):482–92.

    CAS  PubMed  Google Scholar 

  162. American College of Surgeons Committee: on Trauma. Trauma in women. In: Advanced trauma life support for doctors: student course manual. 9th ed. Chicago, Surgeons. 2012;9:259–68.

    Google Scholar 

  163. Epstein FB. Acute abdominal pain in pregnancy. Emerg Med Clin North Am. 1994;12(1):151–65.

    CAS  PubMed  Google Scholar 

  164. Puri A, Khadem P, Ahmed S, Yadav P, Al-Dulaimy K. Imaging of trauma in a pregnant patient. Semin Ultrasound CT MR. 2012;33(1):37–45.

    PubMed  Google Scholar 

  165. Donnelly EH, Smith JM, Farfán EB, Ozcan I. Prenatal radiation exposure: background material for counseling pregnant patients following exposure to radiation. Disaster Med Public Health Prep. 2011;5(1):62–8.

    PubMed  Google Scholar 

  166. De Santis M, Di Gianantonio E, Straface G, Cavaliere AF, Caruso A, Schiavon F, et al. Ionizing radiations in pregnancy and teratogenesis: a review of literature. Reprod Toxicol. 2005;20(3):323–9.

    PubMed  Google Scholar 

  167. Patel SJ, Reede DL, Katz DS, Subramaniam R, Amorosa JK. Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations. Radiographics. 2007;27(6):1705–22.

    PubMed  Google Scholar 

  168. Ray JG, Schull MJ, Urquia ML, You JJ, Guttmann A, Vermeulen MJ, Franco EL, Academic Editor. Major radiodiagnostic imaging in pregnancy and the risk of childhood malignancy: a population-based cohort study in Ontario. PLoS Med. 2010;7(9):e1000337. Published online 7 Sept 2010. https://doi.org/10.1371/journal.pmed.1000337.

  169. Sagiv R, Debby A, Feit H, Cohen-Sacher B, Keidar R, Golan A. The optimal cutoff serum level of human chorionic gonadotropin for efficacy of methotrexate treatment in women with extrauterine pregnancy. Int J Gynaecol Obstet. 2012;116(2):101–4.

    CAS  PubMed  Google Scholar 

  170. Abe T, Akira S, Negishi Y, Ichikawa M, Nakai A, Takeshita T. Relevance of declines in serum human chorionic gonadotropin levels to the management of persistent ectopic pregnancy. J Obstet Gynaecol Res. 2009;35(5):961–6.

    PubMed  Google Scholar 

  171. Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007.

    Google Scholar 

  172. Diagnosis and management of ectopic pregnancy. Green‐top guideline no. 21. 2016;123(13):e15–55. https://doi.org/10.1111/1471-0528.14189. First published: 3 Nov 2016.

  173. Choudhary N, Saha SC, Gopalan S. Abortion procedures in a tertiary care institution in India. Int J Gynaecol Obstet. 2005;91:81–6.

    CAS  PubMed  Google Scholar 

  174. Steinauer JE, Diedrich JT, Wilson MW, Darney PD, Vargas JE, Drey EA. Uterine artery embolization in postabortion hemorrhage. Obstet Gynecol. 2008;111:881–9.

    PubMed  Google Scholar 

  175. O’Connell K, Jones H, Simon M, Saporta V, Paul M, Lichtenberg E. First-trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception. 2009;79:385–92.

    PubMed  Google Scholar 

  176. O’Connell K, Jones HE, Lichtenberg ES, Paul M. Second-trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception. 2008;78:492–9.

    PubMed  Google Scholar 

  177. Tang O, Schweer H, Seyberth H, Lee S, Ho P. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod. 2002;17:332–6.

    CAS  PubMed  Google Scholar 

  178. Meckstroth K, Whitaker A, Bertisch S, Goldberg A, Darney P. Misoprostol administered by epithelial routes: drug absorption and uterine response. Obstet Gynecol. 2006;108:582–90.

    CAS  PubMed  Google Scholar 

  179. Frick AC, Drey EA, Diedrich JT, Steinauer JE. Effect of prior cesarean delivery on risk of second-trimester surgical abortion complications. Obstet Gynecol. 2010;115:760.

    PubMed  Google Scholar 

  180. Olamijulo J, Doufekas K. Intrauterine balloon tamponade for uncontrollable bleeding during first trimester surgical termination of pregnancy. J Obstet Gynaecol. 2007;27:440–1.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. Marta Betti and Dr. Anna Carli for the collaboration offered in the drafting of this chapter.

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Ragusa, A., Svelato, A., Di Tommaso, M., D’Avino, S., Rinaldo, D., Maini, I. (2019). Updates in the Management of Ob-Gyn Emergencies. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-95114-0_33

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95113-3

  • Online ISBN: 978-3-319-95114-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics