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Obstetrics in the Emergency Room

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Handbook of Consult and Inpatient Gynecology

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Abstract

Patients may present to the emergency room with antepartum or postpartum complications, occasionally requiring management without the immediate support of an obstetrics team. This chapter reviews basic principles of obstetric care and discusses the management of normal labor, rupture of membranes, obstetrical hemorrhage, hypertensive emergencies in pregnancy and the postpartum period, and traumatic injury in a pregnant woman.

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References

  1. Leone A, Ersfeld P, Adams M, Schiffer PM, Bucher HU, Arlettaz R. Neonatal morbidity in singleton late preterm infants compared with full-term infants. Acta Paediatr. 2012;101:e6–10.

    Article  CAS  PubMed  Google Scholar 

  2. American College of Obstetricians and Gynecologists. Committee opinion No. 611. Method for estimating due date. Obstet Gynecol. 2014;124:863–6.

    Google Scholar 

  3. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA 2015; 314:1039–51.

    Google Scholar 

  4. Zhang J, Landy HJ, Branch DW, Burkman R, Haberman S, Gregory KD, et al. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol. 2010;116:1281–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. American College of Obstetricians and Gynecologists. Practice bulletin no. 116: management of intrapartum fetal heart rate tracings. Obstet Gynecol. 2010;116:1232–40.

    Article  Google Scholar 

  6. Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Normal labor. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS, editors. Williams obstetrics. 24th ed. New York: McGraw-Hill; 2013. http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=1057&Sectionid=59789162. Accessed 25 Aug 2015.

  7. Brookes C, Shand K, Jones WR. A reevaluation of the ferning test to detect ruptured membranes. Aust N Z J Obstet Gynaecol. 1986;26:260–4.

    Article  CAS  PubMed  Google Scholar 

  8. Department of Health and Human Services. Emergency medical treatment & labor act (EMTALA). https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/. Accessed 25 Aug 2015.

  9. Siff JE. Chapter 298. Legal issues in emergency medicine. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD T, editors. Tintinalli’s emergency medicine: a comprehensive study guide. 7th ed. New York: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=348&Sectionid=40381796.Accessed 25 Aug 2015.

  10. Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease – revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59:1–36.

    PubMed  Google Scholar 

  11. Maternal and Newborn Health/Safe Motherhood Unit, Division of Reproductive Health. “Basic Newborn Resuscitation: a practical guide”. Geneva: World Health Organization; 1999. Available at http://apps.who.int/iris/bitstream/10665/63953/1/WHO_RHT_MSM_98.1.pdf. Accessed 29 Sep 2015.

  12. Combs CA, Laros Jr RK. Prolonged third stage of labor: morbidity and risk factors. Obstet Gynecol. 1991;77:863–7.

    Google Scholar 

  13. Begley CM, Gyte GM, Devane D, McGuire W, Weeks A. Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev. 2015;(3):CD007412.

    Google Scholar 

  14. Du Y, Ye M, Zheng F. Active management of the third stage of labor with and without controlled cord traction: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand. 2014;93:626–33.

    Article  PubMed  Google Scholar 

  15. Jackson Jr KW, Allbert JR, Schemmer GK, Elliot M, Humphrey A, Taylor J. A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage. Am J Obstet Gynecol. 2001;185:873–7.

    Google Scholar 

  16. Combs CA, Murphy EL, Laros Jr RK. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol. 1991;77:69–76.

    CAS  PubMed  Google Scholar 

  17. American College of Obstetricians and Gynecologists. ACOG practice bulletin: number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006;108:1039–47.

    Article  Google Scholar 

  18. Stones RW, Paterson CM, Saunders NJ. Risk factors for major obstetric haemorrhage. Eur J Obstet Gynecol Reprod Biol. 1993;48:15–8.

    Article  CAS  PubMed  Google Scholar 

  19. Dildy 3rd GA. Postpartum hemorrhage: new management options. Clin Obstet Gynecol. 2002;45:330–44.

    Article  PubMed  Google Scholar 

  20. Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Chapter 35. Obstetrical hemorrhage. In: Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. editors. Williams obstetrics, 23rd ed. New York: McGraw-Hill; 2010. http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=350&Sectionid=41680602. Accessed 23 Aug 2015.

  21. Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta. 2008;29:639–45.

    Article  CAS  PubMed  Google Scholar 

  22. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107:1226–32.

    Article  PubMed  Google Scholar 

  23. Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol. 1997;177:210–4.

    Article  CAS  PubMed  Google Scholar 

  24. Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351:2581–9.

    Article  CAS  PubMed  Google Scholar 

  25. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol. 2009;145:24–33.

    Article  CAS  PubMed  Google Scholar 

  26. American College of Obstetricians and Gynecologists. ACOG practice bulletin: thrombocytopenia in pregnancy. Number 6, September 1999. Int J Gynaecol Obstet. 1999;67:117–28.

    Article  Google Scholar 

  27. Rosenstein MG, Vargas JE, Drey EA. Ultrasound-guided instrumental removal of the retained placenta after vaginal delivery. Am J Obstet Gynecol. 2014;211:180.e1–3.

    Article  Google Scholar 

  28. Committee on Trauma. Advanced trauma life support 1 student manual. Eighthth ed. Chicago: American College of Surgeons; 2008.

    Google Scholar 

  29. Vaknin Z, Maymon R, Mendlovic S, Barel O, Herman A, Sherman D. Clinical, sonographic, and epidemiologic features of second- and early third-trimester spontaneous antepartum uterine rupture: a cohort study. Prenat Diagn. 2008;28:478–84.

    Article  PubMed  Google Scholar 

  30. Riskin DJ, Tsai TC, Riskin L, Hernandez-Boussard T, Purtill M, Maggio PM. Massive transfusion protocols: the role of aggressive resuscitation versus product ratio in mortality reduction. J Am Coll Surg. 2009;209:198–205.

    Article  PubMed  Google Scholar 

  31. Pham HP, Shaz BH. Update on massive transfusion. Br J Anaesth. 2013;111 Suppl 1:i71–82.

    Article  PubMed  Google Scholar 

  32. Erber WN, Perry DJ. Plasma and plasma products in the treatment of massive haemorrhage. Best Pract Res Clin Haematol. 2006;19:97–112.

    Article  CAS  PubMed  Google Scholar 

  33. Levy JH, Szlam F, Tanaka KA, Sniecienski RM. Fibrinogen and hemostasis: a primary hemostatic target for the management of acquired bleeding. Anesth Analg. 2012;114:261–74.

    Article  CAS  PubMed  Google Scholar 

  34. Smith GN, Brien JF. Use of nitroglycerin for uterine relaxation. Obstet Gynecol Surv. 1998;53:559–65.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  36. American College of Obstetricians and Gynecologists. Patient safety checklist number 10: postpartum hemorrhage from vaginal delivery. 2013. http://www.acog.org/Resources-And-Publications/Patient-Safety-Checklists/Postpartum-Hemorrhage-from-Vaginal-Delivery. Accessed 25 Jul 2015.

  37. 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.

    Article  PubMed  Google Scholar 

  38. 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.

    Article  CAS  PubMed  Google Scholar 

  39. 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 

  40. Kauff ND, Chelmow D, Kawada CY. Intractable bleeding managed with Foley catheter tamponade after dilation and evacuation. Am J Obstet Gynecol. 1995;173:957–8.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  42. Hansch E, Chitkara U, McAlpine J, El-Sayed Y, Dake MD, Razavi MK. Pelvic arterial embolization for control of obstetric hemorrhage: a five-year experience. Am J Obstet Gynecol. 1999;180:1454–60.

    Article  CAS  PubMed  Google Scholar 

  43. Ojala K, Perälä J, Kariniemi J, Ranta P, Raudaskoski T, Tekay A. Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage. Acta Obstet Gynecol Scand. 2005;84:1075–80.

    PubMed  Google Scholar 

  44. Lu MC, Fridman M, Korst LM, Gregory KD, Reyes C, Hobel CJ. Variants in the incidence of postpartum hemorrhage across hospitals in California. Matern Child Health J. 2005;9:297–306.

    Article  PubMed  Google Scholar 

  45. American College of Obstetricians and Gynecologists: task force on hypertension in pregnancy. Hypertension in pregnancy. 2013. http://www.acog.org/Resources-And-Publications/Task-Force-and-Work-Group-Reports/Hypertension-in-Pregnancy. Accessed 19 Jul 2015.

  46. Sibai BM. Preeclampsia: 3 preemptive tactics. OBG Manage. 2005;17:20–32.

    Google Scholar 

  47. Sibai BM. Etiology and management of postpartum hypertension-preeclampsia. Am J Obstet Gynecol. 2012;206:470–5.

    Article  PubMed  Google Scholar 

  48. American College of Obstetricians and Gynecologists. Committee Opinion No. 623: Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2015;125:521–5.

    Google Scholar 

  49. Zeeman GG. Neurologic complications of pre-eclampsia. Semin Perinatol. 2009;33:166–72.

    Article  PubMed  Google Scholar 

  50. Sibai BM, Ramadan MK, Usa I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169:1000–6.

    Article  CAS  PubMed  Google Scholar 

  51. Johnson W, Nguyen ML, Patel R. Hypertension crisis in the emergency department. Cardiol Clin. 2012;30:533–43.

    Google Scholar 

  52. U.S. National Library of Medicine. Drugs and lactation database (LactMed). http://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm. Accessed 23 Aug 2015.

  53. Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, et al. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002;359:1877–90.

    Article  PubMed  Google Scholar 

  54. Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev 2010;(11):CD000025.

    Google Scholar 

  55. Critchfield AS, Heard AJ. Severe preeclampsia or eclampsia and hypertensive issues. In: LaFontaine D, Angelini DJ, editors. Obstetric triage and emergency care protocol. New York: Springer Publishing Company, LLC; 2013. p. 149–58.

    Google Scholar 

  56. Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the collaborative eclampsia trial. Lancet. 1995;345:1455–63.

    Article  Google Scholar 

  57. Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17:3–23.

    Article  PubMed  Google Scholar 

  58. Hill CC, Pickinpaugh J. Trauma and surgical emergencies in the obstetric patient. Surg Clin North Am. 2008;88:421–40.

    Article  PubMed  Google Scholar 

  59. Fildes J, Reed L, Jones N, Martin M, Barrett J. Trauma: the leading cause of maternal death. J Trauma. 1992;32:643–5.

    Article  CAS  PubMed  Google Scholar 

  60. Kvarnstrand L, Milsom I, Lekander T, Druid H, Jacobsson B. Maternal fatalities, fetal and neonatal deaths related to motor vehicle crashes during pregnancy: a national population-based study. Acta Obstet Gynecol Scand. 2008;87:946–52.

    Article  PubMed  Google Scholar 

  61. Mendez-Figueroa H, Dahlke JD, Vrees RA, Rouse DJ. Trauma in pregnancy: an updated systematic review. Am J Obstet Gynecol. 2013;209:1–10.

    Article  PubMed  Google Scholar 

  62. Weincrot A, Nannini A, Manning SE, Kennelly J. Neonatal outcomes and mental illness, substance abuse and intentional injury during pregnancy. Matn Child Health J. 2012;16:979–88.

    Article  Google Scholar 

  63. Brown HL. Trauma in pregnancy. Obstet Gynecol. 2009;114:147–60.

    Article  PubMed  Google Scholar 

  64. Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, et al. Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S829–61.

    Article  PubMed  Google Scholar 

  65. Chames MC, Pearlman MD. Trauma during pregnancy: outcomes and clinical management. Clin Obstet Gynecol. 2008;51:398–408.

    Article  PubMed  Google Scholar 

  66. Rees GA, Willis BA. Resuscitation in late pregnancy. Anaesthesia. 1988;43:347–9.

    Article  CAS  PubMed  Google Scholar 

  67. Suresh MS, Mason CL, Munner U. Cardiopulmonary resuscitation and the parturient. Best Pract Res Clin Obstet Gynaecol. 2010;24:383–400.

    Article  PubMed  Google Scholar 

  68. Ahnfeldt-Mollerup P, Petersen LK, Kragstrup J, Christensen RD, Sørensen B. Postpartum infections: occurrence, healthcare contacts and association with breastfeeding. Acta Obstet Gynecol Scand. 2012;91:1440–4.

    Article  PubMed  Google Scholar 

  69. Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Chapter 31. Puerperal infection. In: Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY, editors. Williams obstetrics, 23rd ed. New York: McGraw-Hill; 2010. http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=350&Sectionid=41680597. Accessed 23 Aug 2015.

  70. Foxman B, D’Arcy H, Gillespie B, Bobo JK, Schwartz K. Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002;155:103–14.

    Article  PubMed  Google Scholar 

  71. Mass S. Breast pain: engorgement, nipple pain and mastitis. Clin Obstet Gynecol. 2004;47:676–82.

    Article  PubMed  Google Scholar 

  72. Schoenfeld EM, McKay MP. Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm? J Emer Med. 2010;38:e31–4.

    Article  Google Scholar 

  73. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008;78:727–31.

    PubMed  Google Scholar 

  74. Beilman GJ, Dunn DL. Surgical infections. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE, editors. Schwartz’s principles of surgery. 10th ed. New York: McGraw-Hill; 2014. http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=980&Sectionid=59610847. Accessed 11 Jun 2015.

  75. Faro C, Faro S. Postoperative pelvic infections. Infect Dis Clin North Am. 2008;22:653–63.

    Article  PubMed  Google Scholar 

  76. Clarke-Pearson DL, Geller EJ. Complications of hysterectomy. Obstet Gynecol. 2013;121:654–73.

    Article  PubMed  Google Scholar 

  77. Fischerova D. Urgent care in gynaecology: resuscitation and management of sepsis and acute blood loss. Best Pract Res Clin Obstet Gynaecol. 2009;23:679–90.

    Article  PubMed  Google Scholar 

  78. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41:580–637.

    Article  PubMed  Google Scholar 

  79. Keister D, Roberts KT, Werner SL. Strategies for breastfeeding success. Am Fam Physician. 2008;78:225–32.

    PubMed  Google Scholar 

  80. Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506.

    Article  PubMed  Google Scholar 

  81. Lam E, Chan T, Wiseman SM. Breast abscess: evidence based management recommendations. Expert Rev Anti Infect Ther. 2014;12:753–62.

    Article  CAS  PubMed  Google Scholar 

  82. Trop I, Dugas A, David J, El Khoury M, Boileau JF, Larouche N, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011;31:1683–99.

    Article  PubMed  Google Scholar 

  83. Pizzarello M, LaFontaine D. Secondary postpartum hemorrhage and endometritis. In: LaFontaine D, Angelini DJ, editors. Obstetric triage and emergency care protocol. New York: Springer Publishing Company, LLC; 2013. p. 259–302.

    Google Scholar 

  84. Chuang I, Van BC, Beall B, Schuchat A. Population-based surveillance for postpartum invasive group A Streptococcus infections, 1995–2000. Clin Infect Dis. 2002;35:665–70.

    Article  PubMed  Google Scholar 

  85. Stevens DL, Group A. Streptococcal sepsis. Curr Infect Dis Rep. 2003;5:379–86.

    Article  PubMed  Google Scholar 

  86. Hamilton SM, Stevens DL, Bryant AE. Pregnancy-related group a streptococcal infections: temporal relationships between bacterial acquisition, infection onset, clinical findings, and outcome. Clin Infect Dis. 2013;57:870–6.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Rimawi BH, Soper DE, Eschenbach DA. Group A streptococcal infections in obstetrics and gynecology. Clin Obstet Gynecol. 2012;55:864–74.

    Article  PubMed  Google Scholar 

  88. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59:e10–52.

    Google Scholar 

  89. Hammad IA, Chauhan SP, Magann EF, Abuhamad AZ. Peripartum complications with cesarean delivery: a review of Maternal-Fetal Medicine Units Network publications. J Matern Fetal Neonatal Med. 2014;27:463–74.

    Article  PubMed  Google Scholar 

  90. Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk factors for surgical site infection after low transverse cesarean section. Infect Control Hosp Epidemiol. 2008;29:477–84.

    Article  PubMed  Google Scholar 

  91. Jaiyeoba O. Postoperative infections in obstetrics and gynecology. Clin Obstet Gynecol. 2012;55:904–13.

    Article  PubMed  Google Scholar 

  92. Hodges KR, Davis BR, Swaim LS. Prevention and management of hysterectomy complications. Clin Obstet Gynecol. 2014;57:43–57.

    Article  PubMed  Google Scholar 

  93. Fitzwater JL, Tita AT. Prevention and management of cesarean wound infection. Obstet Gynecol Clin North Am. 2014;41:671–89.

    Google Scholar 

  94. Pallin DJ, Binder WD, Allen MB, Lederman M, Parmar S, Filbin MR, et al. Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clin Infect Dis. 2013;56:1754–62.

    Google Scholar 

  95. Webb S, Sherburn M, Ismail KM Managing perineal trauma after childbirth. BMJ. 2014;349:g6829.

    Google Scholar 

  96. Dudley L, Kettle C, Ismail K. Secondary suturing compared to non-suturing for broken down perineal wounds following childbirth. Cochrane Database Syst Rev 2013:(9):CD008977.

    Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA, USA

    Rachel A. Pilliod MD

  2. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA

    Rachel A. Pilliod MD

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Pilliod, R.A. (2016). Obstetrics in the Emergency Room. In: Handbook of Consult and Inpatient Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-27724-0_12

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