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EMU 365: Best Emergency Medicine Articles of the Year 2018

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lunes, 24 de octubre de 2016

In vitro fertilization

emDocs - October 23, 2016 - Author: Cassella C - Edited by: Jamie Santistevan J and Koyfman A
"Pearls and Pitfalls for ART Patients
  • Complications bringing patients to the ED post ART include: pelvic infection, ovarian torsion, OHSS, ectopic/heterotopic pregnancy, and miscarriage
  • Early consultation with gynecology may be helpful in all post-procedure or pregnant ART patients
  • If suspecting OHSS defer pelvic examination until consultation with gynecology
  • Severe OHSS is a life threatening syndrome requiring aggressive IVF resuscitation
  • Beware of electrolyte abnormalities and coagulopathy in OHSS
  • Presence of IUP alone does not exclude ectopic pregnancy in ART
  • Obtain adnexal ultrasound to evaluate for ectopic in ART patients
  • If IUP is visualized, free fluid in the abdomen, abnormal adnexa, or hemodynamic instability should prompt surgical exploration for heterotopic"