Episode 67 – Managing Postpartum Complications in the Emergency Department – An Interview with Dr. Nicole Yuzuk, Dr. Joseph Bove, and Dr. Riddhi Desai

EMplify – March 2022

Interview with the Authors: Nicole Yuzuk, DO, Joseph Bove, DO, and Riddhi Desai, DO

Episode Outline:

1.Why is this an important topic in EM? 

2.Hemorrhage etiologies and definition

3.Headache etiologies, both common and the more dangerous (ICH)

4.Fever and infection

• Mastitis
• Endometritis

5.Preeclampsia/eclampsia 

• Definition, diagnosis, risk factors (Table 1)

6.HELLP syndrome

• Definition, diagnosis (Table 2)

7.Peripartum cardiomyopathy

• Time of onset, how to make the diagnosis, risks (Table 3)

8.Prehospital care

• IV fluids
• TXA
• AMS evaluation
• Chest pain
• Fever/hypotension 

9.ED evaluation 

• History (what kind of things should we remember to ask?) 
• Physical exam (what should we be paying attention to?) 

10.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)

11.Treatment

• Hemorrhage 
• Headache (CVT)
• Infection (mastitis, endometritis, wound Infection)
• Preeclampsia, eclampsia, HELLP, seizures
• Cardiomyopathy

12.What about breastfeeding mothers? 

13.Controversies and cutting edge

• Endovascular therapy
• Thromboelastography