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Sepsis and Infections in Pregnancy

Rachel Bridwell, MD, Gillian Schmitz, MD, Stuart Swadron, MD, FRCPC, and Brandon Carius, PA-C
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21:29
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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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03:55

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EMRAP 2019 03 March Written Summary 434 KB - PDF

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prestwig1 -

How common is normal fetal heart monitoring in Uterine rupture? Or was the thinking that the actual rupture occurred after she left L&D. Was she being monitored in the ED? Sepsis in pregnancy is scary. That fetal monitoring can be normal in uterine rupture is terrifying.

Gillian S., M.D. -

Hey prestwig1, I honestly don't know the incidence of normal fetal heart monitoring in uterine rupture, but apparently it does happen. My guess is that she had a microperforation initially and her pain was from peritonitis. The fetus can survive for some period of time with decreased amniotic fluid and a slow leak, but my hunch is that in this specific case, the rupture progressed and instability of the fetus did not become apparent until late in her presentation. It is terrifying. She had been monitored up in L&D for a few hours before they sent her down to the ED. Fetal monitoring did not continue in the ED because we don't have the equipment and the team caring for her was looking for another diagnosis by that point with the presumption that the fetus was ok.

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EM:RAP 2019 March Full episode audio for MD edition 207:41 min - 289 MB - M4AEM:RAP 2019 March German Edition Deutsche 90:57 min - 125 MB - MP3EM:RAP 2019 March Aussie Edition Australian 34:56 min - 48 MB - MP3EM:RAP 2019 March Farsi Edition Farsi 64:12 min - 88 MB - MP3EM:RAP 2019 March French Edition Français 22:38 min - 31 MB - MP3EM:RAP 2019 March Spanish Edition Español 78:59 min - 108 MB - MP3EM:RAP 2019 March Canadian Edition Canadian 18:22 min - 25 MB - MP3EMRAP_2019 03 March Board Review Answers_V2 135 KB - PDFEMRAP_2019 03 March Board Review Questions_V2 96 KB - PDFEMRAP 2019 03 March Individual MP3 229 MB - ZIPEMRAP_2019_03_March_Individual_Written 601 KB - ZIPEMRAP 2019 03 March Spanish Written 1 MB - PDFEMRAP 2019 03 March Written Summary 434 KB - PDF

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