Precipitous delivery in the emergency department is a high-acuity, low-occurrence event that requires rapid recognition and interdepartment cooperation to prevent fetal and maternal morbidity and mortality. Prompt recognition of the peripartum state can be delayed by reported usage of long-acting contraception and concurrent distracting complaints. In this case report, a young female presented to the emergency department with epigastric abdominal pain in the setting of recent workup for biliary colic and multiple doses of long-acting, depot contraceptive agents. Early utilization of bedside ultrasound confirmed a full-term, intrauterine pregnancy as well as an impacted gallbladder stone, followed by a precipitous footling breech presentation that required an emergent cesarean section.
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http://dx.doi.org/10.7759/cureus.6776 | DOI Listing |
J Alzheimers Dis
November 2024
Nursing Department, The Stanley Steyer School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Ramat Aviv, Israel.
Background: Individuals with dementia are particularly vulnerable during emergency situations due to challenges with cognition, mobility, and daily functioning. However, little is known about how disruptive events may specifically impact the health of those with dementia.
Objective: To evaluate changes in health outcomes for individuals with and without dementia surrounding the Israel-Gaza war in October 2023.
Cureus
September 2024
Emergency Medicine, Indiana University School of Medicine, Indianapolis, USA.
Background Pregnant laboring patients sometimes require interfacility transfer to a higher level of care. There is a paucity of evidence to inform when it is safe to transfer a laboring patient and when delivery may be too imminent to transfer. Methods This is a retrospective study of pregnant patients undergoing interfacility transfer with a specialized obstetric transport team deployed from a large Midwest regional healthcare system.
View Article and Find Full Text PDFCureus
June 2024
Department of Radiology, Aichi Medical University, Nagakute, JPN.
Introduction In stereotactic radiosurgery (SRS) for brain metastasis (BM), volumetric-modulated arcs (VMA) can provide a suitable dose distribution and efficient delivery, even with a widely available 5-mm leaf-width multileaf collimator (MLC). The planning optimization with affirmatively accepting internal high doses of a gross tumor volume (GTV) enhances the steepness of the dose gradient outside the GTV. However, an excessively steep dose falloff outside a GTV is susceptible to insufficient coverage of inherent irradiation uncertainties with the dose attenuation margin.
View Article and Find Full Text PDFInfez Med
June 2024
Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.
Group B Streptococcus (; GBS) infection is a significant contributor to neonatal morbidity and mortality. In the early 1970s, the neonatal mortality rate for infants with invasive GBS disease was 55%. With the adoption of the first medical community guidelines to prevent GBS infection in the 1990s, the mortality rate decreased to approximately 5%.
View Article and Find Full Text PDFCureus
April 2024
Emergency Medicine, Mayo Clinic, Jacksonville, USA.
Hospitals without formal obstetric services place the emergency physician in the position of managing potentially complicated precipitous labor and delivery such as breech presentations. Breech deliveries pose an increased risk of significant morbidity and mortality to both the mother and fetus. Recent emphasis on cesarean section as the optimal delivery method for breech presentation has decreased education and comfort levels with breech vaginal deliveries.
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