OB/GYN

Pregnancy Bleeding

• First trimester: pregnancy test, transvaginal ultrasound, quantitative beta-hCG, Rh status.
• Painless third-trimester bleeding: think placenta previa; avoid digital cervical exam until previa excluded.
• Painful bleeding with tender uterus: think placental abruption.

Preeclampsia

• Hypertension after 20 weeks plus proteinuria or end-organ findings.
• Severe features require magnesium sulfate for seizure prophylaxis and delivery planning.
• Definitive treatment is delivery, timing depends on gestational age/severity.

Postpartum Hemorrhage

• Uterine massage, oxytocin, evaluate 4 Ts: tone, trauma, tissue, thrombin.