- Bartholin Gland Abscess I&D
- Normal Spontaneous Vaginal Delivery
- Pelvic Exam
- Resuscitative Hysterotomy
- Shoulder Dystocia Management

Bartholin Gland Abscess I&D
Rapid Review
- Background
- Common techniques for incision and drainage of bartholin gland abscesses include marsupialization and fistulization with word catheter
- Indications
- Symptomatic abscesses that are at least 1 cm in diameter
- Contraindications
- No absolute contraindications. Relative contraindications include complex abscesses requiring general anesthesia.
- Complications
- Recurrence (30%), bleeding, infection.
Pearls

Normal Spontaneous Vaginal Delivery
Rapid Review
- Background
- Uncomplicated, vaginal delivery of full-term (37-42 week) newborn. Represents the majority of births across the world.
- Indications
- Spontaneous labor mediated by hormone cascade or induction; rupture of amniotic/chorionic membranes.
- Contraindications
- Prolapsed cord, face/breech presentation, abnormal fetal heart patterns (bradycardia/tachycardia)
- Complications
- Premature rupture of membranes, failure to progress, postpartum hemorrhage
Pearls

Pelvic Exam
Rapid Review
- Background
- Speculum examination of the vaginal walls and cervix, as well as a bimanual examination to evaluate the cervical os and evaluate for adnexal masses
- Indications
- Vaginal bleeding (if hemodynamically unstable)
- Acute urinary retention (evaluate for prolapsed organ)
- Contraindications
- Lack of consent
- Complications:
- Anxiety, pain
Pearls

Resuscitative Hysterotomy
Rapid Review
- Background
- Previously known as “perimortem cesarean section”. Involves delivering a fetus from a gravid mother through an abdominal incision during or after maternal cardiopulmonary arrest. Potentially life-saving for both the mother and the fetus.
- Indications
- Maternal cardiac arrest w/o ROSC within 4 minutes
- Contraindications
- Gestational age < 24 weeks, ROSC within 4 minutes
- Complications
- Fetal injury, hemorrhagic shock
Pearls
Deep Dive

Shoulder Dystocia Management
Rapid Review
- Background
- Shoulder dystocia occurs when one or both shoulders become impacted against the bones of the maternal pelvis, preventing vaginal delivery. Management techniques include the McRobert’s, Rubin, Jacquemier, and Woods maneuvers.
- Indications
- Any clinically significant shoulder dystocia
- Contraindications
- Fundal pressure, strong lateral traction, and head rotation beyond 90 degrees should be avoided.
- Complications
- Clavicle fracture, brachial plexus injury
Pearls
Deep Dive
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