Complications of Assisted Reproductive Technology

Assisted reproductive technology (ART) is an evolving field with many therapies that have a common goal: to maximize the chance of pregnancy while minimizing the risk of multiple gestations. As the Canadian infertility rate approaches 15%, the use of ART is steadily increasing (1). In fact, 1-4% of all newborns in industrialized nations are conceived with assisted reproductive technology (2). […]

Pulmonary Embolism in Pregnancy: Diagnostic Dilemmas

Epidemiology of pulmonary embolism in pregnancy The rate of pulmonary embolism (PE) in pregnancy is 5.4 per 10 000 pregnancies. This is 5x the risk of the general non-pregnant female population The rates of venous thromboembolism change throughout pregnancy: Antepartum: 5.4 per 10 000 Peripartum: 7.2 per 10 000 Postpartum: 4.3 per 10 000 This leads to 0.96 deaths per 100 […]

Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5 /5 van der Pol LM, et al. N Engl J Med. 2019 Mar 21;380(12):1139-1149 Question and Methods: Using a prospective cohort study of 510 pregnant women, the authors were trying to see whether an algorithm could safely diagnose PEs and avoid unnecessary imaging. Findings: YEARS algorithm can safely rule out PE […]

What to expect when your patient is expecting! Medical emergencies in pregnancy.

The pregnant or postpartum patient presents a unique set of challenges to the emergency physician. Although life-threatening emergencies are relatively rare, they require specialized protocols and different considerations than we’re used to (i.e. medications contraindicated in pregnancy and lactation). Maternal morbidity is increasing as women are seeking pregnancy at a later age – 1 in 12 births in the US […]

Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies

Journal Club Summary Methodology Score: 4/5                 Usefulness Score: 2/5 Verhaegen J, Gallos ID, van Mello NM, Abdel-Aziz M, Takwoingi Y, Harb H, Deeks JJ, Mol BW, Coomarasamy A BMJ. 2012 Sep 27;345:e6077 Article Link This thorough and well performed systematic literature review found that a single progesterone test before 14 weeks gestational age in women with pain or bleeding and an inconclusive […]