Gynecologic Emergencies

Physiology:

  • Onset of menstruation is called menarche, between 11 & 16.

  • Menopause occurs around 50, natural point where menstruating stops because the ovaries greatly reduce their reproductive hormone production and ovulation ends. Estrogen and progestogen ceases being produced.

  • If fertilization does not occur within 14 days of ovulation it sheds, period.

  • Period:

    • 1 Menstruation Day = First day of bleeding.

    • 2 Follicular Phase = An egg develops in ovary

    • 3 Ovulation = LH surge releases egg (around day 14)

    • 4 Luteal Phase = Progesterone rises

Menstruation: Normal vs Concerning

  • Normal: Vaginal bleeding, lower abdominal/pelvic cramping, Back discomfort, Fatigue, Headache, Mild Nausea

  • Concerning: Severe or sudden pelvic pain, heavy or unusual bleeding,

Pelvic Inflammatory Disease (PID)

  • Infection of upper organs of reproduction, occurs almost exclusively in sexually active women. Can result in increased risk of ectopic pregnancy or sterility, common sign is generalized lower abdominal pain.

  • S/S: Lower abdominal/pelvic pain, fever or chills, abnormal vaginal discharge/bleeding, painful urination, pain during intercourse, nausea/vomiting may occur.

Sexually Transmitted Diseases (STDs/STIs)

  • Can lead to more serious conditions like PID.

  • Chlamydia

    • Most common STD caused by bacteria, usually mild or absent symptoms, can spread to rectum or progress to PID

  • Bacterial Vaginosis

    • Most common vaginal infections, affecting women ages 14 - 44. Normal bacteria in vagina are replaced by overgrowth of other bacteria. If untreated, can progress to premature birth or low birth weight in pregnancy, and PID.

  • Gonorrhea

    • Grows and multiplies rapidly in warm, moist areas of reproductive tract. Cervix, uterus, fallopian tubes in women; urethra in men. If untreated, can enter bloodstream and spready to other parts of body.

Emergency Medical Care:

  • Respect patient privacy.

  • Use sanitary pads on the external genitalia to absorb blood, document number of pads saturated in blood.

  • NEVER pack dressings in women.

  • 1/5 women has reported being raped. 1/3 will be sexually molested.