Clinical decision support that reasons like an OB-GYN: recognize preeclampsia with severe features and give magnesium, manage the abnormal cervical screen by ASCCP, stop the postpartum hemorrhage, and work up the ectopic — with the decision rule and exactly what would change it. Built for verified physicians.
Two real OB-GYN questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
34 weeks, blood pressure 165/115 with a new headache and a falling platelet count — the immediate management?
This is preeclampsia with severe features. Admit, treat the severe-range hypertension within an hour — labetalol, hydralazine or oral nifedipine — to bring the pressure below 160/110, and start magnesium sulfate for seizure prophylaxis. Give antenatal corticosteroids if before 34 weeks for fetal lung maturity. Delivery is the only cure: at 34 weeks or more with severe features, deliver; earlier, individualize while stabilizing mother and fetus.
Decision rulePreeclampsia with severe features → control BP below 160/110 within the hour; magnesium sulfate for seizure prophylaxis; steroids if under 34 weeks; deliver at 34+ weeks with severe features.
Not established from this alone — the gestational age, the severity trajectory and the fetal status change the timing of delivery.
A boggy uterus and brisk bleeding right after a vaginal delivery — the sequence?
Call for help and work the four Ts — Tone, Trauma, Tissue, Thrombin — with uterine atony the commonest cause. Start firm uterine massage and uterotonics: oxytocin first, then methylergonovine, carboprost or misoprostol. Give tranexamic acid early, secure large-bore access and resuscitate, and examine for lacerations and retained tissue. If bleeding persists, escalate to balloon tamponade, then surgical control.
Decision rulePPH → call for help; massage + uterotonics (oxytocin → methylergonovine / carboprost / misoprostol); tranexamic acid early; work the 4 Ts; escalate to tamponade then surgery.
Not established from this alone — the cause, the blood loss and the response change the escalation.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Diagnose severe features by a systolic pressure of 160 or more, a diastolic of 110 or more, a platelet count under 100,000, rising creatinine or transaminases, pulmonary edema, or new neurologic or visual symptoms. Treat severe-range hypertension within an hour to below 160/110, start magnesium sulfate for seizure prophylaxis, and give steroids before 34 weeks. Delivery is definitive — at 34 weeks or more with severe features, proceed.ACOG
Decision ruleSevere features (BP 160/110+, platelets under 100k, organ dysfunction, neuro symptoms) → treat BP within the hour; magnesium; steroids under 34 wk; deliver at 34+ wk.
Missing data: the gestational age, the trajectory and the fetal status change the timing.
Manage by the ASCCP risk-based guidance, which combines the current result with the history to estimate the risk of precancer, not by the single Pap alone. Primary HPV testing or co-testing drives the pathway: colposcopy when the immediate risk of CIN 3+ crosses the threshold, otherwise surveillance at one, three or five years. HPV-16 or 18 positivity, or persistent abnormality, moves the patient toward colposcopy sooner.ASCCP
Decision ruleASCCP risk-based: current result + history → immediate CIN3+ risk; colposcopy above the threshold, else 1/3/5-year surveillance; HPV 16/18 or persistence escalates.
Missing data: the HPV genotype, the screening history and prior results change the next step.
Work the four Ts: Tone (atony, the commonest), Trauma (lacerations, rupture), Tissue (retained products) and Thrombin (coagulopathy). Start uterine massage and uterotonics — oxytocin first, then methylergonovine, carboprost or misoprostol — give tranexamic acid early, and resuscitate with large-bore access and blood as needed. Escalate stepwise to intrauterine balloon tamponade, compression sutures, uterine artery embolization and, finally, hysterectomy.ACOG · PPH
Decision rule4 Ts (Tone/Trauma/Tissue/Thrombin); massage + uterotonics; TXA early; resuscitate; escalate to balloon → compression sutures → embolization → hysterectomy.
Missing data: the cause, the ongoing loss and the coagulation status change the escalation.
Combine the serum beta-hCG with transvaginal ultrasound: above the discriminatory zone an empty uterus suggests an ectopic, while below it a rising or plateauing hCG is followed serially. Offer methotrexate to the hemodynamically stable patient with an unruptured ectopic, a low hCG and no strong contraindication; choose surgery for rupture, instability, a high hCG or failed medical therapy. A stable patient can sometimes be expectantly managed.ACOG · ectopic
Decision ruleBeta-hCG + TVUS vs the discriminatory zone; methotrexate if stable, unruptured, low hCG, no contraindication; surgery for rupture/instability/high hCG/failed medical therapy.
Missing data: the hCG trend, the ultrasound and hemodynamic stability change the treatment.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist OB-GYN colleague across high-risk obstetrics, labor and delivery, cervical screening, abnormal bleeding, early pregnancy and contraception — cited, non-directive, always with the decision rule.
Deep specialist agents for maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and urogynecology — each its own soul and knowledge base — plus your own uploaded materials.
From the magnesium call to the ASCCP threshold the margin is thin. Only one of these reasons like an OB-GYN colleague whose every claim you can trace.
The waitlist is a founding cohort. Members shape the OB-GYN build, get in before anyone else, and lock the founding price for good.
Leave your name and work email. We'll reach out the moment OB-GYN opens — with your Founding OB-GYN offer.
One email at launch. No spam, ever.
It reasons in the frameworks you use — the ACOG hypertension guidance, ASCCP risk-based screening, the four Ts of hemorrhage and the PALM-COEIN bleeding framework — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion on the ward and in clinic. Access is gated to verified physicians.
Maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and urogynecology each have their own deep specialist agent on the Pro plan, on top of the full OB-GYN scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited OB-GYN knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
HeyHippocrates