**1. Introduction**

Gynaecological emergencies are disease conditions of the female reproductive system that threaten the life of the woman, her sexual function and the perpetuation of her fertility. Common gynaecological emergencies present as acute abdomen, abnormal vaginal bleeding, or a combination of both, and are often related to early pregnancy complications, pelvic inflammatory disease (PID) and contraceptive issues.

Some hospitals, mostly in the developed world, have specialist Emergency Gynaecology Units that provide fast intervention for acute gynaecological problems, such as pelvic pain, severe menorrhagia, vulvar problems, acute PID, hyperemesis gravidarum and post gynaecology surgical problems. These units are often manned by specialist nurses, sonologists and an oncall gynaecology medical team headed by a consultant gynaecologist. The aim of such a unit is to deliver adequate healthcare quickly, thus reducing the possible complications, and in so doing reducing the morbidity and mortality associated with such cases.

Advances in sonography, biochemical pregnancy testing, minimal access surgery and new antibiotics have led to early diagnosis of these conditions and adoption of more conservative approaches to treatment.

The basic objective of this chapter is to have an overview of these emergency gynaecological conditions on an individual basis, and their management. The management of these cases often requires history taking, clinical examination, investigations, both general and specific, and instituting the required treatment plan. Time is of the essence in these cases and so often there is an overlap in the management steps, with some requiring immediate resuscitation.

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