All Episodes
Operative Vaginal Deliveries
Incidence: 3.3% as of 2013 Indications: Prolonged second stage Risk of fetal compromise Shortening 2nd stage for maternal benefit (ex: cardiac conditions) Consent: Compari...
Induction of Labor
Indications: Post-dates (42+wks) Late Term (41+ wks) Elective 39+wks Diabetes Hypertension Many more - check out ACOG Medically indicated delivery 39week induction ARRIVE T...
Shoulder dystocia
Definition: Failure to deliver fetal shoulders with normal downward traction Why we care: Baby hypoxia, brachial plexus injuries, maternal injuries Risk factors: DM, excessive w...
Cancer Screening and Vaccinations (HCM)
Cancer Screening Cervical: Age 21-65 Cytology q3yrs, co-test q5 if normal. ASCCP guidelines (there is an app! Or PDF: http://www.asccp.org/Assets/51b17a58-7af9-4667-879a-3ff48472d...
STIs
Swab/Urine Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1 Gonorrhea: often asymptomatic. Screen routinely...
Before Your First: Colposcopy and LEEP
Why: ASCCP guidelines (there is an app! Or PDF) Cervical dysplasia — caused by HPV CIN I–CIN3 is a progression Risk factors: Smoking, other STIs including HIV, immunodeficiency H...
Return OB Visits
Every visit: Doptones, fundal height, vitals Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement By Weeks: 20wks – get and review anatomy US 24wks –...
First Prenatal Visit
Planned/Desired Options counseling if needed Exam/pelvic/pap Ultrasound for dating Screening options: QUAD, Sequential, NIPS, invasive testing Pregnancy guidelines Weight: BMI ...
Before Your First: Hysteroscopy
Hysteroscopy = looking inside the uterus with a scope Steps: Dilate the cervix Distend the uterus with fluid Look around, identify pathology, identify tubal ostia, remove patholog...
Peripartum Fevers
Intrapartum Differential diagnosis for Temp >38.0C Epidural fever (transient), DVT/PE (if prolonged IOL or limited mobility), UTI, Intraamniotic infection (with or without ROM), e...
Postpartum Hemorrhage
Causes (Four T’s): Tone: Atony Pitocin Misoprostol: CI-allergy, SI-transient hyperthermia Methergine: CI-HTN, SE-HTN Hemabate: CI-asthma. SE-diarrhea Tamponade: bakri/utah bal...
Preterm Labor and PPROM
ACOG Practice bulletin: # 171 PTL or TPTL: Preterm <37wks, cervical change Evaluation: SSE first: Collect GC/CT cultures, FFN (no gel, blood or semen), GBS, eval for rupture if ...
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