Procedure Ready: Ob/Gyn

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...

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...

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 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...

Swab/Urine Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1 Gonorrhea: often asymptomatic. Screen routinely...

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...

Every visit: Doptones, fundal height, vitals Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement By Weeks: 20wks – get and review anatomy US 24wks –...

Planned/Desired Options counseling if needed Exam/pelvic/pap Ultrasound for dating Screening options: QUAD, Sequential, NIPS, invasive testing Pregnancy guidelines Weight: BMI ...

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...

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...

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...

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 ...