my tips for OB-GYN rotation

OB

– ask about the BABY status, method of future contraception, and whether they’re breastfeeding. 

– ask about lochia.

– discharge goals for c-section are same as normal surgery: peeing, tolerating PO, no signs of infection/endometritis/fever, ambulating, passed gas.

-learn about fetal heat tracings early on for OB. this includes baseline, level of variability, accels/early or late decels, and how to calculate montevideo units. also know what sufficient power for contraction means (200 montevideo units).

– in your note don’t forget to mention the IUPC (intrauterine pressure catheter) if in place, what method of delivery you anticipate, position of fetus (cephalic or breech), station baby is at, what percent cervix effacement.

– prenatally: always mention fundal height (measured from pubic symphysis) and fetal heart rate (via doppler).

– volunteer to do the 2 hour progress notes for patients in labor. i think the residents will appreciate this as it’s usually quite crazy in the labor and delivery unit.

DON’T PULL ON THE CORD TOO HARD or else you might invert the uterus. that will cause MASSIVE hemorrhage and is considered an emergency.

 

GYN

– abnormal uterine bleeding ALL DAY E’ERDAY. this is probs the majority of what you’ll see, so know the differential diagnosis for it well!

– regarding pelvic exam- you don’t actually push the speculum in the downwards direction that much, only slightly. ***also do NOT push the labia majora from the top, THAT IS WHERE THE CLITORIS IS! so do it from the bottom.

– always ask about menstrual history- this includes age of menarche, number of days, length of cycle, how many pads per day, any pain/dysmenorrhea

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s