How do I get ready for labor and delivery?
Please watch the following videos.
Please read
Blueprints Obstetrics and Gynecology, 7th ed. Chapter 4: Normal Labor and Delivery.
- Dilation
- Expulsion
- Placental
Dilation
Effacement
Station
Consistency
Position
Baseline
Variability
Accelerations
Decelerations
Electronic Fetal Monitoring Tracing Game. Can you recognize the strip elements?
How do I get ready for the operating room?
Scrubbing in the OR
The great Michigan scrub-off
How do I get ready for the Ob/Gyn ambulatory clinic?
Clinical correlation
Blueprints Obstetrics and Gynecology, 7th ed. Chapter 22: Abnormalities of the Menstrual Cycle.
- Know the definition of dysmenorrhea.
- What is the difference between primary and secondary dysmenorrhea?
- How is primary dysmenorrhea treated?
- What are causes of secondary dysmenorrhea?
- What is the definition of a normal menstrual cycle?
- What is the PALM-COIEN system of abnormal uterine bleeding?
- What are the defining features of heavy menstrual bleeding?
- How is abnormal uterine bleeding evaluated?
- What treatments are available for the various causes of abnormal uterine bleeding?
Prenatal care table
Recommended testing/screening
- Rubella titer
- Varicella titer
Recommended immunization(s)
- Rubella
- Varicella
Recommended counseling/anticipatory guidance
- Smoking cessation
- Prenatal Vitamins
Recommended testing/screening
- Weight
- BP
- FHR
- Fundal height (starting at 20 wga)
- +/–Urinalysis
Recommended immunization(s)
- Influenza (pending season)
- COVID-19 (pending season)
Recommended counseling/anticipatory guidance
- Nutrition/exercise, weight gain
Recommended testing/screening
- BMI
- Blood type/Rh
- Hgb/Hct
- Rubella titer
- CT/GC
- Hep BsAg
- Hep C Antibody
- Syphilis
- +/– Varicella titer
- Urine culture
- HIV
- Pap +/– HPV (if due based on history/age)
- NIPS (if desired starting at 10 WGA)
- Carrier Screening (if desired)
- Early 1 hour GTT (if high risk)
Recommended counseling/anticipatory guidance
- Intimate Partner Violence
- Depression
Recommended testing/screening
- NT/sequential/integrated screen (if desired and NIPS declined)
Recommended risk-reduction treatments
- Low-dose aspirin for Preeclampsia prevention if high risk (13–36 wga)
Recommended testing/screening
- AFP optional for fetal oNTD screening
Recommended testing/screening
- Rh (if neg)
- Gestational diabetes screening (if not currently diagnosed with diabetes)
- CBC
Recommended risk-reduction treatments
- Rhogam if Rh negative
Recommended immunizations
- TdaP (27–32 weeks)
Recommended testing/screening
- GBS
- Check fetal presentation
- Check cervix (optional)
Recommended risk-reduction treatments
- HSV prophylaxis starting at 36 weeks-delivery if history of genital HSV lesions
Recommended immunizations
- RSV if 32–36 wga and due September–January (the vaccine should be administered during weeks 32–36 weeks of pregnancy from September through January)
Recommended testing/screening
- Pap +/– HPV (if due based on history/age)
Recommended risk-reduction treatments
- Rhogam (if patient Rh negative and infant Rh positive)
Recommended immunizations
- Rubella (if non-immune)
Helpful tips to succeed in care of the patient with Ob/Gyn needs
- If you’re not early, you’re late.
- “You should read up on/learn about . . . " really means “I will ask you questions about this topic next time we meet, so you must read about it to prepare.”
- Ask the magic questions (of your preceptor, nurses, medical assistants, etc.):
- What can I do to make your day better?
- What else can I help with?
- Ask early and often for directed feedback and assessment:
- “I’m working on improving my Gynecologic history/other WBA skill. Can you help me find a patient today where you could observe this and we could discuss my WBA on this afterward together?”
- “I know we haven’t had an appropriate patient for me to practice performing a supervised pelvic exam yet. Can you help identify an appropriate patient for this today so I can get feedback and improve?”
What are some downloadable resources that I can use?
- Ob-Gyn Notes
Includes:
-
- Sample labor and delivery admit note
- Sample vaginal delivery note
- Sample operative note
- Sample post-partum note: Vaginal delivery
- Ob postpartum note: Cesarean delivery
- Sample gynecologic history and physical
- Sample new obstetrics presentation in the clinic/ambulatory setting
- Sample return obstetrics presentation in the clinic/ambulatory setting
- Sample labor and delivery triage presentation
- Sample labor and delivery admission presentation
- Sample inpatient postpartum patient presentation example
- New gynecology patient/gynecology consultation presentation
- Return gynecology patient to clinic/ambulatory setting
- Sample presentation of gynecology post-operative patient