Pimped: Ob/Gyn https://pimpedmed.com/ Email podcast@pimpedmed.com or tweet @pimpedmed with comments, questions, and episode ideas. Pimped-Ob/Gyn is a podcast aimed at medical, PA, and NP students who are entering their clinical rotation in Ob/Gyn.  It covers topics including Your Ob/Gyn Survival Guide-Tips and Tricks, Labor and Delivery, Vaginal deliveries, C-sections, Hysterectomies and more.   Each podcast walks you through a portion of what you’ll experience during your clinical rotations, gives you tips for excelling, preps you for the Pimping that’ll occur and sets you up to overall Honor the rotation! Wed, 13 Feb 2019 19:07:49 +0000 en-US © 2017 Heroic Ventures, LLC A Guide for Thriving During your Obstetrics and Gynecology Clerkship Jennifer Doorey, MD, MS serial Jennifer Doorey, MD, MS podcast@pimpedmed.com Email podcast@pimpedmed.com or tweet @pimpedmed with comments, questions, and episode ideas. Pimped-Ob/Gyn is a podcast aimed at medical, PA, and NP students who are entering their clinical rotation in Ob/Gyn.  It covers topics including Your Ob/Gyn Survival Guide-Tips and Tricks, Labor and Delivery, Vaginal deliveries, C-sections, Hysterectomies and more.   Each podcast walks you through a portion of what you’ll experience during your clinical rotations, gives you tips for excelling, preps you for the Pimping that’ll occur and sets you up to overall Honor the rotation! Email podcast@pimpedmed.com or tweet @pimpedmed with comments, questions, and episode ideas. Pimped-Ob/Gyn is a podcast aimed at medical, PA, and NP students who are entering their clinical rotation in Ob/Gyn.  It covers topics including Your Ob/Gyn Survival Guide-Tips and Tricks, Labor and Delivery, Vaginal deliveries, C-sections, Hysterectomies and more.   Each podcast walks you through a portion of what you’ll experience during your clinical rotations, gives you tips for excelling, preps you for the Pimping that’ll occur and sets you up to overall Honor the rotation! Pimped podcast@pimpedmed.com clean No https://pimpedmed.com/wp-content/uploads/2017/10/Pimped-Podcast-1.png Pimped: Ob/Gyn https://pimpedmed.com/ https://wordpress.org/?v=5.0.4 Cancer Screening and Vaccinations (HCM) https://pimpedmed.com/podcast/cancer-screening-vaccinations-hcm/ Wed, 15 Aug 2018 18:12:44 +0000 pimped https://pimpedmed.com/?post_type=podcast&p=1214 full 17 1 Cancer Screening

Vaccinations

  • HPV: 3 dose series age 12-26
  • Influenza: annual
  • Pneumovax: 1 dose and 1 booster any age if risk factors. After age 65 if no risk factors
  • Shingles: 2 dose age 50+
  • Hep B: initial vaccination in youth, vaccination for anyone non-immune
  • MMR: if not immune
  • Varicella: if not immune
  • Tdap: Booster at 10yrs, new parents
]]>
Cancer Screening

Vaccinations

  • HPV: 3 dose series age 12-26
  • Influenza: annual
  • Pneumovax: 1 dose and 1 booster any age if risk factors. After age 65 if no risk factors
  • Shingles: 2 dose age 50+
  • Hep B: initial vaccination in youth, vaccination for anyone non-immune
  • MMR: if not immune
  • Varicella: if not immune
  • Tdap: Booster at 10yrs, new parents
]]>
Cancer Screening

Vaccinations

  • HPV: 3 dose series age 12-26
  • Influenza: annual
  • Pneumovax: 1 dose and 1 booster any age if risk factors. After age 65 if no risk factors
  • Shingles: 2 dose age 50+
  • Hep B: initial vaccination in youth, vaccination for anyone non-immune
  • MMR: if not immune
  • Varicella: if not immune
  • Tdap: Booster at 10yrs, new parents
]]>
clean No no no 12:07 pimped
STIs https://pimpedmed.com/podcast/stis/ Wed, 15 Aug 2018 17:40:09 +0000 pimped https://pimpedmed.com/?post_type=podcast&p=1211 full 16 1 Swab/Urine

  • Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1
  • Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin
  • Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
  • HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed.

Serum

  • Syphilis: Painless chancre followed by latent, then secondary with palmar/plantar rash. If unsure stage, treat as if latent, PCN IM x3
  • HIV: Universal screening. PREP if high risk. Referral to ID and counseling if positive.
  • Hep B: Treatable, not curable. Routine serum screening.

No Routine Screening, diagnose if lesion

  • HSV: Antivirals as needed for outbreaks, can prophylax if frequent outbreaks/immunosuppressed. Valacyclovir or acyclovir are most common.
]]>
Swab/Urine

  • Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1
  • Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin
  • Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
  • HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed.

Serum

  • Syphilis: Painless chancre followed by latent, then secondary with palmar/plantar rash. If unsure stage, treat as if latent, PCN IM x3
  • HIV: Universal screening. PREP if high risk. Referral to ID and counseling if positive.
  • Hep B: Treatable, not curable. Routine serum screening.

No Routine Screening, diagnose if lesion

  • HSV: Antivirals as needed for outbreaks, can prophylax if frequent outbreaks/immunosuppressed. Valacyclovir or acyclovir are most common.
]]>
Swab/Urine

  • Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1
  • Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin
  • Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
  • HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed.

Serum

  • Syphilis: Painless chancre followed by latent, then secondary with palmar/plantar rash. If unsure stage, treat as if latent, PCN IM x3
  • HIV: Universal screening. PREP if high risk. Referral to ID and counseling if positive.
  • Hep B: Treatable, not curable. Routine serum screening.

No Routine Screening, diagnose if lesion

  • HSV: Antivirals as needed for outbreaks, can prophylax if frequent outbreaks/immunosuppressed. Valacyclovir or acyclovir are most common.
]]>
clean No no no 13:06 pimped
Before Your First: Colposcopy and LEEP https://pimpedmed.com/podcast/first-colposcopy-leep/ Tue, 13 Feb 2018 22:50:47 +0000 pimped http://pimpedmed.com/?post_type=podcast&p=957 full 14 1 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

 

Histology: Increased Nuclear: cytoplasmic ratio when abnormal

Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.

Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark.  Non-staining cells are abnormal.

 

HPV — changes

Colpo:

Increased vascularity, punctations, mosaicism, surface contour changes

 

LEEP:

Stain abnormality and know where abnormal biopsy was taken

Single pass is ideal–tag a side for orientation

+/- Top Hat depending on ECC result

 

CKC:

Higher up in cervical canal, but more complications

No electricity– okay if pregnant

]]>
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

 

Histology: Increased Nuclear: cytoplasmic ratio when abnormal

Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.

Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark.  Non-staining cells are abnormal.

 

HPV — changes

Colpo:

Increased vascularity, punctations, mosaicism, surface contour changes

 

LEEP:

Stain abnormality and know where abnormal biopsy was taken

Single pass is ideal–tag a side for orientation

+/- Top Hat depending on ECC result

 

CKC:

Higher up in cervical canal, but more complications

No electricity– okay if pregnant

]]>
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

 

Histology: Increased Nuclear: cytoplasmic ratio when abnormal

Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.

Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark.  Non-staining cells are abnormal.

 

HPV — changes

Colpo:

Increased vascularity, punctations, mosaicism, surface contour changes

 

LEEP:

Stain abnormality and know where abnormal biopsy was taken

Single pass is ideal–tag a side for orientation

+/- Top Hat depending on ECC result

 

CKC:

Higher up in cervical canal, but more complications

No electricity– okay if pregnant

]]>
clean No no no 14:50 pimped
Return OB Visits https://pimpedmed.com/podcast/return-ob-visits/ Sun, 11 Feb 2018 19:09:26 +0000 pimped http://pimpedmed.com/?post_type=podcast&p=935 full 19 1 Every visit:

  • Doptones, fundal height, vitals
  • Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement

By Weeks:

  • 20wks – get and review anatomy US
  • 24wks – order glucola, cbc (check for anemia), discuss normal growing pains
  • 28wks – Tdap and Rhogam if needed, discuss kick counts
  • 32wks – Discuss BCM, sign tubal papers if needed, discuss TOLAC if needed
  • 36wks – GBS screening, birth expectations, US for position
  • 38-40wks – VE, “sweep membranes”

 

]]>
Every visit:

  • Doptones, fundal height, vitals
  • Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement

By Weeks:

  • 20wks – get and review anatomy US
  • 24wks – order glucola, cbc (check for anemia), discuss normal growing pains
  • 28wks – Tdap and Rhogam if needed, discuss kick counts
  • 32wks – Discuss BCM, sign tubal papers if needed, discuss TOLAC if needed
  • 36wks – GBS screening, birth expectations, US for position
  • 38-40wks – VE, “sweep membranes”

 

]]>
Every visit:

  • Doptones, fundal height, vitals
  • Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement

By Weeks:

  • 20wks – get and review anatomy US
  • 24wks – order glucola, cbc (check for anemia), discuss normal growing pains
  • 28wks – Tdap and Rhogam if needed, discuss kick counts
  • 32wks – Discuss BCM, sign tubal papers if needed, discuss TOLAC if needed
  • 36wks – GBS screening, birth expectations, US for position
  • 38-40wks – VE, “sweep membranes”

 

]]>
clean No no no 12:14 pimped
First Prenatal Visit https://pimpedmed.com/podcast/first-prenatal-visit/ Thu, 08 Feb 2018 14:09:06 +0000 pimped http://pimpedmed.com/?post_type=podcast&p=931 full 18 1
  • Planned/Desired
  • Options counseling if needed
  • Exam/pelvic/pap
  • Ultrasound for dating
  • Screening options: QUAD, Sequential, NIPS, invasive testing
  • Pregnancy guidelines
  • Weight:
    • BMI under 18.5 should gain 28–40 pounds.
    • Normal-weight women (BMI, 18.5–24.9) should aim for 25–35
    • Overweight women (BMI, 25–29.9) should aim for 15–25
    • Obese women (BMI, 30 or more) should gain only 11–20
  • Food: Avoid unpasteurized dairy, large fish (swordfish, shark, king mackerel, tilefish, bigeye tuna etc), uncooked meat/seafood, uncooked deli meat, EtOH
  • Drugs: Nothing unless cleared by MD. Tylenol okay if needed, PNV, Colace, FeSO4. NO NSAIDs!
  • Exercise: Nothing that could leave a bruise on your belly! Moderate exercise is great.
  • ]]>
  • Planned/Desired
  • Options counseling if needed
  • Exam/pelvic/pap
  • Ultrasound for dating
  • Screening options: QUAD, Sequential, NIPS, invasive testing
  • Pregnancy guidelines
  • Weight:
    • BMI under 18.5 should gain 28–40 pounds.
    • Normal-weight women (BMI, 18.5–24.9) should aim for 25–35
    • Overweight women (BMI, 25–29.9) should aim for 15–25
    • Obese women (BMI, 30 or more) should gain only 11–20
  • Food: Avoid unpasteurized dairy, large fish (swordfish, shark, king mackerel, tilefish, bigeye tuna etc), uncooked meat/seafood, uncooked deli meat, EtOH
  • Drugs: Nothing unless cleared by MD. Tylenol okay if needed, PNV, Colace, FeSO4. NO NSAIDs!
  • Exercise: Nothing that could leave a bruise on your belly! Moderate exercise is great.
  • ]]>
  • Planned/Desired
  • Options counseling if needed
  • Exam/pelvic/pap
  • Ultrasound for dating
  • Screening options: QUAD, Sequential, NIPS, invasive testing
  • Pregnancy guidelines
  • Weight:
    • BMI under 18.5 should gain 28–40 pounds.
    • Normal-weight women (BMI, 18.5–24.9) should aim for 25–35
    • Overweight women (BMI, 25–29.9) should aim for 15–25
    • Obese women (BMI, 30 or more) should gain only 11–20
  • Food: Avoid unpasteurized dairy, large fish (swordfish, shark, king mackerel, tilefish, bigeye tuna etc), uncooked meat/seafood, uncooked deli meat, EtOH
  • Drugs: Nothing unless cleared by MD. Tylenol okay if needed, PNV, Colace, FeSO4. NO NSAIDs!
  • Exercise: Nothing that could leave a bruise on your belly! Moderate exercise is great.
  • ]]>
    clean No no no 17:20 pimped
    Before Your First: Hysteroscopy https://pimpedmed.com/podcast/before-your-first-hysteroscopy/ Wed, 10 Jan 2018 11:04:07 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=858 full 13 1 Hysteroscopy = looking inside the uterus with a scope

    Steps:

    1. Dilate the cervix
    2. Distend the uterus with fluid
    3. Look around, identify pathology, identify tubal ostia, remove pathology if using an operative scope or Myosure or another resectoscope.

    Feared complication: Hyponatremia from excessive hypotonic fluid absorption.

    ]]>
    Hysteroscopy = looking inside the uterus with a scope

    Steps:

    1. Dilate the cervix
    2. Distend the uterus with fluid
    3. Look around, identify pathology, identify tubal ostia, remove pathology if using an operative scope or Myosure or another resectoscope.

    Feared complication: Hyponatremia from excessive hypotonic fluid absorption.

    ]]>
    Hysteroscopy = looking inside the uterus with a scope

    Steps:

    1. Dilate the cervix
    2. Distend the uterus with fluid
    3. Look around, identify pathology, identify tubal ostia, remove pathology if using an operative scope or Myosure or another resectoscope.

    Feared complication: Hyponatremia from excessive hypotonic fluid absorption.

    ]]>
    clean No no no 10:15 pimped
    Peripartum Fevers https://pimpedmed.com/podcast/peripartum-fevers/ Mon, 08 Jan 2018 01:57:36 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=851 full 8 1 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), etc

     

    Chorioamnionitis aka IAI aka Triple-I (intrapartum intraamniotic Infection)

    • One temp >39.0C
    • One temp 38.0C-39.0C AND one or more risk factors
    • Two temps >38.0C 30+ mins apart

    Tx: the standard is Ampicillin/Gentamycin until delivery. Tylenol prn temp>38C, IVF for maternal/fetal tachycardia, cooling blanket if needed to decrease temp.

     

    If mild PCN allergy: Ancef/Gent

    If severe PCN allergy: gent/clinda or gent/vanc

     

    If vaginal delivery: No evidence that continued abx postpartum provide benefit.

     

    If c-section: Add clindamycin to Amp/Gent.

    Continue at least 1 dose postpartum. Clinical judgment on when to d/c. Some do 1 dose, some 24hrs afebrile, until clinical improvement, etc.

     

    Postpartum

    Wind – PNA, atelectasis, URI

    Womb – Endomyometritis — Gent/Clinda x 24hrs afebrile

    Wound – Superficial wound infection, cellulitis — eval for collection, probe wound/fascia if able

    Water – UTI, Pyelo — get UA

    Walking – DVT/PE

    Weening – Engorgement or mastitis

    Wonder drugs

    ]]>
    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), etc

     

    Chorioamnionitis aka IAI aka Triple-I (intrapartum intraamniotic Infection)

    • One temp >39.0C
    • One temp 38.0C-39.0C AND one or more risk factors
    • Two temps >38.0C 30+ mins apart

    Tx: the standard is Ampicillin/Gentamycin until delivery. Tylenol prn temp>38C, IVF for maternal/fetal tachycardia, cooling blanket if needed to decrease temp.

     

    If mild PCN allergy: Ancef/Gent

    If severe PCN allergy: gent/clinda or gent/vanc

     

    If vaginal delivery: No evidence that continued abx postpartum provide benefit.

     

    If c-section: Add clindamycin to Amp/Gent.

    Continue at least 1 dose postpartum. Clinical judgment on when to d/c. Some do 1 dose, some 24hrs afebrile, until clinical improvement, etc.

     

    Postpartum

    Wind – PNA, atelectasis, URI

    Womb – Endomyometritis — Gent/Clinda x 24hrs afebrile

    Wound – Superficial wound infection, cellulitis — eval for collection, probe wound/fascia if able

    Water – UTI, Pyelo — get UA

    Walking – DVT/PE

    Weening – Engorgement or mastitis

    Wonder drugs

    ]]>
    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), etc

     

    Chorioamnionitis aka IAI aka Triple-I (intrapartum intraamniotic Infection)

    • One temp >39.0C
    • One temp 38.0C-39.0C AND one or more risk factors
    • Two temps >38.0C 30+ mins apart

    Tx: the standard is Ampicillin/Gentamycin until delivery. Tylenol prn temp>38C, IVF for maternal/fetal tachycardia, cooling blanket if needed to decrease temp.

     

    If mild PCN allergy: Ancef/Gent

    If severe PCN allergy: gent/clinda or gent/vanc

     

    If vaginal delivery: No evidence that continued abx postpartum provide benefit.

     

    If c-section: Add clindamycin to Amp/Gent.

    Continue at least 1 dose postpartum. Clinical judgment on when to d/c. Some do 1 dose, some 24hrs afebrile, until clinical improvement, etc.

     

    Postpartum

    Wind – PNA, atelectasis, URI

    Womb – Endomyometritis — Gent/Clinda x 24hrs afebrile

    Wound – Superficial wound infection, cellulitis — eval for collection, probe wound/fascia if able

    Water – UTI, Pyelo — get UA

    Walking – DVT/PE

    Weening – Engorgement or mastitis

    Wonder drugs

    ]]>
    clean No no no 21:25 pimped
    Postpartum Hemorrhage https://pimpedmed.com/podcast/postpartum-hemorrhage/ Thu, 14 Dec 2017 02:14:01 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=836 full 9 1 Causes (Four T’s):

    1. Tone: Atony
      1. Pitocin
      2. Misoprostol: CI-allergy, SI-transient hyperthermia
      3. Methergine: CI-HTN, SE-HTN
      4. Hemabate: CI-asthma. SE-diarrhea
      5. Tamponade: bakri/utah balloons
    2. Trauma: Lacerations
    3. Tissue: Retained POC (placenta or membranes)
    4. Thrombin: Coagulopathy  
    5. Other: Involution
    ]]>
    Causes (Four T’s):

    1. Tone: Atony
      1. Pitocin
      2. Misoprostol: CI-allergy, SI-transient hyperthermia
      3. Methergine: CI-HTN, SE-HTN
      4. Hemabate: CI-asthma. SE-diarrhea
      5. Tamponade: bakri/utah balloons
    2. Trauma: Lacerations
    3. Tissue: Retained POC (placenta or membranes)
    4. Thrombin: Coagulopathy  
    5. Other: Involution
    ]]>
    Causes (Four T’s):

    1. Tone: Atony
      1. Pitocin
      2. Misoprostol: CI-allergy, SI-transient hyperthermia
      3. Methergine: CI-HTN, SE-HTN
      4. Hemabate: CI-asthma. SE-diarrhea
      5. Tamponade: bakri/utah balloons
    2. Trauma: Lacerations
    3. Tissue: Retained POC (placenta or membranes)
    4. Thrombin: Coagulopathy  
    5. Other: Involution
    ]]>
    clean No no no 17:55 pimped
    Who’s that collar? https://pimpedmed.com/podcast/whos-that-collar/ Thu, 14 Dec 2017 02:03:54 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=833 bonus 99 1 Hello from Addison and Lundy.

    ]]>
    Hello from Addison and Lundy.

    ]]>
    Hello from Addison and Lundy.

    ]]>
    clean No no no 0:30 pimped
    Preterm Labor and PPROM https://pimpedmed.com/podcast/preterm-labor-pprom/ Thu, 14 Dec 2017 01:56:43 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=830 full 7 1 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 needed

    SVE:

    Cervical change–can dilation or effacement changes

    FFN: Fetal fibronectin

    If tPTL:

    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • Tocolysis for steroid window (48hrs) if <34wks, questionable if 34-36+6. Indocin if <32 wks, Nifidipine if 32+wks
    • IV fluids
    • NICU consult

    PPROM: Preterm <37wks, Ruptured membranes

    SSE: Confirm rupture with Pooling, nitrazine ferning. Collect GC/CT and GBS.

    If PPROM: Delivery at 34wks or at diagnosis if chorio or 34+wks

    • Latency antibiotics: Erythromycin/Azithromycin, Ampicillin x 2 days, PO Erythro/Amoxicillin x 5 days
    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • NO Tocolysis
    • NICU consult
    ]]>
    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 needed

    SVE:

    Cervical change–can dilation or effacement changes

    FFN: Fetal fibronectin

    If tPTL:

    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • Tocolysis for steroid window (48hrs) if <34wks, questionable if 34-36+6. Indocin if <32 wks, Nifidipine if 32+wks
    • IV fluids
    • NICU consult

    PPROM: Preterm <37wks, Ruptured membranes

    SSE: Confirm rupture with Pooling, nitrazine ferning. Collect GC/CT and GBS.

    If PPROM: Delivery at 34wks or at diagnosis if chorio or 34+wks

    • Latency antibiotics: Erythromycin/Azithromycin, Ampicillin x 2 days, PO Erythro/Amoxicillin x 5 days
    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • NO Tocolysis
    • NICU consult
    ]]>
    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 needed

    SVE:

    Cervical change–can dilation or effacement changes

    FFN: Fetal fibronectin

    If tPTL:

    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • Tocolysis for steroid window (48hrs) if <34wks, questionable if 34-36+6. Indocin if <32 wks, Nifidipine if 32+wks
    • IV fluids
    • NICU consult

    PPROM: Preterm <37wks, Ruptured membranes

    SSE: Confirm rupture with Pooling, nitrazine ferning. Collect GC/CT and GBS.

    If PPROM: Delivery at 34wks or at diagnosis if chorio or 34+wks

    • Latency antibiotics: Erythromycin/Azithromycin, Ampicillin x 2 days, PO Erythro/Amoxicillin x 5 days
    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • NO Tocolysis
    • NICU consult
    ]]>
    clean No no no 20:57 pimped
    Indications for a c-section during labor https://pimpedmed.com/podcast/indications-c-section-labor/ Mon, 04 Dec 2017 03:08:16 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=817 full 6 1
  • Nonreassuring fetal heart tracing
    Category 2-remote from delivery
    Minimal/absent variability is most significant predictor of fetal acidemia
    Category 3 any time is emergent deliver
  • Failed IOL
    Many different definitions: Most commonly 12-24hrs ruptured membranes on pitocin without active labor
  • Arrest of dilation
    Can only meet criteria once in active labor 6cm or greater
    Do you know if her contractions are adequate? IUPC with MVUs>200-250
    If the contractions are adequate, no change over 4hrs
    If contractions are inadequate or no IUPC, no change over 6hrs
  • Arrest of descent
    Prime with epidural 3hrs
    Prime without epidural-2hrs
    Mutlip with epidural 2hrs
    Multip without epidural 1hr
  • Cord prolapse
    -Emergency!
  • Malpresentation
    -Breech, transverse, compound
  • ]]>
  • Nonreassuring fetal heart tracing
    Category 2-remote from delivery
    Minimal/absent variability is most significant predictor of fetal acidemia
    Category 3 any time is emergent deliver
  • Failed IOL
    Many different definitions: Most commonly 12-24hrs ruptured membranes on pitocin without active labor
  • Arrest of dilation
    Can only meet criteria once in active labor 6cm or greater
    Do you know if her contractions are adequate? IUPC with MVUs>200-250
    If the contractions are adequate, no change over 4hrs
    If contractions are inadequate or no IUPC, no change over 6hrs
  • Arrest of descent
    Prime with epidural 3hrs
    Prime without epidural-2hrs
    Mutlip with epidural 2hrs
    Multip without epidural 1hr
  • Cord prolapse
    -Emergency!
  • Malpresentation
    -Breech, transverse, compound
  • ]]>
  • Nonreassuring fetal heart tracing
    Category 2-remote from delivery
    Minimal/absent variability is most significant predictor of fetal acidemia
    Category 3 any time is emergent deliver
  • Failed IOL
    Many different definitions: Most commonly 12-24hrs ruptured membranes on pitocin without active labor
  • Arrest of dilation
    Can only meet criteria once in active labor 6cm or greater
    Do you know if her contractions are adequate? IUPC with MVUs>200-250
    If the contractions are adequate, no change over 4hrs
    If contractions are inadequate or no IUPC, no change over 6hrs
  • Arrest of descent
    Prime with epidural 3hrs
    Prime without epidural-2hrs
    Mutlip with epidural 2hrs
    Multip without epidural 1hr
  • Cord prolapse
    -Emergency!
  • Malpresentation
    -Breech, transverse, compound
  • ]]>
    clean No no no 16:03 pimped
    Birth Control https://pimpedmed.com/podcast/birth-control/ Mon, 04 Dec 2017 03:04:55 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=818 full 15 1 Resources:

    https://www.bedsider.org/methods

     

    Table:

    http://www.womenscommunityclinic.org/wp-content/uploads/Bedsider-Birth-Control-Effectiveness-Poster.jpg


    Spanish:

    http://s3.amazonaws.com/providers/images/images/000/000/032/center/Spanish_tiers_of_effectiveness.png?1464661802

    ]]>
    Resources:

    https://www.bedsider.org/methods

     

    Table:

    http://www.womenscommunityclinic.org/wp-content/uploads/Bedsider-Birth-Control-Effectiveness-Poster.jpg


    Spanish:

    http://s3.amazonaws.com/providers/images/images/000/000/032/center/Spanish_tiers_of_effectiveness.png?1464661802

    ]]>
    Resources:

    https://www.bedsider.org/methods

     

    Table:

    http://www.womenscommunityclinic.org/wp-content/uploads/Bedsider-Birth-Control-Effectiveness-Poster.jpg


    Spanish:

    http://s3.amazonaws.com/providers/images/images/000/000/032/center/Spanish_tiers_of_effectiveness.png?1464661802

    ]]>
    clean No no no 19:32 pimped
    Before Your First: Hysterectomy https://pimpedmed.com/podcast/before-your-first-hysterectomy/ Tue, 21 Nov 2017 01:00:37 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=778 full 12 1 What approach: Abdominal, laparoscopic, vaginal or combination
    Taking or leaving the tubes and ovaries?
    Tubes: What benefit do they provide? Risk?
    Ovaries: What benefit do ovaries provide? What about after menopause? Still have benefit for bones and cardiovascular health. 65yr old cut-off

    If it’s laparoscopic–listen to the LSC podcast for more details on the approach

    Let’s talk about important steps:

    1. The round ligament: What artery runs inside the round? Sampson’s.
    2. What structure conceals the blood flow to the ovary? The IP ligament (formerly the suspensory ligament of the ovary). The artery comes from the aorta, so if this is transected before it is fully sealed, it can hemorrhage while retracting back into the retroperitoneum. Badness!
    3. What are the four levels at which the ureter is injured during hysterectomy? 1- At the pelvic brim, 2- medial to the IP ligament, 3- as it passes under the uterine artery (water under the bridge) and 4- lateral to the vaginal cuff closure.
    4. Ligate and transect the uterine arteries–the uterus should blanch white.
    5. Colpotomy– disconnecting uterus from vagina
    6. Close vaginal cuff if total hyst
    ]]>
    What approach: Abdominal, laparoscopic, vaginal or combination
    Taking or leaving the tubes and ovaries?
    Tubes: What benefit do they provide? Risk?
    Ovaries: What benefit do ovaries provide? What about after menopause? Still have benefit for bones and cardiovascular health. 65yr old cut-off

    If it’s laparoscopic–listen to the LSC podcast for more details on the approach

    Let’s talk about important steps:

    1. The round ligament: What artery runs inside the round? Sampson’s.
    2. What structure conceals the blood flow to the ovary? The IP ligament (formerly the suspensory ligament of the ovary). The artery comes from the aorta, so if this is transected before it is fully sealed, it can hemorrhage while retracting back into the retroperitoneum. Badness!
    3. What are the four levels at which the ureter is injured during hysterectomy? 1- At the pelvic brim, 2- medial to the IP ligament, 3- as it passes under the uterine artery (water under the bridge) and 4- lateral to the vaginal cuff closure.
    4. Ligate and transect the uterine arteries–the uterus should blanch white.
    5. Colpotomy– disconnecting uterus from vagina
    6. Close vaginal cuff if total hyst
    ]]>
    What approach: Abdominal, laparoscopic, vaginal or combination
    Taking or leaving the tubes and ovaries?
    Tubes: What benefit do they provide? Risk?
    Ovaries: What benefit do ovaries provide? What about after menopause? Still have benefit for bones and cardiovascular health. 65yr old cut-off

    If it’s laparoscopic–listen to the LSC podcast for more details on the approach

    Let’s talk about important steps:

    1. The round ligament: What artery runs inside the round? Sampson’s.
    2. What structure conceals the blood flow to the ovary? The IP ligament (formerly the suspensory ligament of the ovary). The artery comes from the aorta, so if this is transected before it is fully sealed, it can hemorrhage while retracting back into the retroperitoneum. Badness!
    3. What are the four levels at which the ureter is injured during hysterectomy? 1- At the pelvic brim, 2- medial to the IP ligament, 3- as it passes under the uterine artery (water under the bridge) and 4- lateral to the vaginal cuff closure.
    4. Ligate and transect the uterine arteries–the uterus should blanch white.
    5. Colpotomy– disconnecting uterus from vagina
    6. Close vaginal cuff if total hyst
    ]]>
    clean No no no 20:39 pimped
    Before Your First: Laparoscopy https://pimpedmed.com/podcast/before-your-first-laparoscopy/ Mon, 20 Nov 2017 02:21:27 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=776 full 11 1 Review anatomy– you’ll be able to see well!
    Pimped- Youtube Channel videos for laparoscopic anatomy

    What case are you doing and why?
    Review common indications, steps to procedure and potential risks/complications

    Saying hi to the patient first
    Being helpful setting up — yellowfins or stirrups for lithotomy
    Scrubbing in — ask to grab your gown/gloves for the scrub, open carefully or get help if unsure

    Abx: If entering uterus or vagina ie hyst
    Prep: infection prevention with chloraprep or something
    EtOH based, needs to evaporate before draping or risk fire!
    Vaginal prep — betadine or chlorhexidine
    Then everyone scrubs

    Let resident/attending drape unless asked.
    You may be asked to help with foley/manipulator
    Uterine manipulators: Many sizes/shapes/types
    Vagina is dirty– can’t go from vagina to abdomen

    Abdomen:
    Entry: Typically in umbilicus or just above. Can use Palmer’s Point if needed.
    Direct visualization with Hassan
    Visiport
    Veres needle
    Insufflate with CO2

    Port placement: Typically middle ⅓ of distance between ASIS and umbilicus. Avoid obvious superficial vessels and inferior epigastric –watch from below

    Common procedures:

    • Dx LSC– endometriosis, adhesions
    • Tubal ligation or bilateral salpingectomy
    • Cystectomy
    • BSO
    • Hysterectomy

    Closing ports: Close fascia on ports >5mm due to increased risk of hernia

    Post-op checks: Many LSC cases are same-day, meaning patients go home
    -Nausea/vomiting, eating/drinking, voiding, passing flatus, ambulating
    -UOP, BPs,

    ]]>
    Review anatomy– you’ll be able to see well!
    Pimped- Youtube Channel videos for laparoscopic anatomy

    What case are you doing and why?
    Review common indications, steps to procedure and potential risks/complications

    Saying hi to the patient first
    Being helpful setting up — yellowfins or stirrups for lithotomy
    Scrubbing in — ask to grab your gown/gloves for the scrub, open carefully or get help if unsure

    Abx: If entering uterus or vagina ie hyst
    Prep: infection prevention with chloraprep or something
    EtOH based, needs to evaporate before draping or risk fire!
    Vaginal prep — betadine or chlorhexidine
    Then everyone scrubs

    Let resident/attending drape unless asked.
    You may be asked to help with foley/manipulator
    Uterine manipulators: Many sizes/shapes/types
    Vagina is dirty– can’t go from vagina to abdomen

    Abdomen:
    Entry: Typically in umbilicus or just above. Can use Palmer’s Point if needed.
    Direct visualization with Hassan
    Visiport
    Veres needle
    Insufflate with CO2

    Port placement: Typically middle ⅓ of distance between ASIS and umbilicus. Avoid obvious superficial vessels and inferior epigastric –watch from below

    Common procedures:

    • Dx LSC– endometriosis, adhesions
    • Tubal ligation or bilateral salpingectomy
    • Cystectomy
    • BSO
    • Hysterectomy

    Closing ports: Close fascia on ports >5mm due to increased risk of hernia

    Post-op checks: Many LSC cases are same-day, meaning patients go home
    -Nausea/vomiting, eating/drinking, voiding, passing flatus, ambulating
    -UOP, BPs,

    ]]>
    Review anatomy– you’ll be able to see well!
    Pimped- Youtube Channel videos for laparoscopic anatomy

    What case are you doing and why?
    Review common indications, steps to procedure and potential risks/complications

    Saying hi to the patient first
    Being helpful setting up — yellowfins or stirrups for lithotomy
    Scrubbing in — ask to grab your gown/gloves for the scrub, open carefully or get help if unsure

    Abx: If entering uterus or vagina ie hyst
    Prep: infection prevention with chloraprep or something
    EtOH based, needs to evaporate before draping or risk fire!
    Vaginal prep — betadine or chlorhexidine
    Then everyone scrubs

    Let resident/attending drape unless asked.
    You may be asked to help with foley/manipulator
    Uterine manipulators: Many sizes/shapes/types
    Vagina is dirty– can’t go from vagina to abdomen

    Abdomen:
    Entry: Typically in umbilicus or just above. Can use Palmer’s Point if needed.
    Direct visualization with Hassan
    Visiport
    Veres needle
    Insufflate with CO2

    Port placement: Typically middle ⅓ of distance between ASIS and umbilicus. Avoid obvious superficial vessels and inferior epigastric –watch from below

    Common procedures:

    • Dx LSC– endometriosis, adhesions
    • Tubal ligation or bilateral salpingectomy
    • Cystectomy
    • BSO
    • Hysterectomy

    Closing ports: Close fascia on ports >5mm due to increased risk of hernia

    Post-op checks: Many LSC cases are same-day, meaning patients go home
    -Nausea/vomiting, eating/drinking, voiding, passing flatus, ambulating
    -UOP, BPs,

    ]]>
    clean No no no 29:04 pimped
    Hypertension in Pregnancy https://pimpedmed.com/podcast/hypertension-in-pregnancy/ Mon, 20 Nov 2017 02:17:19 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=771 full 5 1 Hypertension in Pregnancy — One large spectrum

    Mild range: 140/90
    Severe range 160/110

    CHTN → SIPE
    gHTN → Pre-E

    BP meds: Methyldopa, labetalol, hydralazine, nifedipine

    Severe features:

    1. BPs
    2. Neurologic symptoms
    3. Lab findings:

    HELLP
    Hemolysis, Elevated Liver (enzymes), Low Platelets

    Eclampsia — Seizures

    ]]>
    Hypertension in Pregnancy — One large spectrum

    Mild range: 140/90
    Severe range 160/110

    CHTN → SIPE
    gHTN → Pre-E

    BP meds: Methyldopa, labetalol, hydralazine, nifedipine

    Severe features:

    1. BPs
    2. Neurologic symptoms
    3. Lab findings:

    HELLP
    Hemolysis, Elevated Liver (enzymes), Low Platelets

    Eclampsia — Seizures

    ]]>
    Hypertension in Pregnancy — One large spectrum

    Mild range: 140/90
    Severe range 160/110

    CHTN → SIPE
    gHTN → Pre-E

    BP meds: Methyldopa, labetalol, hydralazine, nifedipine

    Severe features:

    1. BPs
    2. Neurologic symptoms
    3. Lab findings:

    HELLP
    Hemolysis, Elevated Liver (enzymes), Low Platelets

    Eclampsia — Seizures

    ]]>
    clean No no no 24:20 pimped
    Before Your First: Cesarean Section https://pimpedmed.com/podcast/first-cesarean-section/ Wed, 15 Nov 2017 02:04:32 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=766 full 4 1 Why?

    Scheduled: Repeat cesarean, hx of uterine surgery, abnormal placentation (placenta previa, vasa previa, accrete, etc) malpresentation (not cephalic), multiple gestation

    In labor: arrest of dilation, arrest of descent, nonreassuring fetal heart tones, elective

    Anatomy: Layers of anterior abdominal wall: skin, subcutaneous tissue, superficial fascia (Campers, scarpa’s), external oblique muscle, internal oblique muscle, transversus abdominis muscle, transversalis fascia, preperitoneal adipose and areolar tissue, and peritoneum. Nerves, blood vessels, and lymphatics are present throughout.

    Now you’re at the uterus — or should be. Clear the surgical field, take down adhesions, bladder flap if needed.

    Hysterotomy — lower uterine segment, lateral uterine vessels to avoid

    Delivery baby — delay cord clamp, placenta

    Likely lots of bleeding — same atony meds as vaginal delivery

    Clean inside of uterus to remove all membranes etc.

    Possibly exteriorize uterus to see better — depends on scaring

    How can you be helpful — visualization! Bladder blade back in, suction or clean with lap between when surgeon placing sutures.

    Two layers to hysterotomy if they might ever want to labor again or if needed for hemostasis.

    Clean up the abdomen–irrigation vs moist laps vs suction

    Now to close:

    Peritoneium — either way, close or not– no evidence either way
    Muscle– don’t close, evidence that closing it can cause hematoma
    Fascia–Close!

    Closing Fascia:

    Nerves at the lateral edges of the fascial incision are ilioingiunal, iliohypogastric

    Subcutaneous fat — if >2cm depth, close to reduce risk of seroma/hematoma/infection

    Skin closure — stables, suture, absorbable stables

     

     

    ]]>
    Why?

    Scheduled: Repeat cesarean, hx of uterine surgery, abnormal placentation (placenta previa, vasa previa, accrete, etc) malpresentation (not cephalic), multiple gestation

    In labor: arrest of dilation, arrest of descent, nonreassuring fetal heart tones, elective

    Anatomy: Layers of anterior abdominal wall: skin, subcutaneous tissue, superficial fascia (Campers, scarpa’s), external oblique muscle, internal oblique muscle, transversus abdominis muscle, transversalis fascia, preperitoneal adipose and areolar tissue, and peritoneum. Nerves, blood vessels, and lymphatics are present throughout.

    Now you’re at the uterus — or should be. Clear the surgical field, take down adhesions, bladder flap if needed.

    Hysterotomy — lower uterine segment, lateral uterine vessels to avoid

    Delivery baby — delay cord clamp, placenta

    Likely lots of bleeding — same atony meds as vaginal delivery

    Clean inside of uterus to remove all membranes etc.

    Possibly exteriorize uterus to see better — depends on scaring

    How can you be helpful — visualization! Bladder blade back in, suction or clean with lap between when surgeon placing sutures.

    Two layers to hysterotomy if they might ever want to labor again or if needed for hemostasis.

    Clean up the abdomen–irrigation vs moist laps vs suction

    Now to close:

    Peritoneium — either way, close or not– no evidence either way
    Muscle– don’t close, evidence that closing it can cause hematoma
    Fascia–Close!

    Closing Fascia:

    Nerves at the lateral edges of the fascial incision are ilioingiunal, iliohypogastric

    Subcutaneous fat — if >2cm depth, close to reduce risk of seroma/hematoma/infection

    Skin closure — stables, suture, absorbable stables

     

     

    ]]>
    Why?

    Scheduled: Repeat cesarean, hx of uterine surgery, abnormal placentation (placenta previa, vasa previa, accrete, etc) malpresentation (not cephalic), multiple gestation

    In labor: arrest of dilation, arrest of descent, nonreassuring fetal heart tones, elective

    Anatomy: Layers of anterior abdominal wall: skin, subcutaneous tissue, superficial fascia (Campers, scarpa’s), external oblique muscle, internal oblique muscle, transversus abdominis muscle, transversalis fascia, preperitoneal adipose and areolar tissue, and peritoneum. Nerves, blood vessels, and lymphatics are present throughout.

    Now you’re at the uterus — or should be. Clear the surgical field, take down adhesions, bladder flap if needed.

    Hysterotomy — lower uterine segment, lateral uterine vessels to avoid

    Delivery baby — delay cord clamp, placenta

    Likely lots of bleeding — same atony meds as vaginal delivery

    Clean inside of uterus to remove all membranes etc.

    Possibly exteriorize uterus to see better — depends on scaring

    How can you be helpful — visualization! Bladder blade back in, suction or clean with lap between when surgeon placing sutures.

    Two layers to hysterotomy if they might ever want to labor again or if needed for hemostasis.

    Clean up the abdomen–irrigation vs moist laps vs suction

    Now to close:

    Peritoneium — either way, close or not– no evidence either way
    Muscle– don’t close, evidence that closing it can cause hematoma
    Fascia–Close!

    Closing Fascia:

    Nerves at the lateral edges of the fascial incision are ilioingiunal, iliohypogastric

    Subcutaneous fat — if >2cm depth, close to reduce risk of seroma/hematoma/infection

    Skin closure — stables, suture, absorbable stables

     

     

    ]]>
    clean No no no 24:41 pimped
    Before Your First: Vaginal Delivery https://pimpedmed.com/podcast/know-first-vaginal-delivery/ Mon, 30 Oct 2017 01:45:59 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=742 full 3 1
  • Cardinal movements of labor: engagement, descent, flexion, internal rotation, extension, external rotation and expulsion
  • Complete dilation, now station: Labor down vs push
  • 2nd Stage of labor: Pushing
  • Offer to help with maternal positioning—holding ankle/leg
  • Delivery—downward traction on head, thumbs to nose, anterior shoulder, posterior shoulder, body. Skin to skin. Delayed cord clamping.
  • 3rd stage placenta: Active management, Pitocin, gentle cord traction. 3 signs of placental detachment
  • Bleeding: Atony, meds
  • Lacerations: degree, repair
  • Postpartum: Fundal tenderness, lochia, voiding, BMC.
  • ]]>
  • Cardinal movements of labor: engagement, descent, flexion, internal rotation, extension, external rotation and expulsion
  • Complete dilation, now station: Labor down vs push
  • 2nd Stage of labor: Pushing
  • Offer to help with maternal positioning—holding ankle/leg
  • Delivery—downward traction on head, thumbs to nose, anterior shoulder, posterior shoulder, body. Skin to skin. Delayed cord clamping.
  • 3rd stage placenta: Active management, Pitocin, gentle cord traction. 3 signs of placental detachment
  • Bleeding: Atony, meds
  • Lacerations: degree, repair
  • Postpartum: Fundal tenderness, lochia, voiding, BMC.
  • ]]>
  • Cardinal movements of labor: engagement, descent, flexion, internal rotation, extension, external rotation and expulsion
  • Complete dilation, now station: Labor down vs push
  • 2nd Stage of labor: Pushing
  • Offer to help with maternal positioning—holding ankle/leg
  • Delivery—downward traction on head, thumbs to nose, anterior shoulder, posterior shoulder, body. Skin to skin. Delayed cord clamping.
  • 3rd stage placenta: Active management, Pitocin, gentle cord traction. 3 signs of placental detachment
  • Bleeding: Atony, meds
  • Lacerations: degree, repair
  • Postpartum: Fundal tenderness, lochia, voiding, BMC.
  • ]]>
    clean No no no 22:41 pimped
    Labor and Delivery Triage https://pimpedmed.com/podcast/labor-delivery-triage/ Mon, 30 Oct 2017 01:29:25 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=739 full 2 1
  • The OB One-Liner: “This is a _ yr old G_ P_ @_ wks GA here for ____.”
    Ex: This is a 34yo G3P2002 @ 38wks3days GA here for contractions
  • Triage: 4 essential questions to ask every pregnant woman in triage
    Contractions, leaking fluid, vaginal bleeding, fetal movement
  • What is labor? Cervical change and contractions
  • Evaluate for ROM: Pooling, nitrazine (pH), ferning.
  • Vaginal bleeding—when do we care? 2nd or 3rd trimester worry about placenta: abruption, previa, vasa previa
  • DFM: NSTs, BPPs, Kick counts
  • ]]>
  • The OB One-Liner: “This is a _ yr old G_ P_ @_ wks GA here for ____.”
    Ex: This is a 34yo G3P2002 @ 38wks3days GA here for contractions
  • Triage: 4 essential questions to ask every pregnant woman in triage
    Contractions, leaking fluid, vaginal bleeding, fetal movement
  • What is labor? Cervical change and contractions
  • Evaluate for ROM: Pooling, nitrazine (pH), ferning.
  • Vaginal bleeding—when do we care? 2nd or 3rd trimester worry about placenta: abruption, previa, vasa previa
  • DFM: NSTs, BPPs, Kick counts
  • ]]>
  • The OB One-Liner: “This is a _ yr old G_ P_ @_ wks GA here for ____.”
    Ex: This is a 34yo G3P2002 @ 38wks3days GA here for contractions
  • Triage: 4 essential questions to ask every pregnant woman in triage
    Contractions, leaking fluid, vaginal bleeding, fetal movement
  • What is labor? Cervical change and contractions
  • Evaluate for ROM: Pooling, nitrazine (pH), ferning.
  • Vaginal bleeding—when do we care? 2nd or 3rd trimester worry about placenta: abruption, previa, vasa previa
  • DFM: NSTs, BPPs, Kick counts
  • ]]>
    clean No no no 22:34 pimped
    Your Ob/Gyn Survival Guide: Tips and Tricks https://pimpedmed.com/podcast/obgyn-survival-guide-tips-tricks/ Mon, 23 Oct 2017 19:10:30 +0000 pimped http://pimpedapp.com/?post_type=podcast&p=727 full 1 1 High yield resources and tips for your Ob/Gyn clerkship.

    Youtube Playlist: http://bit.ly/pimped-ob

    Books:

    • Netters
    • Obstetrics and Gynecology by Beckmann

    Apps:

    • Pimped App – Clinical questions to expect in the OR and on the wards
    • Uptodate
    • Epocrates
    • GoodRx
    • LactMed – medications safe in breastfeeding
    • ASCCP: Cervical cancer screening
    • CDC STI guidelines
    • ACOG app/website
    • OB Wheel or dating

    Tips and Tricks:

    • Be Proactive—talk to students who just finished the rotation about ways to be helpful and the day to day logistics.
    • Expectations: Ask for them to be set at the beginning. Clarify as needed.
    • Be Self-sufficient, but ask for help when appropriate
    • Before leaving for the day, ask when you should come in to round, who to pre-round on and where to meet.
    • Once or twice a week ask for feedback when everyone has a down moment.

    Labor and Delivery:

    1. Gs & Ps aka Gravity and Parity.
    2. Primes, multips
    3. Gestational age Preterm vs term
    ]]>
    High yield resources and tips for your Ob/Gyn clerkship.

    Youtube Playlist: http://bit.ly/pimped-ob

    Books:

    • Netters
    • Obstetrics and Gynecology by Beckmann

    Apps:

    • Pimped App – Clinical questions to expect in the OR and on the wards
    • Uptodate
    • Epocrates
    • GoodRx
    • LactMed – medications safe in breastfeeding
    • ASCCP: Cervical cancer screening
    • CDC STI guidelines
    • ACOG app/website
    • OB Wheel or dating

    Tips and Tricks:

    • Be Proactive—talk to students who just finished the rotation about ways to be helpful and the day to day logistics.
    • Expectations: Ask for them to be set at the beginning. Clarify as needed.
    • Be Self-sufficient, but ask for help when appropriate
    • Before leaving for the day, ask when you should come in to round, who to pre-round on and where to meet.
    • Once or twice a week ask for feedback when everyone has a down moment.

    Labor and Delivery:

    1. Gs & Ps aka Gravity and Parity.
    2. Primes, multips
    3. Gestational age Preterm vs term
    ]]>
    High yield resources and tips for your Ob/Gyn clerkship.

    Youtube Playlist: http://bit.ly/pimped-ob

    Books:

    • Netters
    • Obstetrics and Gynecology by Beckmann

    Apps:

    • Pimped App – Clinical questions to expect in the OR and on the wards
    • Uptodate
    • Epocrates
    • GoodRx
    • LactMed – medications safe in breastfeeding
    • ASCCP: Cervical cancer screening
    • CDC STI guidelines
    • ACOG app/website
    • OB Wheel or dating

    Tips and Tricks:

    • Be Proactive—talk to students who just finished the rotation about ways to be helpful and the day to day logistics.
    • Expectations: Ask for them to be set at the beginning. Clarify as needed.
    • Be Self-sufficient, but ask for help when appropriate
    • Before leaving for the day, ask when you should come in to round, who to pre-round on and where to meet.
    • Once or twice a week ask for feedback when everyone has a down moment.

    Labor and Delivery:

    1. Gs & Ps aka Gravity and Parity.
    2. Primes, multips
    3. Gestational age Preterm vs term
    ]]>
    clean No no no 15:45 pimped