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

• 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

• 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.