obgynTYPHON

H&P 1 CC: vaginal bleeding x6 weeks. HPI AL is a 43 y/o female G4P3013 with a history of abnormal uterine bleeding presenting today with vaginal bleeding. Patient underwent vaginal myomectomy 6/15/2020 for an aborting leiomyoma. Procedure was complicated by heavy vaginal bleeding 2 days later which prompted her to go to the ER and received 3UPRBC. A total vaginal hysterectomy was discussed with the patient prior as a possible treatment option. States she has had mild spotting daily since after the transfusion using 2 pads per day and takes iron three times daily. Denies any pain, passage of clots, …

During the first clinical site visit, I presented 1 focused H&P and five drug cards. I discussed a patient who presented with abnormal uterine bleeding who was scheduled for a total vaginal hysterectomy. My site evaluator and I discussed her case fully and also several causes and treatment options for abnormal uterine bleeding. He provided good constructive feedback on how I could elaborate on the patient’s story and how to document a more detailed preoperative note. During the second site visit, I presented another focused H&P, five drug cards, and an article. I discussed a patient who came to the …

The article is titled Delayed versus immediate pushing in the second stage of labor in women with neuraxial analgesia: a systemative review and meta-analysis of randomized controlled trials.  This article was a systematic review and meta-analysis of RCTs that included 5,445 women. 2,754 of these women were randomized to the delayed pushing group and 2,691 to the immediate pushing group. These women were evaluated on the effect of delayed versus immediate pushing in the second stage of labor. The primary outcome was the mode of delivery, which included spontaneous vaginal delivery, operative vaginal delivery, and cesarean delivery. They found that …

Overall this rotation was a great learning experience. Each week I was scheduled to a different service in OB/GYN which exposed me to a variety of diagnoses and procedures. For example, during week 1 I was in labor and delivery, week 2 was GYN, and week 3 and 4 was clinic. In labor and delivery, I triaged patients, conducted pelvic exams, learned how to read transabdominal and transvaginal sonograms, experienced fetal non-stress tests, and assisted in vaginal deliveries and cesarean sections. This week was challenging as I learned how to effectively conduct a thorough OB history and physical, but felt …