Introduction to Obstetrics & Gynecology Overview
Objectives • • • Match the terms r/t OB-GYN w/correct definitions Review female anatomy List purposes of OB-GYN surgery Discuss types of abortions Match common GYN complications with correct definitions Match diagnostic techniques w/correct definitions Match abdominal procedures w/correct descriptions Define and discuss vaginal procedures Explain applications of lasers in GYN surgery
Objectives • Match the types of genital fistulas w/correct illustrations • Select true statements r/t special features of OB/GYN surgery • Match basic OB-GYN medications and solutions w/their uses • Identify specialized instruments for OB/GYN surgery • Discuss the steps of a D & C
OB-GYN Terms • • • Carcinoma in Situ Cervical Chromotubation Conization Cystocele Dilatation Dysplasia Endometriosis Enterocele Episiotomy • • • Fibroma GIFT Insufflation Marsupilization Myoma Pneumoperitoneum Presentation Rectocele Stress Incontinence Vaginal Vault
Female Reproductive System
Anatomy: Bony Pelvis/Girdle
Anatomy: External Genitalia • Vagina • Uterus – Cervix • Fallopian tubes/ovaries • External genitalia
Anatomy: Female Pelvis
Support of Female Pelvis
Uterus, Fallopian Tubes, Ovaries • Hollow, thick-walled • Situated between bladder and rectum • Lined with endometrium • Ligaments suspend the uterus
Female Reproductive System Concept Map
Why OB-GYN Surgery? • • Dx abnormal symptoms Tx abnormal conditions Relieve pain Electively prevent pregnancy Assist infertile couples to conceive Prevent Spontaneous abortion w/structural defects Abdominally deliver an infant when vaginal delivery is contraindicated or not possible
Types of Abortions • • • Missed Incomplete Imminent Spontaneous Voluntary Interrupted
Common OB Complications • • • Dystocia Placenta Previa Abruptio Placenta CPD Abnormal presentations – Breech, Transverse, Footling, Vertex • Incompetent cervical os • Infertility • Ectopic pregnancy
Common GYN Complications • Menstrual abnormalities – Amenorrhea, dysmenorrhea, menorrhagia, metrorrhagia • Lesions • Weakened musculature • STDs
Diagnostics • • • Colposcopy Colpotomy Conization of Cervix Culdocentesis Culdoscopy Hysterpsalpingography • • • Hysteroscopy PAP smear Punch Biopsy Rubin’s test Schiller’s test Uterine curettage
Abdominal Procedures • • • Abdominal Hysterectomy Cesarean Section Laparoscopy MMK Suspension Microscopic Reconstructive Surgery of Fallopian Tubes Myomectomy Oophorocystectomy Pelvic Exenteration Salpingectomy/Salpingostomy Tubal ligation
Fibroid tumors
Vaginal Procedures • • • • Anterior & Posterior repair Conization of cervix Dilatation & Curettage Hysteroscopy LAVH Colpocleisis Marsupilization of Bartholin’ s duct cyst Repair of fistula Shirodkar or Mac. Donald cerclage Simple vulvectomy Suction curettage Trachelorrhaphy Vaginal Hysterectomy
Lasers in GYN • Most commonly used: Argon, CO 2, Nd: YAG • Applications – Ablation – Eradication – Endometrial ablation – Transecting uterine ligaments & controlling bleeding
Genital Fistulas • • Vesicovaginal Ureterovaginal Urethrovaginal Rectovaginal
Special Features • • • Typically pt is catheterized General or spinal Important: antiembolic devices, ambulation Drains Lithotomy/Vaginal: Long instruments Vaginal procedures: sponges/medicated packing Use of catheters: ID of ureters Order of procedures: vag/abd Separate set-ups Special equipment
Medications & Solutions • • Oxytocics Lugol’s solution Acetic Acid 3 % Anti-infective creams Methylene blue Solutions for hysteroscopic exams Solutions for laser & cautery
Specialized Instruments • • • Abdominal Hysterectomy Vaginal Laparoscopic Obstetrical Adaptations for vag hyst Adaptations for LAVH
ABD Hysterectomy
D & C Procedure Summary • • • Lithotomy position Insert Weighted speculum Grasp cervix w/ Tenaculum Dilation using Graduated sound into cervix: depth & direction Curette of choice for Endocervical curettings specimen Endometrial curettings Dilation using Hegar or Hanks uterine dilators Curettings: Telfa strip for specimen Dressing: perineal pad
Labor & Delivery Stages • • Stage one: onset of labor Stage two: complete dilatation of cervix Stage three: birth of the infant Stage four: after placenta is delivered
Objectives • • • Match the terms r/t OB-GYN w/correct definitions List purposes of OB-GYN surgery Discuss types of abortions Match common GYN complications with correct definitions Match diagnostic techniques w/correct definitions Match abdominal procedures w/correct descriptions Define and discuss vaginal procedures Explain applications of lasers in GYN surgery Match the types of genital fistulas w/correct illustrations
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