Introduction to Obstetrics & Gynecology Overview Objectives Match

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 Oophorectomy 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 MacDonald cerclage Simple vulvectomy Suction curettage Trachelorrhaphy Vaginal Hysterectomy

Lasers in GYN Most commonly used: Argon, CO2, 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 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