1. Obstetrics and Gynecology
Chapter 26
Obstetrics and Gynecology

2. Obstetrics Care of mother and fetus during pregnancy 40-week pregnancy
Puerperium—6 weeks following delivery

3. Obstetrics and the TPMS

4. Obstetrics Initial prenatal visit
Prevention of diseases and complications
Thorough history and physical
Pelvic measurements
Laboratory tests
Blood and urine tests
Patient education
(see Procedure 26-1 in the text)
(discuss the Critical Thinking Box)

5. Obstetrics Prenatal history Identify high risk
Attention given to risk factors
Diseases
Age
OB history
Gravida, Para
Potential serious problems

6. Subsequent Prenatal Visits
Vital signs
Blood work
Measurement of fundus
Nagele’s rule
(discuss the Critical Thinking Box)

7. Subsequent Prenatal Visits
Tests and procedures
Alpha Fetal Protein (AFP)
Performed at 16 weeks
Amniocentesis
Chronic Villi Sampling (CVS)
Performed if history of abnormalities such as thalassemia, sickle cell anemia, or Tay-Sachs
Performed at 8–10 weeks gestation

8. Subsequent Prenatal Visits
Tests and procedures
Ultrasonography/amniocentesis
Ultrasound produces image of fetus
Prep—1 qt. water 1 hour prior
Amniocentesis—surgical puncture of amniotic sac
Obtain sample of amniotic fluid
Diagnose certain congenital abnormalities
Fetal heart rate
Nonstress test monitors (mother’s heart)
Stress test monitors (fetal heart rate)
(discuss the Critical Thinking Box)

9. Disorders of Pregnancy
Abortion or interruption of pregnancy
Eclampsia (toxemia)
Life-threatening
Gestational diabetes
Usually disappears after delivery

10. Disorders of Pregnancy
Placenta previa >>
Placenta may cover cervical os
Placenta abruption >>
Placenta separates from uterine lining

11. Disorders of Pregnancy
Hyperemesis gravidarum (excessive vomiting)
Severe dehydration can result
Rh Incompatibility
Impaired fertility

12. Parturition (Labor) Three stages Braxton Hicks contractions
Dilation
Expulsion
Placental
Braxton Hicks contractions
Amniotomy >>

13. Postpartum Period Puerperium Lochia 6 week follow-up appointment
The body returns to a nonpregnant state
The uterus involutes
Lochia
6 week follow-up appointment

14. Contraception Nonprescription Prescription Sterilization
Condoms, sponges
Prescription
Hormonal contraceptives, cervical cap, IUD, vaginal rings
Sterilization

15. Gynecology
Studies diseases of female reproductive tract

16. Gynecologic Exam Assisting with gynecological examination (GYN)
Consist of four or five parts
Exam with PAP equipment

17. Gynecologic Exam
Watch the video

18. Gynecologic Exam
PAP smear performed annually for detection of cervical cancer

19. Breast Exam Breast exam Checks for abnormalities
Medical assistant may teach patient about breast self-exam
(discuss the Critical Thinking Box and see Procedure 26-2 in the text)

20. Gynecological Diseases and Conditions
Infertility
Common causes
Menopause
Occurs between 35 and 58 years
Ovaries produce less estrogen
Surgical menopause
Surgical removal of ovaries
Signs and symptoms
Treatment

21. Gynecological Diseases and Conditions
Endometriosis
Endometrial tissue outside the uterus
Cause unknown
Treatment

22. Gynecological Diseases and Conditions
Ovarian cysts
Cysts on ovaries
Detection
Treatment

23. Gynecological Diseases and Conditions
Ovarian cancer
Difficult to diagnose
Symptoms
Diagnosis

24. Gynecological Diseases and Conditions
Pelvic Inflammatory Disease (PID)
Usually caused by STDs
Diagnosis
Treatment
Human Papilloma Virus
Gardisil vaccine
(discuss the Critical Thinking Box)

25. Other Diagnostic Tests
Colposcopy
Exam of vagina and cervix by lighted instrument
Performed after abnormal PAP
Follow-up treatment of cervical cancer
Endometrial biopsy/sampling
Postmenopausal bleeding
(discuss the Critical Thinking Box)

26. Other Diagnostic Tests
Cervical punch biopsy
Done with colposcopy
Performed after abnormal PAP
Cervical cone biopsy
Loop electrosurgical excision procedure (LEEP)

27. Other Diagnostic Tests
Cryosurgery
Treat tissue with freezing temperatures
Treatment for chronic cervicitis and cervical erosion
Procedure with probe

28. Other Diagnostic Tests
Wet prep/wet mount for yeast, bacteria, and trichomonas
Potassium hydroxide for fungus
(see Procedure 28-4 in the text)

29. Other Diagnostic Tests
Laparoscopy >>
Lighted view of pelvic cavity
Dilation and Curettage (D&C)
Surgical procedure
Dilating and scraping of the endometrial tissue