Chapter 26 Obstetrics and Gynecology Copyright 2010 Delmar

Obstetrics • Care of mother and fetus during pregnancy – 40 -week pregnancy –

Obstetrics and the TPMS Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Obstetrics • Initial prenatal visit – – Prevention of diseases and complications Thorough history and physical Pelvic measurements Laboratory tests • Blood and urine tests – Patient education Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Obstetrics • Prenatal history – Identify high risk – Attention given to risk factors • Diseases • Age • OB history – Gravida, Para – Potential serious problems Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Subsequent Prenatal Visits • Vital signs – Blood work • Measurement of fundus •

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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

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) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Disorders of Pregnancy • Abortion or interruption of pregnancy • Eclampsia (toxemia) – Life-threatening • Gestational diabetes – Usually disappears after delivery Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Disorders of Pregnancy • Placenta previa >> – Placenta may cover cervical os • Placenta abruption >> – Placenta separates from uterine lining Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Disorders of Pregnancy • Hyperemesis gravidarum (excessive vomiting) – Severe dehydration can result • Rh Incompatibility • Impaired fertility Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Parturition (Labor) • Three stages – Dilation – Expulsion – Placental • Braxton Hicks

Postpartum Period • Puerperium – The body returns to a non-pregnant state – The

Contraception • Nonprescription – Condoms, sponges • Prescription – Hormonal contraceptives, cervical cap, IUD, vaginal rings • Sterilization Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Gynecology • Studies diseases of female reproductive tract Copyright © 2010 Delmar, Cengage Learning.

Gynecologic Exam • Assisting with gynecological examination (GYN) – Consist of four or five

Gynecologic Exam Click Here to play the video Copyright © 2010 Delmar, Cengage Learning.

Gynecologic Exam • PAP smear performed annually for detection of cervical cancer Copyright ©

Breast Exam • Breast exam – Checks for abnormalities – Medical assistant may teach

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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Gynecological Diseases and Conditions • Endometriosis – Endometrial tissue outside the uterus • Cause

Gynecological Diseases and Conditions • Ovarian cysts – Cysts on ovaries – Detection –

Gynecological Diseases and Conditions • Ovarian cancer – Difficult to diagnose – Symptoms –

Gynecological Diseases and Conditions • Pelvic Inflammatory Disease (PID) – Usually caused by STDs – Diagnosis – Treatment • Human Papilloma Virus – Gardisil vaccine Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

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 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Other Diagnostic Tests • Cervical punch biopsy – Done with colposcopy – Performed after abnormal PAP • Cervical cone biopsy • Loop electrosurgical excision procedure (LEEP) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Other Diagnostic Tests • Cryosurgery – Treat tissue with freezing temperatures • Treatment for chronic cervicitis and cervical erosion – Procedure with probe Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Other Diagnostic Tests • Wet prep/wet mount for yeast, bacteria, and trichomonas • Potassium

Other Diagnostic Tests • Laparoscopy >> – Lighted view of pelvic cavity • Dilation and Curettage (D&C) – Surgical procedure – Dilating and scraping of the endometrial tissue Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.