ob/gyn clinical notes

2nd half of 2nd trimester is when estrogen upregs oxytocin receptors
hemabate

giving a uterotonic must ask two questions?
asthmatic or hypertensive?
postpartum hemorrhage? what do you do?
vaginal exam
1. where bleeding?
uterus, cervix (laceration), vagina
2. stop the bleeding

risk of cervical laceration - leep (changes nature of tissue), big baby, compound presentation (finger on head), sulcal tear vagina, tears can go all the way back.
drusian's incicsions cut cervix 12, 4, 8 oclock, don't cut 3&9 oclock where uterine arteries

risk factors for atony - multiple gestations, polyhydramnios, big baby, tocolytic (mag), prolonged labor, fibroids
blynch sutures - suspenders for the uterus to stop it from bleeding

then
uterine artery ligation
then
hysertectomy

hyaline casts in lungs - pathognomonic for amniotic fluid embolism

eclampsia - seizure and htn (don't need proteinuria)

code right after birth? think amniotic fluid embolism

boggy uterus - massage, not working give uterine tonics- stick w/one agent max it out
1mg cytotec (misoprostol),
methergine or hemabate, or pit wide open

flagyl - metronidazole - anearobes

subcutaneous emphesyma - used for laparoscope (rice krispies sign)

hpv vaccine - tetravalent insures against warts and cancers

endometritis = uterine tenderness postpartum + fever, physical diagnosis

gentamicin - covers aerobes, clinda- covers ug aneareaboes
ampicillin -