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