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By Jennifer Doorey, MD, MS
4.9
259259 ratings
The podcast currently has 35 episodes available.
Incidence:
3.3% as of 2013
Indications:
Consent:
Prep:
Episiotomy – NO!
Contraindications
Indications:
39week induction
ARRIVE Trial - Multicenter RCT showing benefit to 39wk IOL over expectant management to ~41wks
Included
Results
Conclusion
The IOL Process:
Evaluate and Prep:
Options for IOL: if biship score <8 for prime or <6 for multip, ripen first!
Contractions (pitocin)
Augmentation: AROM
Failed IOL
Definition: Failure to deliver fetal shoulders with normal downward traction
Why we care: Baby hypoxia, brachial plexus injuries, maternal injuries
Risk factors:
Prevention
What do to:
What you’ll see:
Cancer Screening
Vaccinations
Swab/Urine
Serum
No Routine Screening, diagnose if lesion
Why: ASCCP guidelines (there is an app! Or PDF)
Cervical dysplasia — caused by HPV
CIN I–CIN3 is a progression
Risk factors: Smoking, other STIs including HIV, immunodeficiency
Histology: Increased Nuclear: cytoplasmic ratio when abnormal
Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.
Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark. Non-staining cells are abnormal.
HPV — changes
Colpo:
Increased vascularity, punctations, mosaicism, surface contour changes
LEEP:
Stain abnormality and know where abnormal biopsy was taken
Single pass is ideal–tag a side for orientation
+/- Top Hat depending on ECC result
CKC:
Higher up in cervical canal, but more complications
No electricity– okay if pregnant
Every visit:
By Weeks:
The podcast currently has 35 episodes available.
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