Rotation expectations

Call group (only cover patients of the following):

Dr. Vishwanath

Dr. Dickinson

Dr. Marquez

Dr. Gade

Dr. Matharu

Any unassigned patients 

Door Codes:

Sleep Rm 4th floor 611#

6th floor doctors’ lounge 33115

From elevator on 6th floor 425#

From COVID area to 6th floor 425 

Expectations: 

Round on postpartum patients - 4th floor

Roun on Antepartum patients - 6th floor 

Cover patients in L&D

See all patients in OB ED - 4th floor 

Assist for CSs (Surgery is on 2nd floor close to main elevator)

Read NSTs 

Cover GYN consults in ER or floors 

Postpartum Rounds

1. Post Op Fever: 

Wind - atelectasis 

Water - UTI

Wound - infection

Walk - DVT

Wonder drug - heparin

Woman - mastitis, breast engorgement

Womb - endometriosis

1. Postpartum Hemorrhage:

Pre Delivery Hgb → Post Delivery Hgb

Significant drop is > 2

1. Pitocin IV
2. Methergine 0.2mg IM or PO (contraindication: HTN) 
3. Hemabate IM (contraindication: asthma)
4. Misoprostol 200 mcg (up to 3 tabs PR or 1 tab PO) 
5. TXA 1gm IVPB

Post-Partum Counseling

1. Breastfeeding or Bottle Feeding? - Takes 4 days for milk letdown 
2. Contraceptive Counseling 

1. BCP - wait 4 wks postpartum (early Estrogen increases risk for DVT)

 - estrogen can cause decrease milk production if breastfeeding

1. Micronor (progesterone only) - 4 mos postpartum
2. Depo provera 150 mg IM q3 mo - 4 mos postpartum

1. IUD - 3 mos PP (earlier uterus is too big) 

Post partum Vaccine

1. Rubella - if nonimmune or equivocal, need vaccine]
2. If Rh negative - check infant

If infant positive → Rhogam

If infant negative → none