Obstetrics Block

The obstetrics block is a rotation on the Nebraska Medicine labor and delivery inpatient services, which combines daytime work and night on-call responsibilities (work rounds, teaching rounds, admissions, following laboring patients and participating in deliveries and postpartum care). All team members will attend daily morning Labor and Delivery rounds. The Chief Resident will release the post-call student to home after morning rounds. Each student will be scheduled on-call four weeknights and weekends as needed. A similar arrangement will be set up at Methodist Hospital.  Students at Methodist will report to the Methodist resident assigned to the "perinate" service and Methodist Maternal Fetal Medicine specialists.  Methodist students will also be able to participate in the labor and delivery care of the generalist OB-GYN patients. 

Learning Objectives for Obstetrics Block:

Cognitive: Students should become familiar with the following topics:

Normal Obstetrics

• Preconception counseling
• Diagnosis of pregnancy
• Physiology and maternal adaptation of pregnancy
• Antepartum care including prenatal diagnosis
• Labor and delivery including induction of labor
• Obstetric analgesia and anesthesia
• The puerperium
• Postpartum care and lactation
• Counseling on male circumcision

Abnormal Obstetrics

• Bleeding in pregnancy - second and third trimester
• Fetal death in utero
• Dystocia
• Breech
• Cesarean section and VBAC
• Hypertensive disorders in pregnancy - preeclampsia
• Isoimmunization
• Multiple gestation
• Intrauterine growth restriction
• Premature rupture of membranes
• Preterm labor
• Postpartum hemorrhage
• Puerperal fever
• Medical and surgical complications of pregnancy: anemia, cardiac disease, diabetes, pyelonephritis,
  other

Knowledge and Skills Expectations:

By the end of the Obstetrics block students will be expected to competently:

1. Obtain, present, and document a relevant history on patients being evaluated or admitted; examinations will be done with supervising resident/faculty
2. Interpret and document fetal heart rate monitoring strips
3. Assess and document labor course in patients
4. Understand the normal hospital course for the patient after a vaginal delivery and operative cesarean delivery

Directed Studying Recommendations:

Web-based learning: Students have only 6 weeks to cover a wide range of clinical problems seen by OB-GYNs. It is important that students use "down-time" for directed studying. On the Obstetrics block, activities aimed at directed studying include:

• Ultrasound Images part 1 and Ultrasound Images part 2
• AAFP FHT Tracing
• Learning about Nurse Midwifery
• Breastfeeding Information
• Virtual Hospital (patient education on OB topics)