First day in Ob/Gyn core rotation

3/9/2004 9:41 pm

Well, Psych is over and I was excited about getting started in ob/gyn. I was apprehensive about this rotation because: (1) I am a male and have limited exposure to female problems (no jokes, please!), (2) I do not have any children and have never witnessed a live birth and (3) I have not been around infants and small children a lot.

I arrived my first day at 5:30 am. Our scheduled time of reporting in was 6:00 am. However, I always find it useful to arrive in time to meet the night shift of nurses and get a heads up on what's cooking. We had one first-time mother (grava 1: Para: 1) ready to give birth. Since she had been there since midnight, it was decided to induce contractions with oxytocin (Pitocin). By about 6:30 am, the resident decided to induce artifical rupture of membranes (AROM). pardon the comparison but seeing the meconium-stained amniotic fluid flow out of the vagina was like watching Linda Blair vomit the green stuff in the movie 'The Exorcist'. By about 8:00 am, the baby's heart rate began to fall into the 80s. Interesting that for fetuses, normal HR is 120 to 160. Anything below 120 is considered bradycardia. Interesting contrast with adults where normal HR is 60 - 120 and anything above 120 is considered tachycardia. Anyway, after trying various things -- adjusting the position of the mother, discontinuing the oxytocin drip, a decision was made to do a C-section. Since this was my first day in the unit and I had never scrubbed in for surgery before, I was assigned the role of watching another medical student scrub in and told to observe everything she would do during the procedure.

The C-section was great. It was everything I had read and seeing the baby be drawn out of the opened uterus was the coolest thing I have seen yet. The resident did all the work, while the attending just helped. I had a great view and could see everything clearly.

We went to lunch afterwards and I had a pizza with lots of tomato sauce (I know, pretty sick of me, no?). The rest of the day was kind of slow. I developed either the beginnings of a cold or an allergic rhinitis and was sneezing all day. That was not so good. My first call is Sunday. It seems that in this unit, medical students are really encouraged to participate in delivering babies, procedures and the like. I am excited and looking forward to every day here.