During my OB/GYN rotation, I prepared 2 H&Ps, drug cards, and journal article to present for my Site Evaluation. When I presented my first H&P (about a patient with preterm prelabor rupture of membranes) during my first Site Evaluation, I received great feedback that helped me improve my writing and presenting skills for my second Site Evaluation. I learned that when writing up an H&P regarding an OB/Gyn case, it’s best to be as focused as possible, while also including all the pertinent information pertaining to the patient’s obstetrical and gynecological history. This should also include a full list of the patient’s antepartum problems, as well any important prenatal lab testing that was done. When discussing a plan, it’s important to address all aspects of the patient’s care. For instance, aside from creating a plan that addresses the patient’s prelabor rupture of membranes (PROM), the plan should also address the fact that the PROM was preterm, and therefore steroids should be given for fetal lung maturity. The professor also explained that while induction of labor might be necessary, it’s important to allow the steroids to adequately mature the fetal lungs as much as possible before treating the PROM with labor induction. My professor and I also had great conversation about what to look for on vaginal exam in a patient with suspected PROM, and what is limited by vaginal exam. For instance, one should look for frank pooling of fluids in the vaginal vault; however, keep in mind that to diagnose rupture of membranes an amnisure should be obtained. 

The Site Evaluation also included a discussion of the Pharm cards I presented and journal article pertaining to my patient’s diagnosis. For my second site evaluation, I chose to write an H&P about a patient who presented to the clinic following an episode of vaginal bleeding secondary to placenta previa. I found an interesting article that demonstrates the correlation between a history of placenta previa and adverse outcomes in subsequent pregnancies. The article explains the mechanism behind this correlation in a clear way that allowed for interesting discussion. While presenting my Pharm cards, my professor and I discussed the multiple ways in which the different drugs I chose could be used, and how they relate to OB/Gyn from a practical standpoint. Finally, my Professor took the time to really point out my strengths and help me hone in on my weaknesses, so that I could work to improve those weaknesses by the end of the rotation. For instance, understanding how to prioritize certain treatments over others and decide when the risks outweigh the benefits of treatment and vise versa. Overall, the site evaluation was a very helpful way for me challenge myself and ask any questions I had, while also receiving valuable feedback.