Image: Quincy, Illinois Family Medicine Residency Program
Image: 612 N. 11th, Suite B, Quincy, IL, 62301, 217-224-9484, Fax: 217-224-7950
Email link: quincyfpinfo@siumed.edu
Curricula Descriptions

Maternity Care Curriculum

Goals:
  1. The resident shall gain knowledge, skills and attitude to effectively interact with expectant mothers and their support systems. Assess and manage the health care of expectant mothers.
  2. The resident will recognize and facilitate treatment and referral of pregnant women requiring special intervention.
Objectives:

The resident will develop skills, knowledge and attitudes in:

  1. Management of Pregnancy:
    1. Know how to establish EDC.
    2. Recognize normal and abnormal prenatal findings.
    3. Know the indications and appropriate timing of ultrasound examinations.
    4. Become competent in fetal surveillance – non-stress test, contraction stress test, oxytocin contraction test, biophysical profile.
    5. Understand family-centered maternity care (birth position, fetal surveillance, pain relief, support, bonding attachment).
    6. Understand and interpret results of prenatal tests.
    7. Understand some of the controversies in current OB care (labor induction, use of IV fluids, epesiotomy/c-section, trial of labor after c-section).
    8. Be familiar with use and safety of pharmaceuticals during pregnancy and lactation. Identify and obtain antepartum and intrapartum referral when necessary.
  2. Management of Labor:
    1. Become competent with sterile vaginal/speculum exam.
    2. Be familiar with pain control options during labor (IV meds, epidural)
    3. Understand fetal heart rate monitoring – know when and how to intervene.
    4. Know indications and methods of labor induction and augmentation.
    5. Know how to manage a post-date pregnancy.
    6. Recognize and become familiar with non-routine pregnancy problems, including:
      1. Vaginal bleeding during pregnancy
      2. Preterm labor
      3. Hypertensive disorders of pregnancy
      4. Diabetic disorders of pregnancy
      5. Prelabor and preterm rupture of membranes
      6. Medical complications of pregnancy
  3. Postpartum Care:
    1. Assess and manage postpartum infections, depression, and hemorrhage.
    2. Discuss advantages, disadvantages and techniques of different neonatal feeding methods in a patient sensitive fashion.
  4. Discharge Planning:
    1. Anticipatory guidance (exercise, birth control, use of vitamins and iron, and other medications, follow-up, postpartum depression, child care question, family relationships).
  5. Skills and Procedures:
    1. Determination of dilation, effacement, station, presentation and position
    2. First assist at C-section
    3. Amniotomy
    4. Placement of fetal scalp electrodes
    5. Placement of IUPC
    6. Interpretation of fetal heart rate patterns
    7. Normal spontaneous cephalic vaginal delivery
    8. Indication and technique of midline episiotomy
    9. Repair of episiotomy and laceration (1st, 2nd & 3rd degree)
    10. Repair of episiotomy (4th degree) and cervical laceration with consultation
    11. Indications and technique of vacuum-assisted delivery
    12. Indications for forceps-assisted delivery with consultation (senior residents only)
    13. Placental delivery
    14. Recognition and management of postpartum hemorrhage
    15. Surgical techniques – suturing
    16. Surgical technique – knot tying
    17. Telephone management of pregnancy problems
Teaching Strategies—Noon Conference Objectives
Noon Lectures Rotation/Cycle
Preterm Labor Annually
Preterm Rupture of Membranes Annually
Hypertensive Disorders of Pregnancy Annually
Diabetic Disorders of Pregnancy Annually
Fetal Heart Interpretation Annually
Introduction to Ultrasound Annually
First Trimester Bleeding Annually
First OB Visit Annually
Preconception Counseling Annually
Postpartum Hemorrhage Annually
Rotation Experiences/Activities (Items marked with * address other curriculum goals and objectives but are integrated during this rotation.)
Continuity of Care Clinic
Residents will provide longitudinal prenatal care. Some residents will provide longitudinal prenatal care at Lewis County Health Department or Pittsfield in addition to prenatal care to members of their Quincy patient panel. Residents will provide care to pregnant women with acute and chronic medical problems. Resident will develop skills in preconception counseling.
Emergency Room
Residents will provide effective compassionate care to pregnant women seeking emergency services.
Rotation Mechanics
1st Month
  1. Introduce yourself to as many nurses and OB providers (FPs & OBs) as you can.
  2. Be attentive, polite and interested.
  3. Review and practice interpretation of FHT strips.
  4. Know the ways of providing pain control - pharmacologic and non-pharmacologic.
  5. Become familiar with different positions to help during labor - 1st and 2nd stage.
  6. Take the opportunity to learn from every delivery (vaginal and C/S) you attend.
  7. Ask specifics about delivery methods, hand positions, etc... - do this at an appropriate time and place - maybe after the delivery in the nurses' station rather than in the delivery room.
  8. Learn how to assess cervical dilation, effacement and station (work with the nurses).
  9. Read the articles in the manual.
  10. Do practice Boards questions on www.familypractice.com.
  11. Follow all patients you deliver (C/S and vaginal delivery) post partum. Babies of faculty physicians will go to service. If you are on for Lewis County or Pittsfield, you will follow the mom and baby. These babies do not go to "No Doc" Peds. Any OB patients of attendings that present with a primarily OB complaint will go to OB service. Any OB patients with a non OB primary complaint will go to FPS.
  12. Attend a nurse discharge session for one C/S and vaginal delivery patient. Listen to a discharge session for the baby also.
  13. Gain exposure to suturing, first assist in OR and perineal repair in L&D.
  14. Become proficient in SVE, SSE, Ferning (observe ferning under the microscope).
  15. Meet with Dr. White and review perineal repair.
  16. Record all your deliveries in New Innovations.
  17. Meet with Dr. Miller, White, Stanton or Friye and practice on the OB mannequin.
  18. OPTIONAL: Amniotomy, placement FSE, IUPC

2nd Month

  1. Complete all the objectives from the first month and try to complete all the optionals.
  2. Practice more surgical techniques - get better.
  3. Do more triage with nurses. Start calling attendings and suggesting management plans. - More involvement than 1st month.
  4. Keep reading articles and doing practice Board questions.
  5. For each woman you attend in the Labor and Delivery suite, do Leopold's Maneuvers on the baby. Estimate the fetal weight. Write the weight down. Try to develop a sense for size of the babies.
  6. Practice-assisted delivery techniques on the OB manikin.
  7. OPTIONAL: Assisted deliveries - vacuum and forceps.
3rd - 5th Month
  1. All of above.
  2. Be more active in management.
  3. Be available for and involved with assisted deliveries.
  4. Manage more high-risk situations: preterm labor, preeclampsia, etc.
Lewis County, Pittsfield OB, Personal Patients
  1. All of the above
  2. You are primary for the mother and baby, both during labor and in the postpartum. If one of your patients is scheduled for a C-Section, you are required to attend the C-Section. Please also let the OB faculty know at least a week ahead of time for all planned C-Sections, if possible, so they can make arrangements to attend if schedules allow.
Video taping
Videotape sessions will occur at QFPC.
In-training exam
Review OB section of In-Training Exam.
www.familypractice.com (for In-Training and Board Exam practice questions.
Resource List
Last updated: 8/17/07

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