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THE ORAL EXAMINATION

Procedure

3. Obstetrical Patients

A list of obstetric patients should be prepared in the requested format .

List separately each patient with a complication or abnormality, as well as medical and surgical intervention during pregnancy, labor, delivery and the puerperium.

In addition, a total of the number of normal, uncomplicated obstetric patients managed during the same 12-month period (or 18- month period, if an extended time case list is submitted) should appear on the obstetrical summary sheet and at the beginning of the obstetrical list. These normal, uncomplicatd obstetrical patients should not be listed individually..

Interpretation of "normal obstetrical patients" for this listing implies that the:

a. pregnancy, labor, delivery and the puerperium were uncomplicated, labor began spontaneously
between the 37th and 42nd week of gestation;

b. membranes ruptured or were ruptured after labor began;

c. presentation was vertex, position was occiput anterior or transverse, labor was less than 24 hours
in duration;

d. delivery was spontaneous or by outlet forceps with or without episiotomy, from an anterior
position;

e. infant had a five minute Apgar score of 6 or more and weighed between 2500 and 4500 gms and
was healthy; and

f. placental delivery was uncomplicated and blood loss was less than 500 mL.

All deliveries not fulfilling these criteria must be listed individually. Include gestational age at admission.

A minimum of twenty (20) obstetrical patients is required, and a candidate can not count more than two (2) patients from each of the categories listed below.

For example, if a candidate has five (5) patients with diabetes mellitus, they must all be reported on the case list, but only two (2) of the five (5) will be counted as meeting the minimum requirement of twenty (20) obstetrical cases.

Group patients together under each separate category (1-31) then list the remaining patients who do not "fit into" categories 1-31.

OBSTETRICAL CATEGORIES

1. reech and other fetal malpresentations

2. Intrapartum infection (amnionitis)

3. Puerperal infection

4. Third trimester bleeding

5. Multifetal pregnancy

6. Cesarean hysterectomy

7. Premature rupture of fetal membranes at term

8. Preterm premature rupture of membranes

9. Preterm delivery

10. Hypertensive disorders of pregnancy (chronic hypertension, preeclampsia, eclampsia)

11. Second trimester spontaneous abortion

12. Cardiovascular and/or pulmonary diseases complicating pregnancy

13. Renal diseases and/or neurological diseases complicating pregnancy

14. Hematological diseases and/or endocrine diseases complicating pregnancy

15. Infections complicating pregnancy

16. Postterm pregnancy

17. Abnormal fetal growth

18. Vaginal birth after cesarean delivery

19. Any maternal complication which delayed maternal hospital discharge by 48 or more hours

20. Any neonatal complication which delayed neonatal hospital discharge by 48 or more hours

21. Pregnancies complicated by fetal anomalies

22. Pregnancies complicated by human immunodeficiency virus infection (HIV)

23. Primary cesarean delivery

24. Repeat cesarean delivery

25. Inductions and/or augmentations of labor

26. Puerperal hemorrhage

27. Readmission for maternal complication up to 6 weeks postpartum

28. Obstetrical vaginal lacerations (3rd and 4th degree lacerations)

29. Trauma in pregnancy (automobile accidents)

30. Pregnancy and coexisting malignancies

31. Preconception evaluation, prenatal and genetic diagnoses

If, but only if, a candidate can not acquire the necessary twenty (20) obstetrical cases in the above categories, they may use an 18-month case list and/or select an appropriate number of cases from their fellowship or senior residency case list (see item 5.c. under Written Exam Requirements, and item 6 under Oral Exam Requirements and Admission to the Oral Examination, Patient Lists for the Oral Examination, Procedure, Office Practice Patients, Gynecology, Obstetrics, Affidavits, and Summary Sheet).

Obstetrical Case List Forms

*Patients' names, initials, hospital names must not be used. Also, patients who are over 89 years of age must not have their age listed.

# refers to a sequential ordering which is assigned by the computer for ALL patients from all hospitals, i.e. 1-xxx.

Hospital # refers to the sequential ordering of hospitals being reported from, i.e.,
Hospital A = First hospital from which patients are being reported;
Hospital B = Second hospital from which patients are being reported;
Hospital C = Third hospital from which patients are being reported.

Patient # refers to a sequential ordering of patients reported from a given hospital, i.e., Hospital A, patients 1-x; Hospital B, patients 1-xx.

The American Board of Obstetrics and Gynecology offers a case list collection and reporting software package for the oral examination
(e-mail - caselist@abog.org or phone 214-871-1619).

Next: Procedure: Cover Sheets

Also see:

• Patient Lists for the Oral Examination
• Procedure
• Office Practice Patients
• Gynecologic Patients
• Case List Software

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