How to present on OB/GYN
OB/GYN presentations are short and dense. On labor and delivery you have about a minute to give the patient's whole obstetric picture, and the shorthand has to be exact: G2P1001 at 39 and 2 means something precise, and a fetal tracing is always described in the same order.
- Target
- 60 to 90 seconds on labor and delivery or postpartum, about 2 minutes for a GYN consult
- Lead with
- Exact obstetric shorthand and the fetal tracing
Here is the format for labor and delivery, postpartum and GYN patients, a word-for-word example from a fictional induction, and the questions you can expect.
What your attending listens for
OB/GYN moves as fast as surgery, but it runs on exact nomenclature: gravidity and parity, gestational age to the day, the prenatal labs, and a fetal heart tracing described in full.
The structure
Step 1: One-liner
OB: age, G and P (TPAL), gestational age in weeks and days and how it was dated (ultrasound or LMP), and why she is here. GYN: age, G and P, last menstrual period, and the problem, such as abnormal bleeding or pelvic pain.
Step 2: Subjective and labor course
Labor: contraction frequency, membrane status (spontaneous or artificial rupture, the time, the fluid color), fetal movement, epidural. Postpartum: bleeding (pad count), pain, voiding, breastfeeding, mood.
Step 3: Vitals, fetal tracing and exam
Labor: blood pressure trend, the fetal heart tracing (baseline, variability, accelerations, decelerations, then the category), contractions on toco, and the cervical exam (dilation, effacement, station). Postpartum: fundus, lochia, perineum or incision.
Step 4: Prenatal labs and ultrasound
Blood type and Rh, antibody screen, GBS, HIV, RPR, hepatitis B, rubella, the diabetes screen, and the latest growth ultrasound with estimated fetal weight and presentation.
Step 5: Assessment and plan
Stage and progress of labor, the oxytocin or misoprostol plan, GBS prophylaxis, or the postpartum discharge checklist: Rh immune globulin, contraception, and the MMR vaccine if she is not immune to rubella.
A word-for-word example
Step 1: One-liner
Ms. Patel is a 29-year-old G2P1001 at 39 weeks and 2 days, dated by an 8-week ultrasound, admitted for elective induction of labor.
Step 2: Subjective and labor course
She is on oxytocin at 12 milliunits per minute and comfortable with her epidural. Her membranes ruptured spontaneously at 4 a.m. with clear fluid.
Step 3: Vitals, fetal tracing and exam
She is afebrile with a blood pressure of 116/74. The fetal heart tracing is Category I: baseline 135, moderate variability, accelerations present, no decelerations. Toco shows contractions every 2 to 3 minutes. Her cervix at 5:30 was 6 centimeters, 90% effaced, minus 1 station, vertex.
Step 4: Prenatal labs and ultrasound
Prenatal labs: O positive, antibody screen negative, and GBS positive, so she is getting penicillin G every 4 hours.
Step 5: Assessment and plan
This is a 29-year-old G2P1 at 39 and 2 in the active phase of the first stage of labor, with reassuring maternal and fetal status. We will keep titrating oxytocin and recheck her cervix in 2 hours, or sooner if she feels the urge to push.
Ward pearls
- Know the five parts of a fetal heart tracing cold: baseline, variability, accelerations, decelerations, and the category (I, II or III).
- State Rh and GBS status on every labor and postpartum patient.
- On a GYN consult in the ED, rule one is a pregnancy test, urine or serum hCG, before anything else.
- On postpartum rounds, always ask about mood, contraception plans, voiding and passing gas.
Classic pimp questions
- VEAL CHOP: what causes each fetal heart rate pattern and how to manage it
- Preeclampsia with severe features: systolic 160 or diastolic 110 or higher, platelets under 100,000, creatinine over 1.1, transaminases twice normal, pulmonary edema, new headache or visual changes
- The 4 Ts of postpartum hemorrhage (tone, trauma, tissue, thrombin) and the contraindications to each uterotonic
- PALM-COEIN for abnormal uterine bleeding
Not sure how to field them? How to take the questions
Practice it out loud
A script you have read is not one you can say. Present a fictional patient to an AI attending who cuts in, asks why, and grades you on a rubric, then drills whatever you missed.
Try a free caseOne case, free. No signup, no card.
Other rotations
Educational content with fictional patients, not medical advice. Teams and institutions differ: follow your attending, your institution's protocols and current guidelines.