627242025167-ADMISSIONSCONFERENCEFORPRES.pptx

This is an admission conference discussing different cases admitted

1. ADMISSIONS CONFERENCE Dr. Gallito/Chan, Guballa/Bongalon, TAN/Pascual/Gonzales, Zenarosa JUNE 26-27, 2024

2. ER CONSULTS: 24 GENERAL SERVICE 17 GYNECOLOGIC ONCOLOGY 7 TOTAL ADMISSIONS : 11 GENERAL SERVICE 10 GYNECOLOGIC ONCOLOGY 1

3. ADMISSIONS: OB PHYSIOLOGIC 2 OB PATHOLOGIC 4 OB OPERATIVE 1 OB PENDING 3 GYNECOLOGIC ONCOLOGY 1

4. ADMISSIONS Dr. Gallito/Chan, Guballa/Bongalon, TAN/Pascual/Gonzales, Zenarosa 4 Dr. Bombase/ Chan, Guballa/Bongalon, TAN/Pascual/Gonzales, Zenarosa 1 Dr. Carino/Chan, Guballa/Bongalon, TAN/Pascual/Gonzales, Zenarosa 1 Dr. Tagayuna/Chan, Guballa/BONGALON, Tan/Gumatay/Atienza, Gonzales 1 Dr. Carino/Decipulo/ACASIO, Cagampan/Gumatay/Altura, Pangan 1 Dr. Amparo/San Pedro/Cagampan, Neptuno/BARCELONA/Atienza, Andoy 1 Dr. Valencia/ Chan, Guballa/Bongalon, TAN/Pascual/Gonzales, Zenarosa 1

5. OB PHYSIOLOGIC: 2 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION WORKING DIAGNOSIS PLAN Dr. Ga/Ch/TN C.D. 21 years old G2P1 (1001) NR Chief complaints: Labor pains BP 110/70 PR 90 RR 19 T 36.5 C 99 % at room air  FH: 32 FHT: 140s EFW: 3200g by Palm 3100g by Johnson’s Rule Internal examination : cervix is Fully dilated at station +1 Gravida 2 Para 1 (1001) Pregnancy uterine 36 1/7 weeks age of gestation Cephalic in labor Normal spontaneous delivery with right mediolateral episiotomy and repair Gravida 2 Para 2 (2002) Pregnancy uterine term cephalic delivered spontaneously to a live baby girl with APGAR score 8,9, Ballard Score 37 weeks, Birthweight 2250g, appropriate for gestational age For postpartum care and monitoring Continue postnatal medications Advised exclusive breastfeeding For PSI insertion as family planning of choice

6. OB PHYSIOLOGIC: 2 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION WORKING DIAGNOSIS PLAN Dr. Ga/Ch/TN L.J. 18 years old G2P1 (1001) NR Chief complaints: Labor pains BP 120/80 PR 78 RR 18 T 36.7 C 99 % at room air  FH: 32 FHT: 140s EFW: 3200g by Palm 3100g by Johnson’s Rule Internal examination : cervix is 7cm dilated, 50% effaced, cephalic, ruptured, station -2 Gravida 2 Para 1 (1001) Pregnancy uterine 40 5/7 weeks age of gestation Cephalic in labor Teenage pregnancy Normal spontaneous delivery with right mediolateral episiotomy and repair Gravida 2 Para 2 (2002) Pregnancy uterine term cephalic delivered spontaneously to a live baby girl with APGAR score 8,9, Ballard Score 39 weeks, Birthweight 3300g, appropriate for gestational age Teenage pregnancy For postpartum care and monitoring Continue postnatal medications Advised exclusive breastfeeding For PSI insertion as family planning of choice

7. OB PATHOLOGIC: 4 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION WORKING DIAGNOSIS PLAN Dr. Ga/Ch/TN R.M. 23 years old G2P1 (1001) NR Chief complaints: Labor pains BP 110/80 PR 81 RR 18 T 36.7 C 99 % at room air  FH: 32 FHT: 140s EFW: 3200g by Palm 3100g by Johnson’s Rule Internal examination : cervix is Fully dilated at station +2 Gravida 2 Para 1 (1001) Pregnancy uterine 36 weeks age of gestation Cephalic in labor Normal spontaneous delivery with perineal support Gravida 2 Para 2 (2002) Pregnancy uterine preterm cephalic delivered spontaneously to a live baby girl with APGAR score 8,9, Ballard Score 36 weeks, Birthweight 2000g, appropriate for gestational age For postpartum care and monitoring Continue postnatal medications Advised breastmilk expression reastfeedingFor DMPA injecttion as family planning of choice

8. OB PATHOLOGIC: 4 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION WORKING DIAGNOSIS PLAN Dr. Ca/Ch/TN M.E. 41 years old G4P3 (3003) R Chief complaints: Labor pains BP 120/70 PR 85 RR 19 T 36.4 C 99 % at room air  FH: 33 FHT: 140s EFW: 3200g by Palm 3255g by Johnson’s Rule Internal examination : cervix is 4cm dilated, beginning effacement, cephalic, intac BOW, station -3 Gravida 4 Para 3 (3003) Pregnancy uterine 39 1/7 weeks age of gestation Cephalic in labor Multinodular toxic goiter, biochemically and clinically euthyroid Gestational diabetes mellitus, controlled Normal spontaneous delivery with right mediolateral episiotomy and repair, with postplacental delivery IUD insertion Gravida 2 Para 2 (2002) Pregnancy uterine preterm cephalic delivered spontaneously to a live baby girl with APGAR score 8,9, Ballard Score 39 weeks, Birthweight 3300g, appropriate for gestational age Multinodular toxic goiter, biochemically and clinically euthyroid Gestational diabetes mellitus, controlled For postpartum care and monitoring For 75g OGTT 6 weeks postpartum Continue postnatal medications Advised breastmilk expression

9. OB PATHOLOGIC: 4 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION FINAL DIAGNOSIS PLAN Dr. Bo/Ch/TN C.S. 18 years old G1P0 R Chief complaints: Labor pains BP 110/70 PR 90 RR 19 T 36.5 C 98 % at room air  FH: 26cm FHT: 140s EFW: 2000g by Palm 2170g by Johnson’s Rule Internal examination : cervix is Fully dilated at station 0 Gravida 1 Para 0 Pregnancy uterine 34 weeks age of gestation Cephalic in preterm labor Normal spontaneous delivery with perineal support Gravida 2 Para 2 (1102) Pregnancy uterine preterm cephalic delivered spontaneously to a live baby girl with APGAR score 2,5,7, Ballard Score 36 weeks, Birthweight 2200g, appropriate for gestational age Thickly stained amniotic fluid For postpartum care and monitoring Continue postnatal medications Co-amoxiclav 1g tab BID for 7 days Advised breastmilk expression For DMPA injecttion as family planning of choice

10. OB PATHOLOGIC: 4 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION FINAL DIAGNOSIS PLAN Dr. Ta/Ch/BO O.C. 30 years old G2P1 (1001) R Chief complaints: Labor pains BP 120/70 PR 93 RR 20 T 36.5 C 98 % at room air  FH: 25cm FHT: 130s EFW: 2015g by Palm 2170g by Johnson’s Rule Internal examination : cervix is Fully dilated at station 0 Gravida 2 Para 1 (1001) Pregnancy uterine 33 4/7 weeks age of gestation Cephalic in preterm labor Gravidocardiac, congenital heart disease, PDS; Valvular heart disease - mild TR and PR, NYHA FC 1, WHO II Pulmonary tuberculosis, bacteriologically confirmed Normal spontaneous delivery with right mediolateral episiotomy and repair, postplacental delivery IUD insertion Gravida 2 Para 2 (1102) Pregnancy uterine preterm cephalic delivered spontaneously to a live baby girl with APGAR score 8,9, Ballard Score 34 weeks, Birthweight 1700g, appropriate for gestational age Gravidocardiac, congenital heart disease, PDA; Valcular heart disease - mild TR, PR, NYHA FC I, WHO Class II Pulmonary tuberculosis, bacteriologically confirmed For postpartum care and monitoring Well-balanced diet Limit OFI <1.5L/day For baseline AST/ALT For initiation of Anti-Koch’s regimen Continue postnatal medications Advised breastmilk expression Secure compression stockings Refer back to Perinatology and Cardiology Refer to TB DOTS and IM Pulmo Refer to Ophtha

11. OB OPERATIVE: 1 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION FINAL DIAGNOSIS PLAN Dr. Ga/Ch/TN D.S. 21 years old G1P0 NR Chief complaints: Hypogastric pain BP 80/50 PR 130s RR 20 T 36.5 C 98 % at room air Abdomen flat , with board-like rigidity, with tenderness on all quadrants  Internal examination : cervix is firm and closed, with cervical motion tenderness,, corpus is small, with right adnexal tenderness, with fullness on the culdesac Gravida 1 Para 0 To consider ectopic pregnancy, probably right, probably ruptured Exploratory laparotomy, salpingectomy, right Gravida 1 Para 0 tubal pregnancy, 9 weeks AOG, right ampullary area, ruptured For postpartum care and monitoring Diet progression For HIV screening, RPR/VDRL. HBsAg of both patient and partner Continue Cefoxitin 2g IV q6 fro 24 hours To start Doxycycline 100mg tab BID for 7 days For the partner: Ceftriaxone 500mg TIM single dose Doxycycline 100mg tab q8 PRN for 14 days

12. OB PENDING: 3 PATIENT DETAILS ADMITTING DIAGNOSIS INTERVENTION WORKING DIAGNOSIS PLAN Dr. Ca/Dp/AC M.J. 27 years old G2P1 (1001) R Chief complaints: labor pains BP 110/70 PR 87 RR 20 T 36.5 C 98 % at room air Fundic height 30 cm FHT 130s EFW: 2500 grams by Palm method, Internal examination : Cervix is 3cm dilated, beginning effacement, cephalic, with intact bag of waters, at station -3  Gravida 2 Para 1 (1001) Pregnancy uterine 40 5/7 weeks AOG Cephalic in labor Gravida 2 Para 1 (1001) Pregnancy uterine 40 5/7 weeks AOG Cephalic in labor Continue cervical ripening with evening primrose oil capsules Continue prenatal medications For early amniotomy once bag is accessible Hook to continuous CTG monitoring We will watch out for fetomaternal distress