Obstetrics: Admission, work-up, diagnosis and provision of care for female patients of all ages presenting in any condition of pregnancy or illness, injuries, or disorders of the obstetric system. Privileges include management of labor with a singleton pregnancy that is greater than 34 weeks gestation, management of mild preeclampsia, premature rupture of membranes, immediate care of newborn (including resuscitation), amniotomy, application of a fetal scalp electrode, use of local anesthesia (including pudendal block), repair of episiotomies with a 1st, 2nd, or 3rd degree extension, management of normal puerperal patient, and emergency use of obstetric ultrasound.
Conditions that a consultation is suggested: Chronic hypertension on medication Gestational diabetes-diet controlled Systemic lupus erythematosis Uncontrolled or symptomatic asthma Hyperthyroidism on medication Severe systemic bacterial, viral or parasitic infection
Conditions requiring a mandatory consultation: Preterm Labor or PROM < 34 weeks gestation Any fetus considered to be greater than 4000 grams Insulin dependent diabetes History of prior cesarean section Polyhydramnios or oligohydramnios Post-term pregnancies (> 42 weeks and 0 days) Preeclampsia that requires magnesium sulfate Rupture of Membranes greater than 24 hours Arrest of Labor > 4 cm dilated Placenta previa or significant antepartum hemorrhage from previa or suspected Abruption Multiple pregnancy Repair of 4th degree lacerations and/or cervical or vaginal lacerations (unless privileges have been granted)
Use of vacuum extractor (10)
Use of outlet forceps (20)
Induction and Augmentation of labor without consultation (10)
Circumcision of newborn (10)
Management of fetal demise (1)
4th degree episiotomy repair (10)
Gynecology:
Admission, work-up, diagnosis and provision of care for female patients presenting with illness, injuries, or disorders of the gynecological system. Privileges include medical management of pelvic inflammatory disease, and evaluation of pelvic pain of undetermined etiology.
Other privileges that may be requested with documentation of experience:
Dilation and curettage
Suction Curettage
CATEGORY II (Obstetrics and Gynecology Training)
Training: Must be a DO or MD and have successfully completed an approved residency in Obstetrics and Gynecology. Applicant shall have demonstrated competency in the following areas. Certification of training and competency shall be made by the applicant's Program Director. This includes all procedures covered in Category I privileges not otherwise defined here or expanded on.
Obstetrics: This includes all things covered in Category I Obstetric Privileges not otherwise defined here or expanded on. Management of normal and abnormal labor and delivery (including premature labor, breech, cesarean delivery, use of prostaglandin derivatives and/or oxytocin, outlet forceps, vacuum extractor deliveries, low forceps and rotations. Management of medical and/or surgical complications of pregnancy Delivery of vaginal births after a previous cesarean section Cesarean hysterectomy All episiotomy repairs including vaginal and cervical lacerations Treatment of incompetent cervix Routine obstetrical and pelvic ultrasound and interpretation External version of breech presentation
Obstetrical analgesia: local, pudendal Management of the normal and abnormal puerperal patient
Gynecology: This includes all procedures covered in Category I Gynecology privileges not otherwise defined here or expanded on. Dilation and curettage Suction curettage Surgical and/or Medical Treatment of Ectopic Pregnancy Exploratory laparotomy Hysterectomy, abdominal and vaginal Supportive procedures for pelvic relaxation and urinary incontinence (Colporrhaghy or Burch type procedures) Adnexal surgery Laparoscopy-diagnostic and therapeutic Colpotomy Perineoplasty Conization of cervix or Loop Electrosurgical Excision procedures (LEEP) Hysteroscopy-diagnostic and therapeutic Incidental appendectomy
Vaginal and abdominal incontinence surgery (Sling or Tension Free Vaginal)
Tape (TVT)