1. OB SIMULATION ORIENTATION

2. BUBBLE LE B: Background and Breasts U: Uterus B: Bladder B: Bowels
L: LOF/Lochia
E: Effacement/Episiotomy
L: Lower Extremities
E: Emotional State

3. Background EDD/EDC Gestational age Term – 37 weeks to 40 weeks
Late term – 40 weeks to 416/7 weeks
Post term – 42 weeks or greater
Late preterm – 34 weeks to 36 6/7
Preterm – Less than 37 weeks
Viability – 22 weeks to 25 weeks

4. Background
G/P (TPAL)
Gravity – Total number of pregnancies including the current pregnancy
Parity- Number of pregnancies that have reached 20 weeks gestation
Term deliveries
Preterm deliveries
Abortions or Miscarriages
Living Children

5. Background Prenatal History Complications Infectious disease testing
GBS status is especially relevant to L&D clinical experience

6. Breasts What is the mothers plan for feeding her infant
Baby Friendly initiative
Reasons some women can not breastfeed
Reasons women should not breastfeed

7. Uterus
True labor?
Tocotransducer
Placed on the fundus of the uterus

8. Uterus
Contractions
Duration
Frequency
Intensity

9. Uterus
Fetal heart monitor

10. Uterus
Leopold’s Maneuver

11. Uterus Fetal heart rate Fetal acid/base balance
Fetal neurologic function

12. Uterus
Baseline heart rate
bpm

13. Uterus Variability Fluctuations in fetal heart rate baseline
Four basic types of variability
Absent
Minimal
Moderate
Marked

14. Uterus
Absent variability

15. Uterus
Minimal variability
1-5 bpm variability in baseline heart rate

16. Uterus
Moderate variability
6-25 bpm variability in fetal heart rate

17. Uterus
Marked variability
> 25 bpm variability in fetal heart rate

18. Uterus V E A L C H O P

19. Uterus
Variable Decelerations
C: Cord Compression

20. Uterus
Early Decelerations
Head Compression

21. Uterus
Accelerations
OK 

22. Uterus
Late Decelerations
Placental Insufficiency