Operational obstetrics gynecology the health care of women in military settings
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Operational Obstetrics & Gynecology The Health Care of Women in Military Settings. Captain Mike Hughey, MC, USNR. Operational Medicine is not Identical to Civilian Medicine. Isolated Settings. Minimal Support Limited Consultation Long MEDEVAC times. Limited Resources.

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Operational obstetrics gynecology the health care of women in military settings

Operational Obstetrics & GynecologyThe Health Care of Women in Military Settings

Captain Mike Hughey, MC, USNR



Isolated settings
Isolated Settings

  • Minimal Support

  • Limited Consultation

  • Long MEDEVAC times


Limited resources
Limited Resources

  • What did you bring with you?

  • Resupply? Maybe

  • Whatever you use up today you won’t have tomorrow.

  • IV antibiotics often mean transfer.


Operational commitments
Operational Commitments

  • Medical care is not the first priority.

  • It may not be the second priority either.


Then sometimes medical care is the mission
Then sometimes, medical care is the mission

  • Medical personnel, supplies and equipment for combat are different than those used for humanitarian missions.

  • Before deployment, learn as much as you can about everything.


Field expedient gyn exam table
Field Expedient GYN Exam Table

  • Litter

  • Litter Stands

  • IV Poles

  • Small Battle Dressings


Field expedient vaginal speculum
Field Expedient Vaginal Speculum

  • GI mess kit spoons (2) bent at 45° angle, or

  • Two spoons joined by rubber band


Ectopic pregnancy management naval hospital pensacola fl
Ectopic Pregnancy ManagementNaval Hospital Pensacola FL

  • Transvaginal ultrasound

  • Quantitative  HCG

  • Serial hgb

  • Laparoscopy

  • Methotrexate

  • Blood bank



Ectopic pregnancy management operational setting
Ectopic Pregnancy ManagementOperational Setting

  • Laparotomy (sometimes)

    Non-surgical management

  • IV fluids

  • Mast suit

  • Donor-to-victim blood transfusion


Field expedient vaginitis rx
Field Expedient Vaginitis Rx

  • If it itches, it’s yeast. (Monistat)

  • If it smells bad, it’s BV. (Flagyl)

Mucopurulent, chlamydia

Dry, curdy, yeast

Bubbly, frothy, trichomonas


Urinary tract infections
Urinary Tract Infections

  • Treat UTI’s based on symptoms.

  • Cultures and dipsticks in many operational settings are, at best a waste of time, and may be misleading and dangerous.


Unknown lesions of the vulva
Unknown Lesions of the Vulva

  • Each of these requires some unavailable test to confirm the diagnosis.

  • What is the test for each of them?


Bartholin duct cyst and abscess
Bartholin Duct Cyst and Abscess

  • Drain it or leave it alone?




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