Operational Medicine Medical Education and Training

Operational OB-GYN Practical Knowledge Test

LCDR Dewey complains of mild cramping and spotting. She has a positive pregnancy test and her LMP was 6 weeks ago. Her uterus is enlarged, slightly tender, and her cervix is closed. Your ship is underway from Guam to Yokosuka, Japan, and due to arrive in 23 hours. It is a dark and stormy night. Your Plans for LCDR Dewey:

A. Helo MEDEVAC to USNH Yokosuka

B. Bedrest. Advise Yokosuka of your situation and ETA.

C. Give Methergine.

D. Give IV antibiotics

(B is correct)


LCDR Dewey has a threatened abortion which can likely be postponed by having her lie still. Antibiotics will not be helpful and Methergine may worsen it.

You are only 23 hours away from a safe, pier-side transfer of LCDR Dewey to an ambulance. Helo OPS at night in bad weather are very dangerous and not justified here.

Medical Care on the Ward

Operational OB-GYN Practical Knowledge Test

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24 Slides
1.0 MB ppt file

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LTJG Decatur started her first pack of OCPs 9 days ago. She complains of nausea, depression, tender breasts, and thinks she may be pregnant. Your ship left Norfolk yesterday for exercises off Guantanamo before a 6-month deployment to Italy. You Should:

A. Obtain a Pregnancy Test

B. Stop the OCPs

C. MEDEVAC for a mammogram

D. Continue the OCPs if the pregnancy test is negative and the symptoms mild

(A and D are the correct)


You should always obtain a pregnancy test whenever a woman believes she may be pregnant. She is often right.

It is not necessary to stop the BCPs. The side-effects she’s experiencing are common in the first month and should disappear.

The first few days or weeks of a deployment can be very stressful, particularly for junior personnel on their first deployment.

LTJG Decatur returns 3 days later. The nausea and depression are gone. Her breast tenderness is improved. Her Division Officer complimented her on her good performance while underway. She noticed a tiny amount of spotting after exercise yesterday.

Your Advice to LTJG Decatur:

A. Transfer off the ship because of these endless gynecologic problems.

B. Bedrest for 4 days.

C. GYN consultation at Guantanamo

D. Spotting during the 1st cycle of OCPs is common and not dangerous.

(D is correct)


80% of women starting OCPs have no side effects.

The other 20% may have spotting, nausea, breast tenderness, and headaches.

These usually disappear after the first month.

If they don’t, switching to a different OCP from a different manufacturer, will generally solve the problem.

Continue to the PowerPoint Lecture...


Operational Obstetrics & Gynecology
2nd Edition

Bureau of Medicine and Surgery
Department of the Navy

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