Gynecology and Obstetrics

Final Professional Examination:
Marks distribution of Assessment of Obstetrics & Gynecology
Total marks – 500 (Summative)
• Written =200
(Formative =(10+10)=20, MCQ=40 (SBA-20, Multiple true false -20), SAQ & SEQ=140 (SAQ50+50=100) (SEQ-20+20=40)
• SOE=100
• Clinical=100
• Practical=100

 

Related Equipment/Instrument:
Forceps, Ventouse, Female bony pelvis & dummy fetus, Folley’s catheter, Plain rubber catheter Sponge holding forceps, Alli’s tissue forceps, Artery forceps, Volsellum, Hegar’s dilators, Uterine sound & Curette, Sim’s vaginal speculum, Cusco’s speculum, BP blade with handle, Dissecting forceps, Needle holder, Suture materials Contraceptives – OCP, progesterone only pill (POP or minipill), implants (2 rods and 1 rod), Injectable contraceptives (IM and sub-cutaneous), IUCD, Barrier methods (condoms), IUD and Emergency Contraceptive Pill (ECP). MR Syringe with Canula

 

Core contents of Obstetrics:
Conception and development of fetoplacental unit

a) Fertilization, implantation, fetoplacental unit, placental barrier
b) Placenta, amniotic fluid and umbilical cord: Development, structure and function

 

Anatomical and physiological changes during pregnancy
Diagnosis of pregnancy
Counseling in reproductive health

 

Antenatal care
a. Counselling
b. Objectives, principles of antenatal care, identification of high risk pregnancy
c. Nutrition during pregnancy and lactation
d. Vomiting in early pregnancy

 

Normal labor
a. Criteria of normal labor
b. Stages, mechanism of normal labor
c. Diagnosis of labor
d. Management of normal labor
e. Assessment of progress of labor
f. Monitoring maternal and fetal condition
g. Partograph
h. Pain relief

 

Normal puerperium
a. Anatomical and physiological changes during puerperium
b. Management of normal puerperium
c. Post-partum family planning
d. IYCF — Breast feeding & Complementary feeding

 

Hypertensive disorder in pregnancy including pre-eclampsia and eclampsia Medical disorders in obstetrics
a. Anemia in pregnancy
b. Urinary problems in obstetrics
c. Diabetes
d. Heart disease
e. Hepatitis

 

Antepartum hemorrhage
Definitions, classification, clinical features, complications and management

 

Rh incompatibility
Blood transfusion in Obstetrics
Multiple pregnancy
Definitions and types, clinical features, complications, diagnosis and principles of management

 

Malposition and malpresentation
Types, causes, diagnosis, complications and management

 

Abnormalities of labor
a) Prolonged labor: Definition, an etiology, diagnosis, complications, management
b) Obstructed labor: Definition, an etiology, diagnosis, complications, management

 

Post-partum hemorrhage (PPH)
Definitions, causes (atonic, traumatic and others) of PPH, prevention and management, follow up.

 

Abnormal puerperium
Causes, diagnosis and management

 

The newborn
Resuscitation, examination and care of the newborn.

 

Neonatal problems
Birth Asphyxia
Jaundice
Infection
Feeding
Other problems of newborn
IYCF — Breast feeding & Complementary feeding

 

IUGR & IUD
Causes, diagnosis and management

 

Obstetric operative procedures
Episiotomy, caesarean section, vacuum and forceps deliveries, version, destructive operations: their indications an complications Steps of operation: Episiotomy, vacuum & forceps delivery

 

Vital statistics:
Maternal morbidity & mortality
Perinatal morbidity and mortality
Neonatal morbidity & mortality

 

Diagnostic aids in obstetrics
a) Ultrasonography
• Basics of ultrasound
• Role in obstetrics
b) Fetal monitoring- CTG
c) Amniocentesis and other prenatal diagnostic techniques

 

Social Obstetrics
a) Maternal & perinatal morbidities and mortalities
b) Direct causes of maternal & perinatal morbidity and mortality – Contributing socio-economic & environment factors
c) Importance of family planning in prevention of obstetric problem
d) Strategies for promotion of maternal health & prevention of illness emphasizing maternal nutrition, hygiene & medical care
e) National programs for MCH&FP, EOC, Combined service delivery

 

Core contents of Gynecology

Anatomy of the female reproductive organs
a) Basic anatomy of uterus, ovaries, tubes, vagina and vulva
b) Relationship of uterus, ovaries, tubes and vagina to other pelvic organs
c) Developmental anomaly of genital organs

 

Physiology of reproduction
a) Puberty and its complication, menstruation, ovulation
b) Fertilization and implantation

 

Bleeding in early pregnancy
• Abortion: Definition, types, causes and management of all types of abortion and these complications.
• Ectopic pregnancy: Definition, etiopathology, clinical feature, differential diagnosis and abdomen of acute principles of surgical management
• Trophoblastic tumors:
i. Hydatidiform mole: types, clinical features, complications, differential diagnosis, management and follow up.
ii. Choriocarcinoma: diagnosis and management, follow up

 

Vaginal discharge
Physiological and pathological, Diagnosis and treatment.

 

Menstrual disorder
a) Amenorrhea: Types, causes and principles of management
b) Menorrhagia: Definition, causes and management
c) Metrorrhagia: Definition, causes and management
d) Dysmenorrhea: Definition types, causes and management.
e) Abnormal uterine bleeding Definition, PALM-COIN classification, diagnosis, principles of investigation and management

 

Genital tract infection
a) Defensive mechanism of genital tract
b) Pelvic inflammatory diseases: acute and chronic
c) Sexually transmitted diseases
d) Genital tuberculosis

 

Urinary incontinence – definition, types
a) Genitourinary fistula:- Types, causes, clinical features, principles of management, prevention

 

Other genital tract injuries:
a) Perineal tear
b) RVF

 

Genital prolapse
Types, etiology, supports of uterus, clinical features, diagnosis, differential diagnosis, principles of management, prevention

 

Endometriosis
Definition, types, clinical features, principles of management

 

Neoplasia of reproductive organs
• Benign & malignant conditions of vulva & vagina
• Benign, precancerous & malignant conditions of cervix
• Benign and malignant conditions of uterus
• Benign and malignant tumors of ovary

 

Subfertility
a) Causes, investigation and management both male and female partner.
b) Assisted reproductive techniques
c) Concepts of medical biotechnology in relation to Obstetrics

 

Contraception
Importance
Counselling
Classification, mechanism of action, advantages, disadvantages, complications of all methods particularly sterilization and MR & MRM

 

Menopauses
a) Definition, physiological basis, changes in different organs of body, clinical features of menopausal syndrome, principles of management
b) Post-menopausal bleeding
c) Hormone replacement therapy (HRT)

 

Diagnostic Technique
a) Cervical smear
b) Laparoscopy
c) Hysteroscopy
d) Colposcopy
e) Ultrasonography
f) CT scan
g) MRI

 

Principles of common gynecological operations: MVA, D&C, E&C, suction evacuation, hysterectomy

Additional Contents
Obstetrics
1) Developmental structure of placenta
2) Antenatal Foetal screening
3) Mechanism of onset of normal labor (theories)
4) Labor analgesia
5) Thromboembolism
6) Other hypertensive disorders
7) Pathophysiology of pre-eclampsia and eclampsia in details
8) Hemolytic anemia
9) Nephritis and renal failure in obstetrics
10) Treatment of Rh incompatibility
11) Management of IUGR
12) Management of inversion of uterus
13) Post-partum and post-MR contraception
14) Diagnostic aids in obstetrics
a) Ultrasonography
b) Foetal monitoring-CTG
c) Amniocentesis, CVS, MSAFP
d) X ray

 

Gynecology
1) Management of endometriosis – recent advances
2) Assisted reproductive techniques
3) Hormone replacement therapy
4) Diagnostic techniques
a) Laparoscopy 417
b) Hysteroscopy
c) Colposcopy
d) Ultrasonography
5) Hormonal disorders in gynecology
6) STD