Obstetrics and Gynecology - SE

Syllabus

Syllabus  (teaching schedule)  OBSTETRICS AND GYNAECOLOGY

 VI. year, English, General Medicine

 Bed-side teaching:  5 hours per day in block - 20 days

 Student‘s independent work in all divisions of the department under teacher‘s guidance.

                Labor and delivery, postpartum care, postoperative care, high risk pregnancy,                 out patients, ultrasound, operative rooms, general gynecology

                /Preterm Labor and Delivery, Hemorrhage in Obstetrics, Hormonal Treatment,   

                Gynecological Oncology/ 

State examination (test, oral)

 Literature:

 McKay Hart, Norman, Callander, Ramsden: Gynecology Illustrated. Churchill Livingstone, 2000,

Hanretty, Ramsden, Callander: Obstetrics Illustrated. Churchill Livingstone, 2010  

Topics for state exam in Gynecology and Obstetrics

 Group 1.

Physiology, propedeutics

·         Development of reproductive organs.

·         Anatomy of female reproductive tract.

·         Gynecological examination + medical history.

·         Prebioptic methods in gynecology, screening -  cervix, breast.

·         Imaging methods in gynecology.

·         Female reproductive hormones.

·         Menstrual cycle and its regulation.

·         Climacterium - definitions, hormonal changes, acute climacteric syndrome, organic and metabolic estrogen-deficient syndrome.

·         Contraception - male, female.

·         Hormonal contraception.

·         Puberty, development of secondary sex characteristics.

·         Human gametes, fertilization, blastogenesis, nidation. Embryogenesis.

·         Symptoms and diagnosis of pregnancy, estimation of date of delivery.

·         Physiological changes in female body during pregnancy.

·         Placenta, morphology and function, variations and anomalies.

·         Feto-maternal circulation.

·         Amniotic fluid - composition, function, formation. Polyhydramnios, oligohydramnios.

·         Fetal lie, position, presentation and attitude in the uterus. External obstetric examination.

·         Prenatal care in normal pregnancy, its organization, examinations in prenatal visits.

·         Non-invasive methods of prenatal diagnostic testing. Screening for chromosomal anomalies and congenital fetal malformations.

·         Invasive methods of prenatal diagnostic testing. The most common genetic syndromes.

·         Birth canal. Internal obstetric examination.

·         Forces of labor.

·         First stage of labor. Definition, duration, mechanism of cervical dilatation.

·         Obstetric anatomy of fetal skull.

·         Second stage of labor. Definition, duration, mechanism of delivery of the fetus.

·         Third stage of labor. Definition, duration, mechanism of delivery of the placenta.

·         Admission of a parturient to labor ward. Management of labor.

·         Obstetric analgesia - methods, benefits and disadvantages.

·         Cardiotocography.

·         Intrapartal fetal pulse oxymetry (IFPO), ST analysis of the fetus (STAN).

·         Ultrasound in obstetrics.

·         Puerperium - physiological changes.

·         Newborn, postpartum adaptation, resuscitation of a newborn.

·         Breasts and lactation.

 Group 2.

Obstetrics

·         PROM. Causes, diagnosis, risk, management of pregnancy.

·         Fetal distress.

·         Maternal obstetric injury. Episiotomy. Uterine rupture.

·         Ceasarean delivery.

·         Operative vaginal delivery: Forceps, ventouse.

·         Breech delivery. Management of pregnancy and delivery.

·         Transverse and oblique lie of the fetus. Abnormal presentation.

·         Abnormalities of the 1st and the 2nd stage of labor

·         Fetal macrosomia. Shoulder dystocia.

·         SGA/IUGR.

·         Deflexed cephalic presentations.

·         Abnormalities of the 3rd (4th) stage of labor. Postpartum hemorrhage.

·         DIC.

·         Abortion, miscarriage.

·         Placenta praevia.

·         Placenta abruption

·         Rhesus and AB0 blood group system. Isoimmunization in pregnancy.

·         Preterm birth (premature delivery).

·         Post-term pregnancy, postmaturity - definition, management of pregnancy. Labor induction.

·         Multiple pregnancy.

·         Infections in pregnancy, GBS - pregnancy management.

·         Diabetes in pregnancy

·         Hypertension in pregnancy. Preeclampsia and eclampsia.

·         Cardiovascular diseases in pregnancy.

·         Thromboembolic disorders during pregnancy.

·         Neurological and respiratory diseases in pregnancy.

·         Stillbirth.

·         HELLP syndrome, intrahepatic cholestasis of pregnancy.

·         Gastrointestinal diseases in pregnancy.

·         Uropoetic diseases in pregnancy.

·         Acute abdomen in pregnancy.

·         Systemic and endocrine diseases in pregnancy.

·         Abnormal puerperium. (lochiometra, hemorrhage in puerperium, puerperal infections, vulvar and paravaginal hematoma).

·         Abnormal lactation.

·         Perinatal audit. Perinatal morbidity and mortality.

·         Perinatal audit. Maternal mortality a morbidity.

Group 3.

Gynecology

 ·         Abnormal menstrual cycle - terminology, diagnostic and therapeutic algorithm.

·         Primary and secondary amenorrhea.

·         Dysmenorrhea, Premenstrual syndrome.

·         Hormonal replacement therapy - HRT.

·         Sterilization and  medical abortion.

·         Vulvovaginitis - etiology, differential diagnosis, therapy.

·         Cervicitis, Endometritis, Myometritis, Perimetritis.

·         Pelvic inflammatory disease (PID) - classification, etiology, spread, therapy.

·         Veneric diseases and STD.

·         HPV and vaccination.

·         Ectopic pregnancy.

·         Acute abdomen in gynecology.

·         Pelvic pain.

·         Endometriosis.

·         Benign diseases and precanceroses of the vulva and the vagina.

·         Benign diseases and precanceroses of the cervix.

·         Benign diseases and precanceroses of the uterus/endometrium.

·         Benign diseases and precanceroses of the ovary and the Fallopian tube.

·         Ovarian cysts.

·         Benign diseases and precanceroses of the breast.

·         Basics of oncogynecology - terminology, histology, therapeutic modalities.

·         Malignancies of the vulva and the vagina.

·         Malignancies of the cervix.

·         Malignancies of the uterus.

·         Ovarian and Fallopian tube malignancies.

·         Gestational trophoblastic disease.

·         Breast malignancy.

·         Human infertility.

·         Assisted reproduction, IVF.

·         Urine incontinence - terminology, diagnostic methods.

·         Urge incontinence, OAB (Overactive bladder).

·         Stress incontinence.

·         POP - Pelvic Organs Prolapse.

·         Female sexuality and sexual disorders.

·         Pediatric gynecology.

·         Congenital malformations of female reproductive tract.

·         Endocrinopathies in gynecology - hyperandrogenic syndrome, hyperprolactinemia.

·         Preparation for surgery and postoperative care in gynecological patients.

·         Laparoscopy in gynecology - indications, procedure description, complications.

·         Hysteroscopy - indications, procedure description, complications.

·         Vaginal gynecologic operations.

·         Abdominal gynecologi

Annotation

Gynecology: Intersexuality. HRT. Contraception. Hormonal treatment in gynecology. Endometriosis. Pelvic pain. Pelvic inflammatory disease. Sexually transmitted diseases. Gynecologic operations. Urogynecology. Precancerosis of the uterine cervix and the endometrium.

Obstetrics: Bleeding in pregnancy. Obstetric analgesia. Coagulopathy, DIC. Breech presentation. Caesarean Section. Multiple pregnancy. Postpartum care. Maternal and perinatal mortality.