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