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 mini pill), implants (2 rods and 1 rod), Injectable contraceptives (IM and subcutaneous), 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 — Breastfeeding & 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 pregnancies
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, etiology, diagnosis, complications, management
b) Obstructed labor: Definition, 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 — Breastfeeding & Complementary feeding
IUGR & IUD
Causes, diagnosis, and management
Obstetric operative procedures
Episiotomy, caesarean section, vacuum and forceps deliveries, version, destructive operations: their indications and 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 socioeconomic & environmental factors
c) Importance of family planning in the 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 the 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 complications, 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 the 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 the cervix
- Benign and malignant conditions of the uterus
- Benign and malignant tumors of the ovary
Subfertility
a) Causes, investigation, and management of both male and female partners.
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 the 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 detail
8) Hemolytic anemia
9) Nephritis and renal failure in obstetrics
10) Treatment of Rh incompatibility
11) Management of IUGR
12) Management of inversion of the 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