Medical maps: Obstetrics overview

Obstetrics: the clinical speciality concerned with pregnancy, childbirth and the postnatal period. There are six key parts to the obstetrics syllabus in medical school:

  • Uncomplicated pregnancy and labour
  • Maternal issues in pregnancy
  • Baby issues in pregnancy
  • Labour complications and postpartum complications
  • Pregnancy loss
  • Prescribing in pregnancy and breastfeeding

If you understand these key areas, you’ll be fine in the exam. Below, the topics are broken down in a little more detail:

  • Understanding uncomplicated pregnancy and labour (including an appreciation of the difference between midwife-led and consultant-led care)
    • Pre-conception period
      • Dietary recommendations
      • Folic acid supplementation
      • Smoking and alcohol consumption
    • Recognising pregnancy
      • Presumptive signs (possibility of pregnancy)
      • Probable signs (likelihood of pregnancy)
      • Positive signs (confirming pregnancy)
    • 1st, 2nd and 3rd trimesters
      • Be aware of common complaints in each trimester
    • Labour
      • Recording labour with a partogram
      • 1st stage: cervical dilatation
        • Latent stage (0-4cm)
        • Active stage (4-10cm)
      • 2nd stage: up to the delivery of the foetus
      • 3rd stage: up to the delivery of the placenta
    • Postpartum and breastfeeding
  • Understanding maternal problems during pregnancy
    • Pre-existing issues
      • Hypertension
      • Epilepsy
      • Diabetes
      • (CKD – possibly a bit too detailed)
    • Acquired issues
      • Earlier in pregnancy (<20wk) – early pregnancy bleeding, hyperemesis
      • Later in pregnancy (>20wk) – late pregnancy bleeding, gestational disease (hypertension, diabetes, PET/eclampsia, liver disease, thromboembolic)
  • Understanding baby problems during pregnancy
    • Size issues
      • Large for gestational age (macrosomia)
      • Small for gestational age (IUGR)
    • Amniotic fluid issues
      • Excess (polyhydramnios)
      • Too little (oligohydramnios)
    • Foetal hydrops
      • Immune foetal hydrops
        • Haemolytic disease of the newborn
      • Non-immune foetal hydrops
        • Chromosomal
        • Infective
    • Multiple pregnancy (focus for exams is on twins, not triplets)
      • Dizygotic
      • Monozygotic
  • Understanding labour + postpartum complications
    • Problems with powers (uterine contractions)
      • Too weak
      • Too strong
    • Problems with passenger
      • Size
      • Lie
      • Attitude
      • Presenting part
    • Problems with passage
      • Soft tissue – failure of cervix to dilate
      • Bony pelvis – cephalopelvic disproportion
    • Postpartum problems
      • Medical: Shock and haemorrhage
      • Psychiatric: ‘Baby-blues’, depression and psychosis
  • Pregnancy loss
    • Unintended pregnancy loss
      • Miscarriage (<20wk)
      • Recurrent miscarriage
      • Stillbirth (>20wk)
    • Intended pregnancy loss
      • Termination of pregnancy (ToP)
  • Prescribing during pregnancy and breastfeeding

And here is the medical map to guide you through obstetrics:

IMG_1071

Medical map for obstetrics. Hopefully, this is a useful roadmap for the key areas you need to cover during your obstetrics placement. Click to enlarge.

The next post will be about uncomplicated pregnancy: from the preconception period through to labour and the postpartum period.

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