GYNAECOLOGY
OBSTETRICS &
SEXUAL HEATH
4TH YEAR MEDICINE
Indeera Shankla
, Table of Contents
Aims and Learning Objectives ................................................................................................................. 3
Knowledge ....................................................................................................................................................... 3
Skills ................................................................................................................................................................ 3
Attitudes .......................................................................................................................................................... 4
Pre-Requisite Knowledge.................................................................................................................................. 4
Obstetrics Core Conditions ..................................................................................................................... 5
General Definitions .......................................................................................................................................... 5
Antenatal Care ................................................................................................................................................. 6
Routine Antenatal Care ............................................................................................................................................. 6
Antenatal Problems ................................................................................................................................................ 13
High Risk Pregnancies ............................................................................................................................................. 20
Pregnancy Loss ........................................................................................................................................................ 31
Intrapartum Care ........................................................................................................................................... 33
Normal Labour ........................................................................................................................................................ 33
Induction of Labour ................................................................................................................................................. 39
Abnormal Labour .................................................................................................................................................... 42
Obstetric Complications .......................................................................................................................................... 47
Post-partum Care ........................................................................................................................................... 52
Gynaecology & Sexual Health Core Conditions ...................................................................................... 58
General Gynaecology ..................................................................................................................................... 58
Basic Science ........................................................................................................................................................... 58
Menstrual Cycle ...................................................................................................................................................... 59
Postmenopausal Bleeding ....................................................................................................................................... 64
Chronic Pelvic Pain .................................................................................................................................................. 66
Early Pregnancy Problems .............................................................................................................................. 70
Benign Tumours ...................................................................................................................................................... 73
Specialist Gynaecology ................................................................................................................................... 75
Sub-fertility ............................................................................................................................................................. 75
Urinary Incontinence .............................................................................................................................................. 77
Prolapse................................................................................................................................................................... 78
Cancer ..................................................................................................................................................................... 79
Contraception ......................................................................................................................................................... 84
Sexual Health Core Conditions .............................................................................................................. 97
General Topics ............................................................................................................................................... 97
Bacterial STIs................................................................................................................................................ 102
Chlamydia.............................................................................................................................................................. 102
Gonorrhoea ........................................................................................................................................................... 103
Trichomonas.......................................................................................................................................................... 104
Genital Infections and Dermatosis ................................................................................................................ 105
Thrush ................................................................................................................................................................. 105
Bacterial Vaginosis ................................................................................................................................................ 106
Genital Skin Conditions ......................................................................................................................................... 107
Viral STIs ...................................................................................................................................................... 109
Herpes ................................................................................................................................................................... 109
Genital Warts ........................................................................................................................................................ 109
Syphilis ........................................................................................................................................................ 110
HIV .............................................................................................................................................................. 111
Skills ................................................................................................................................................... 114
Obstetric History ................................................................................................................................................. 114
1
, Obstetric Examination ......................................................................................................................................... 116
Gynaecological History ....................................................................................................................................... 117
Sexual History ...................................................................................................................................................... 119
Female Genital Examination .............................................................................................................................. 120
Male Genital Examination .................................................................................................................................. 122
Prescribing in Pregnancy & Breastfeeding ............................................................................................................ 123
OSCE .................................................................................................................................................. 124
OSCE Stations ............................................................................................................................................... 124
COCP............................................................................................................................................................ 125
Emergency Contraception............................................................................................................................. 126
Gynaecological History ................................................................................................................................. 127
Obstetrics Exam ........................................................................................................................................... 128
2
, Aims and Learning Objectives
Have gained an understanding of the mechanisms governing sexual health and women’s health and
reproduction.
Be able to understand and discuss the clinical practice of Gynaecology, Obstetrics and Sexual Health.
Have a holistic approach to women and the integral part their families and the community play in their health
Have gained competence in assessing women through history and examination (both in obstetrics and
gynaecology)
Have gained competence in assessing patients attending a sexual health clinic.
Have an understanding of the particular issues and sensitivities that affect health care in the areas of sexual
health and reproduction.
Be able to understand and discuss the clinical science basis of obstetrics and gynaecology.
Be able to recognize the common syndromes of sexually transmitted infections (STI) and HIV likely to present in
non-specialist settings.
Gain an understanding of the principles of managing sexually transmitted infections (STI) including the
importance of confidentiality and partner notification.
Be able to take a clinical history and perform a physical examination in an obstetric or gynaecology patient.
Be able to take an appropriate history from patients at risk of STI, including Sexual history and HIV risk history.
Be able to discuss relevant differential diagnoses and develop management plans.
Develop skills in communication and be aware of the sensitivities involved in practising clinical Gynaecology,
Obstetrics and Sexual Health.
Be aware of the relevance of clinical governance in Gynaecology, Obstetrics and Sexual Health.
Be aware of the current ethical issues in Gynaecology, Obstetrics and Sexual Health.
Be able to understand the physical, emotional and social impact of sexually transmitted infections on the
individual and the general community.
Knowledge
An understanding of normal changes in development and function of the female genital tract in relation to
women’s health
To understand the normal and abnormal antenatal course
To recognize the difference between the normal and abnormal processes of parturition
To understand the role of aftercare of the mother and infant following parturition
An understanding of the community services and facilities available to women,
To develop a better understanding of the various methods which are available for the delivery of child, antenatal
and gynaecological health care
An understanding of the medical, legal and ethical dilemmas of caring for pregnant women
The nature and functioning of sexual health services provided to men and women
An understanding of the principles and methods of contraception and family planning
Skills
Development of an ability to relate to patients presenting for care in the sexual health and in obstetric and
gynaecological settings
To develop the interpersonal and organisation skills required to take a competent history from such patients
Development of the necessary examination skills
An ability to evaluate a clinical problem after the history and examination, and thereby be able to deduce a
reasonable differential diagnosis
An ability to describe the principles of further management including appropriate investigation, therapeutic
options, and the importance of communication / counselling
3
OBSTETRICS &
SEXUAL HEATH
4TH YEAR MEDICINE
Indeera Shankla
, Table of Contents
Aims and Learning Objectives ................................................................................................................. 3
Knowledge ....................................................................................................................................................... 3
Skills ................................................................................................................................................................ 3
Attitudes .......................................................................................................................................................... 4
Pre-Requisite Knowledge.................................................................................................................................. 4
Obstetrics Core Conditions ..................................................................................................................... 5
General Definitions .......................................................................................................................................... 5
Antenatal Care ................................................................................................................................................. 6
Routine Antenatal Care ............................................................................................................................................. 6
Antenatal Problems ................................................................................................................................................ 13
High Risk Pregnancies ............................................................................................................................................. 20
Pregnancy Loss ........................................................................................................................................................ 31
Intrapartum Care ........................................................................................................................................... 33
Normal Labour ........................................................................................................................................................ 33
Induction of Labour ................................................................................................................................................. 39
Abnormal Labour .................................................................................................................................................... 42
Obstetric Complications .......................................................................................................................................... 47
Post-partum Care ........................................................................................................................................... 52
Gynaecology & Sexual Health Core Conditions ...................................................................................... 58
General Gynaecology ..................................................................................................................................... 58
Basic Science ........................................................................................................................................................... 58
Menstrual Cycle ...................................................................................................................................................... 59
Postmenopausal Bleeding ....................................................................................................................................... 64
Chronic Pelvic Pain .................................................................................................................................................. 66
Early Pregnancy Problems .............................................................................................................................. 70
Benign Tumours ...................................................................................................................................................... 73
Specialist Gynaecology ................................................................................................................................... 75
Sub-fertility ............................................................................................................................................................. 75
Urinary Incontinence .............................................................................................................................................. 77
Prolapse................................................................................................................................................................... 78
Cancer ..................................................................................................................................................................... 79
Contraception ......................................................................................................................................................... 84
Sexual Health Core Conditions .............................................................................................................. 97
General Topics ............................................................................................................................................... 97
Bacterial STIs................................................................................................................................................ 102
Chlamydia.............................................................................................................................................................. 102
Gonorrhoea ........................................................................................................................................................... 103
Trichomonas.......................................................................................................................................................... 104
Genital Infections and Dermatosis ................................................................................................................ 105
Thrush ................................................................................................................................................................. 105
Bacterial Vaginosis ................................................................................................................................................ 106
Genital Skin Conditions ......................................................................................................................................... 107
Viral STIs ...................................................................................................................................................... 109
Herpes ................................................................................................................................................................... 109
Genital Warts ........................................................................................................................................................ 109
Syphilis ........................................................................................................................................................ 110
HIV .............................................................................................................................................................. 111
Skills ................................................................................................................................................... 114
Obstetric History ................................................................................................................................................. 114
1
, Obstetric Examination ......................................................................................................................................... 116
Gynaecological History ....................................................................................................................................... 117
Sexual History ...................................................................................................................................................... 119
Female Genital Examination .............................................................................................................................. 120
Male Genital Examination .................................................................................................................................. 122
Prescribing in Pregnancy & Breastfeeding ............................................................................................................ 123
OSCE .................................................................................................................................................. 124
OSCE Stations ............................................................................................................................................... 124
COCP............................................................................................................................................................ 125
Emergency Contraception............................................................................................................................. 126
Gynaecological History ................................................................................................................................. 127
Obstetrics Exam ........................................................................................................................................... 128
2
, Aims and Learning Objectives
Have gained an understanding of the mechanisms governing sexual health and women’s health and
reproduction.
Be able to understand and discuss the clinical practice of Gynaecology, Obstetrics and Sexual Health.
Have a holistic approach to women and the integral part their families and the community play in their health
Have gained competence in assessing women through history and examination (both in obstetrics and
gynaecology)
Have gained competence in assessing patients attending a sexual health clinic.
Have an understanding of the particular issues and sensitivities that affect health care in the areas of sexual
health and reproduction.
Be able to understand and discuss the clinical science basis of obstetrics and gynaecology.
Be able to recognize the common syndromes of sexually transmitted infections (STI) and HIV likely to present in
non-specialist settings.
Gain an understanding of the principles of managing sexually transmitted infections (STI) including the
importance of confidentiality and partner notification.
Be able to take a clinical history and perform a physical examination in an obstetric or gynaecology patient.
Be able to take an appropriate history from patients at risk of STI, including Sexual history and HIV risk history.
Be able to discuss relevant differential diagnoses and develop management plans.
Develop skills in communication and be aware of the sensitivities involved in practising clinical Gynaecology,
Obstetrics and Sexual Health.
Be aware of the relevance of clinical governance in Gynaecology, Obstetrics and Sexual Health.
Be aware of the current ethical issues in Gynaecology, Obstetrics and Sexual Health.
Be able to understand the physical, emotional and social impact of sexually transmitted infections on the
individual and the general community.
Knowledge
An understanding of normal changes in development and function of the female genital tract in relation to
women’s health
To understand the normal and abnormal antenatal course
To recognize the difference between the normal and abnormal processes of parturition
To understand the role of aftercare of the mother and infant following parturition
An understanding of the community services and facilities available to women,
To develop a better understanding of the various methods which are available for the delivery of child, antenatal
and gynaecological health care
An understanding of the medical, legal and ethical dilemmas of caring for pregnant women
The nature and functioning of sexual health services provided to men and women
An understanding of the principles and methods of contraception and family planning
Skills
Development of an ability to relate to patients presenting for care in the sexual health and in obstetric and
gynaecological settings
To develop the interpersonal and organisation skills required to take a competent history from such patients
Development of the necessary examination skills
An ability to evaluate a clinical problem after the history and examination, and thereby be able to deduce a
reasonable differential diagnosis
An ability to describe the principles of further management including appropriate investigation, therapeutic
options, and the importance of communication / counselling
3
