Pathological and Operative Obstetrics

Study Course Description

Course Description Statuss:Approved

Course Description Version:5.00

Study Course Accepted:06.01.2023 12:34:30

Study Course Information
Course Code:		DUGK_008		LQF level:		Level 6
Credit Points:		2.00		ECTS:		3.00
Branch of Science:		Clinical Medicine; Obstetrics and Gynaecology		Target Audience:		Midwifery
Study Course Supervisor
Course Supervisor:		Olga Boka-Veide
Study Course Implementer
Structural Unit:		Department of Obstetrics and Gynaecology
The Head of Structural Unit:
Contacts:		Riga, Miera street 45, Riga Municipality Ltd. Riga Maternity Hospital, dzgkrsu[pnkts]lv, +371 67293837
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		5	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		10
Classes (count)		11	Class Length (academic hours)		2	Total Contact Hours of Classes		22
Total Contact Hours								32
Study course description
Preliminary Knowledge:
Female anatomy, pathological anatomy, knowledge of physiological course of pregnancy, childbirth and postpartum period, pathological course of pregnancy.
Objective:
To promote the acquisition of knowledge about the course of pathological childbirth and operative methods in the provision of childbirth assistance, the need for anaesthesiology and intensive care; to develop an understanding of the course of the pathological postpartum period; to acquire competence in the diagnosis and treatment of the most common acute complications of childbirth and the postpartum period.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Labour dystocia – anomalies of the pelvis, labour anomalies. Types of female pelvis. Examination of the placenta after delivery, placental anomalies, indications for pathohistological examination, findings. Manual placenta removal – technique, anesthesia.			Lectures		1.00	clinical base
				Classes		1.00	METC
2	Observation of the foetus during childbirth, foetal hypoxia, its manifestations, diagnostic methods, treatment options, tactics. CTG and STAN analysis.			Classes		1.00	clinical base
3	Bleeding during childbirth and in the early postpartum period, diagnosis, tactics. Principles of blood transfusion.			Lectures		1.00	E-Studies platform
				Classes		1.00	clinical base
4	Incorrect occiput position of the foetus, incorrect position of the foetus. Diagnosis. Management of pregnancy and childbirth.			Lectures		0.50	clinical base
				Classes		1.00	clinical base
5	Operative vaginal delivery. Forceps. Vacuum extraction, indications, contraindications, technique. Episiotomy, perineal tear during childbirth, cervical tears, principles of suturing, wound care in the postpartum period.			Lectures		0.50	E-Studies platform
				Classes		1.00	clinical base
6	Caesarean section. Types. Indications, risks and complications. Management of the postpartum period after caesarean section. Vaginal delivery after caesarean section. Uterine rupture – aetiology, pathogenesis, diagnosis, complications, tactics.			Lectures		0.50	E-Studies platform
				Classes		1.00	clinical base
7	Pathological postpartum period – uterine subinvolution, infections, bleeding and other complications, preventive measures. Lactostasis, mastitis. Postpartum sadness, depression.			Lectures		0.50	E-Studies platform
				Classes		1.00	clinical base
8	Emergency conditions in obstetrics – thromboembolism, amniotic fluid embolism, post-haemorrhagic shock, emergency aid algorithm.			Classes		1.00	clinical base
9	Diagnosis of twin pregnancy, complications of multiple pregnancy, course and management of twin birth. Feto-fetal transfusion syndrome.			Lectures		0.50	E-Studies platform
				Classes		1.00	clinical base
10	Preterm birth, risk factors, diagnostic criteria, prevention. Tactics. Delaying preterm birth. Complications. Post-term pregnancy. Labour induction, indications, methods.			Lectures		0.50	E-Studies platform
				Classes		1.00	clinical base
11	Labour analgesia – methods, indications, side effects			Classes		1.00	E-Studies platform
Assessment
Unaided Work:
Preparation for the topic of the respective class, using recommended literature and Internet sources, with subsequent evaluation thereof and practical application in practical classes. Independent acquisition of practical skills as laboratory work under the lecturer’s guidance, writing and defending the clinical history of labour and partogram in the case of pathological labour. Students should fill out the study course survey questionnaire (for an example, see the video: https://panopto.rsu.lv/Panopto/Pages/Viewer.aspx?id=9558208…)
Assessment Criteria:
Class attendance (30%), multiple-choice test results (30%), final test (40%)
Final Examination (Full-Time):		Exam (Written)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		The student understands and knows how to explain the course of abnormal labour, the principles of the organisation of childbirth assistance in the case of abnormal births and the main quality indicators of childbirth assistance, knows how to explain postpartum sadness and depression.
Skills:		As a result of completing the study course, students have learned and practically know how to apply the following skills: - describe the anatomy of the pelvis – planes, dimensions; foetal head anatomy, dimensions; - describe and demonstrate the biomechanism of childbirth in case of anterior and posterior occiput position; - evaluate the partogram in the event of a labour anomaly; - assess the condition of the foetus – listen to the foetal heartbeat with a stethoscope, foetal Doppler, assess the cardiotocogram in case of foetal hypoxia/distress; - act in case of bleeding during childbirth and in the early postpartum period; - diagnose and manage childbirth with an incorrect occiput position of the foetus; - describe the methods, indications, contraindications, technique, complications, differences of operative vaginal delivery; - describe indications, contraindications, technique, complications of caesarean section, know how to prepare the patient for surgery and observe in the postoperative period; - describe the principles of suturing perineal and vaginal tears, wound care in the postpartum period; - solve problems in various clinical situations in the postpartum period.
Competencies:		As a result of acquiring theoretical and practical knowledge, the student is able to: - ensure basic antenatal care; - decide on the need for operative vaginal delivery; - assist in abnormal labour; - provide primary resuscitation in cases of emergency.
Bibliography
No.	Reference
Required Reading
1	Dzemdniecība, D. Rezebergas redakcijā, Nacionālais apgāds, 2016.
2	Latvijas ginekologu un dzemdību speciālistu asociācijas vadlīnijas mājas lapā www.ginasoc.lv
Additional Reading
1	Cunningham, F., Leveno, K., Dashe, J., Hoffman, B., Spong, C., & Casey, B. (2022). Williams Obstetrics (Twenty Sixth ed., McGraw-Hill's AccessMedicine). New York, N.Y: McGraw-Hill Education LLC.
2	emedicine.medscape.com
Other Information Sources
1	Lekciju materiāls.
2	RSU bibliotēkas resursi
3	www.pubmed.com
4	uptodate.com