Obstetrics and Gynaecology (DUGK_019)
About Study Course
Objective
To provide students with knowledge of conception, course of pregnancy, the physiology and pathology of the birth process and the postnatal period, as well as the necessary practical skills to apply this knowledge. To provide students with knowledge of the physiology and pathology of the sexual system in different periods of a woman’s life, the main gynaecological diseases, diagnosis, differential diagnosis and treatment principles thereof, prevention of gynaecological diseases, rehabilitation of gynaecological patients, methods of family planning, as well as to teach the necessary practical skills for the application of this knowledge.
Prerequisites
Human anatomy, histology, medical cell biology, embryology, human homeostasis, physiology, medical microbiology, medical genetics, pathology, propedeutics, functional morphology, basic topographical anatomy, adaptation of body functions, internal diseases (cardiology), clinical pharmacology, introduction to surgery, radiology, tumour pathology and morphology, medical ethics.
Learning outcomes
Knows the definitions of reproductive health and reproductive rights. Understands the principles of organisation of perinatal care, the main quality indicators of obstetric assistance (maternal mortality and perinatal mortality). Orients in Latvian legislation on reproductive health issues.
Is able to describe and explain the anatomy and physiology of the female genital organs, the process of fertilisation, the development of the foetus and placenta, and the physiology of pregnancy.
Knows the principles of reproductive anamnesis taking and basic gynaecological examination methods.
Has good knowledge of basic antenatal care, screening of the foetus for congenital anomalies, understands normal and abnormal pregnancy: spontaneous termination of pregnancy up to week 22 of pregnancy, ectopic pregnancy, trophoblastic diseases, normal delivery, physiological postpartum period, breast feeding, preterm delivery, post-term pregnancy, multifoetal pregnancy, assessment of the foetal condition during pregnancy, TORCH infection in pregnant women, isoimmunisation during pregnancy, haemorrhage during pregnancy and the postpartum period, birth trauma to mother and foetus, hypertensive complications during pregnancy, systemic diseases during pregnancy, operative obstetrics, septic postpartum complications, adaptation of the newborn after birth and primary resuscitation, clinical pharmacology of medicinal products used in perinatal care. Understands the procedure and methods of termination of pregnancy up to week 22 of pregnancy. Understands the role of normal genital tract microflora in pregnancy and causing gynaecological pathologies: STI, endogenous and iatrogenic infection – aetiology, diagnostic methods, impact on reproductive health, treatment, including during pregnancy, pelvic inflammatory disease, septic complications in the postpartum period (endometritis, wound infection). Understands the causes of uterine bleeding: menstrual cycle disorders, endometrial precancerous diseases and endometrial cancers, principles of diagnosis and treatment thereof. Understands the possibilities of primary and secondary prevention of cervical cancer, the pathogenesis of cervical cancer, and the principles of cervical cancer diagnosis and treatment. Has good knowledge of family planning methods and principles of selection. Understands the causes of female virilisation, the diagnosis of polycystic ovary syndrome, the principles of treatment, the role of oestrogens in the female body at different periods of life and the pathogenesis of pathologies caused by oestrogen deficiency, the principles of treatment (menopause, hormone replacement therapy). Understands the pelvic floor dysfunction and infertility. Understands the main gynaecological operations and manipulations, how to prepare patients for them and how to manage the post-operative period. Has good knowledge of benign and malignant tumours of genitals – uterine fibroids and ovarian tumours, causes of chronic pelvic pain and differentiation thereof, endometriosis, primary and secondary dysmenorrhoea, premenstrual syndrome.
Skills to be acquired independently:
1. Bimanual examination of the uterus.
2. Cervical examination with a mirror, oncocytology smear.
3. Leopold maneuvers and uterine height measurement.
4. Neonatal resuscitation.
5. Assisting with normal birth.
Takes reproductive anamnesis. Performs a general examination on a pregnant woman and a gynaecological patient. Determines the gestational age. Understands the process of physiological birth and the principles of birth management. Demonstrates manual techniques in assisting with physiological birth and care for the newborn. Knows how to assess the state of the foetus – listening to the foetal heartbeat with a foetal doppler. Knows what parameters to assess in a newborn after birth to decide on the state of health of the newborn, knows how to provide a safe environment for the newborn after birth and understands if any support is needed. Knows how to prescribe and explain the need for examinations and interpret the results during antenatal care in case of a physiologically normal pregnancy, is able to identify abnormalities and understand the following tactical steps in case of major pregnancy pathologies: risk of foetal genetic abnormalities, asymptomatic bacteriuria, gestational diabetes mellitus, iron deficiency anaemia. Knows how to explain the nature of primary and secondary prevention of cervical cancer, explain how to collect cervical cytology and interpret cervical cytology results. Is competent to advise women on the choice and use of family planning methods. Is able to explain to a woman the symptoms of gynaecological diseases, the possibilities of examination and the informativeness of the methods of examination, and the possibilities of prevention and treatment of diseases.
