Code: OBGN 501 - · PDF fileThe topics covered will include introduction to the physiology of ... hazards of post-maturity, prematurity, intrauterine fetal death ... Describe the anatomy

Code: OBGN 501

University of Taibah

College of Medicine

Table of Contents

Items Page

Overview of the course 2

Code of conduct 3

Educational objectives 3

Teaching/learning methods 5

Individual teaching and learning activities 8

Students' assessment 60

Contact details 61

Prescribed and recommended resources 62

Overviewof the Course:

Organization of the course:

This course lasts approximately 12 weeks including introductory lectures, principal lectures,

practical sections .audiovisual settings, as well as delivery room compulsory attendance

Course lectures are devoted to the main content area of the course and there are also

lectures on subsidiary subjects such as reproductive endocrinology, gynecologic urology and

principals of gynecologic oncology. Also there are practical sessions covering high risk

pregnancy cases, routine antenatal care and major reproductive endocrinology disorders.

Theoretical and practical teaching are supplemented by delivery room orientation sessions.

Skill lab and audiovisual teaching. There will be may evaluation opportunities in the form of

Clinical Scenarios, MCQ.

Extended Matching Question, EMQ.

OSCE I ( Computer Based Exam ) .

OSCE II (Computer Based Exam)

Clinical OSCE examination

Midterm ( 40 Marks)

20 Marks - OSCE I

20 Marks - written (Clinical scenarios, extended matching questions, recall questions).

Final exams ( 60 Marks)

At the ends of each semester in the form of short objectively structured questions, and multiple

choice questions of different forms including:

15 Marks – -------OSCE II (Computer Based Exam) .

15 Marks - ------- Clinical OSCE Examination.

25 Marks --------- Written (Clinical scenarios, extended matching questions ) .

5 Marks ---------- Tutorial presentation.

Timing:

This course 12 weeks for male students and another 12 weeks for females students .

Venue:

All lectures,audiovisuals and practical sections will be held in the Obstetrics and gynecology

hall, teaching building, Maternity and Children Hospital, AlmadinahAlmunawarrah .

Skill activities will be in the skill lab.

Code of conduct:

All lectures and practical are compulsory.

The whole batch will be divided into 4 groups. Ensure that you know in which group and

practical/ clinical round you are working. You areallowedto change groups.

A tutorial topic will be allocated to small groups of students to be presented by them

according to the pre-made time table. A review article will be presented by each student

separately at the end of the course.

It is strictly forbidden to take photographs of any human tissue or patients in laboratory

sections or clinical rounds. Guilty students run the risk of being expelled.

In lectures halls , clean the work area and leave it in a tidy condition

It is compulsory to wear a clean white coat, closed shoes and long trousers (for men) to the

practical and clinical sections. You will not be allowed into the practical or clinical rounds

without the correct clothing. The same rules apply to the practical and clinical assessing.

Your general appearance should be neat and respectable.

Some other points that must be elaborated in the clinical disciplines such as: informed

consent, confidentiality, respect for patient autonomy, doctor patient relationship

.

Attendance of the students will be according to the faculty regulations

Participation all students are expected to participate actively in all scientific activities

Educational objectives

a. Knowledge:

On successful completion of the course of Obstetrics and Gynecology, the students shall be

able to:

1- Recognize the latest development in the fields of clinical Obstetrics and Gynecology as intra

cytoplasmic sperm injection and surgical laparoscopy.

2- Describe how to take Obstetric& Gynecologic history including, complaint, personal, present, past

and family history

3- Describe how to do clinical examination focusing on general .abdominal, obstetric and vaginal

examination

4- Explain emergency management, and complications of pregnancy such as: - Bleeding, including hemorrhagic shock - Hypertension including eclampsia / pre-eclampsia - Infections, including septic shock

5- Attend care during labor:

- Identify changes of normal progress of labor using the partograph.

- Recognize indications for episiotomy

- Identify ominoussigns or complications before or during labor

6-Postpartum care: Recognize the importance of post-partum care.

b. Cognitive Skills:

By the end of the course, the students should be able to:

1- Interpret the most important clinical presentations of Obstetrics & Gynecologic disorders 2-

Interpret patient’s data in an organized and informative manner.

3- Formulate appropriate management plans for individual patients presenting with the most

common Obstetric& Gynecologic disorders.

4- Interpret results of antenatal screening.

5- Diagnose first and second degree perineal lacerations.

6- Diagnose, cases of postpartum hemorrhage.

7-Diagnose riskin patients as appropriate for conditions such as:

Diabetes , Heart disease , Anemia

c. Interpersonal Skills and Responsibility(by the end of the course, the students should

be able to):

1-Improve communication skills with pregnant women,.

2-Improve skills in providing antenatal care

3- Counsel the patients and their families about different management strategies and methods

Of prevention of their illness.

4- Counsel postpartum women for breastfeeding and self-care

5-Counsel patients about appropriate contraception.

6-Improve experience in family planning methods

d. Communication, Information Technology and Numerical Skills( not applicable)

e. Psychomotor Skills (if applicable)

By the end of the course, the students should be able to:

1- Develop obstetrical examination skills needed for antenatal assessment 2- Perform pelvic examination applied on pelvic models for improving these skills 3-Perform clinical examinations for obstetrical cases in the maternity wards

Teaching/learning methods: - Lectures:

- Purpose: to develop sound understanding of the basic knowledge in Obstetrics and

Gynecology. The topics covered will include introduction to the physiology of normal

pregnancy, early fetal development, normal &abnormal pregnancy, medical disorders with

pregnancy, normal labour and its abnormalities & principles of main obstetric operations,

instruments, gynaecologic imaging, fetal monitoring and guidelines of gynaecologic

screening.

Both traditional and interactive teaching including brain storming problems& clinical

scenarios are implemented.

Tutorials :

Purpose:

These are used for developing the ability of students to:

1. Integrate knowledge.

2. Express themselves in scientific language.

3. Participate in discussions.

4. Acquire problem-solving abilities.

5. Receive additional in-depth information.

How it work?

Students are, therefore, expected to:

(a) Read tutorial topics before hand, prepared in power point .

(b) Prepare themselves for discussing their clinical problems, and

(c) Ask questions on points which require clarification.

(D)Each tutorial is represented by 4-5 students , supervised by a staff member according

to time table

(E)A review article will be presented by each student separately at the end of the term .

- Skill lab:

Purpose: by the end of this course the student should be able to: 1- Conduct P/V examination on pelvic models .

2- Awareness with different types of gynecologic speculae , their diagnostic &

therapeutic use and mode of application .

3- Screening for lower genital malgnancies , utilization of Pap smear .

4- Bacteriologic sampling of vagina & uterine cervix .

5- Bimanual examination, IUCD insertion & removal and female catheterization .

6 – General and specific obstetric abdominal examination including fundal level,

fundal grip , umbilical grips , first & second pelvic grips .

7- Assessment of fetal well being .

- Assignments&Self-directed learning:

Purpose:

Some of the lectures are structured as reading assignments for the students; they are

informed about their titles, allocated dates and time well in advance. The students are expected to

have acquired detailed information on the topics by using multiple sources and prepare themselves

for active participation.

The topics are then discussed in small groups of students. Despite shortage of staff, every

effort is made to ensure that all staff members participate in such discussion; otherwise the whole

class is taken as a single group and the teachers monitor the topic preparation by observing the

students' participation and their input in the discussions.

The idea is to create a compulsion for the students to undertake in-depth learning on their

own on the areas structured as reading assignments.

- Clinical sessions:

Long case history taking, discussion ,examination of the case& compulsory delivery room

attendance .

Purpose: by the end of this course the student should develop the ability for :

1- Auscultation of fetal heart sound.

2- General & medical assessment of obstetric patients , vital signs monitoring and

detection of signs and symptoms in critically ill obstetric patients .

3 - Observe the conduct of second and third stages of labor

4 - Attend management and observe signs of obstructed labor

5 - Recognize the causes, diagnosis, and management of post-term pregnancy and

hazards of post-maturity, prematurity, intrauterine fetal death

6 - Recognize the types, etiology, clinical picture, prevention, and management

of brain hemorhage, brachial plexus injury, & skeletal and muscle injuries

7 - Recognize how to evaluate the newborn condition and to diagnose neonatal

respiratory distress. Learn how to competently resuscitate a newborn infant in respiratory

- Others :

Audiovisual sessions are designed to supply the students with simple & demonstrative and

valuable videos for common Obstetric and Gynecologic operations

Lecture 1

Individual Teaching and Learning activities

Lectures

Topic Introduction to the course

Tutor Dr. Magdeldin Gaafar Taha

Location Maternity and Children Hospital- teaching building

Specific Objectives by the end of this lecture every student should be able to:

1- Identify the staff members. 2- Identify the contents of the course curriculum.

3- Identify the pre-requisites 4- Recognize duties, time table and methods of evaluation.

Should the students do preparatory work before attending?

Learning resources

Self- assessment questions

Pag

e8

Lecture 2

Topic Anatomy of female genital tract

Tutor Dr. Nada elnugomy



1. Describe the anatomy of genital organs

2. Describecongenital malformation 3. Recognise importance of surgical

anatomy


1- Review of anatomy of the pelvis and perineum .

Learning resources

1. Essentials of obstetrics and

gynecology – Hacker etal :Saunder

USA ; Latest Edition.

2. Obstetrics and Gynecology Recall

–Boureois ; Williams &Willkins

Baltimore USA . Latest Edition.


The pelvis includes which of the following bones: A. Trochanter, hip socket, ischium, sacrum & pubis.

B. Ilium, ischium, pubis, sacrum & coccyx. C. Ilium, ischium & pubis. D. Sacrum, Ischium, ilium & pubis. E. Trochanter, sacrum, coccyx, ilium & pubis.

Lecture 3

Topic Physiology of menstruation & Puberty

Tutor Dr. tameem



1. describe the hormonal control of menstrual cycle

2. Describe ovarian, uterine, cervical, and vaginal changes during the menstrual cycle.

3. Define puberty 4. State the physiological changes at the time

of puberty


1- Review of the physiology of the endocrine system .

2- Review of the embryologic development of the female genital system .

Learning resources 1-Essentials of obstetrics and gynecology

– Hacker etal :Saunder USA ; Latest

Edition.

2-Obstetrics and Gynecology Recall –

Boureois ; Williams &Willkins Baltimore

USA . Latest Edition.

Self- assessment questions Estrogen hormone is produced from all of the following organs EXCEPT:

A. Corpus luteum. B. Anterior pituitary (anterior lobe of hypophysis). C. Placenta. D. Testes, E. Adrenal glands.-

Lecture 4

Topic Physiological changes of pregnancy

Tutor Dr. Magdeldin


Specific Objectives 1. List genital changes during pregnancy, with emphasis on the difference between upper and lower uterine segments.

2. List the breast changes during pregnancy.

3. List the cardiovascular changes during pregnancy.

4. Correlate these changes to the general condition of the woman


Review of Physiological changes During pregnancy

Learning resources 1. Obstetrics and Gynecology – Mark Mogan and Sam Siddighi, Saunders, Latest Edition.

2. Obstetrics and Gynecology by Ten Teachers Latest Edition- Cambleetal.

3. Essentials of obstetrics and gynecology – Hacker etal :Saunder USA ; Latest Edition.

4. Obstetrics and Gynecology Recall – Boureois ; Williams &Willkins Baltimore USA . Latest Edition.


The following are presumptive skin signs of pregnancy except:

A. Chloasma B. Maculo-papular rash C. Linea Nigra D. Stretch Marks C. Spider Telangiectases

Lecture 5

Topic Ante-natal care

Tutor Dr .Tameem


Specific Objectives 1. Define the objectives of antenatal care

2. List the value of the first visit correctly and the objectives of subsequent visits with correlated routine investigations for pregnant women

3. describe the warning symptoms of pregnancy, risk factors for pregnancy and to be able to Plan a protocol for antenatal care including determining the frequency of visits

4. determine the items of an appropriate history,

5. Describe how to Perform examination for a pregnant woman during antenatal visit including :general examination, obstetric examination ,and pelvic examination

6. Interpret obstetric conditions from the results of routine investigations and to be able to counsel woman with warning symptoms of pregnancy


1- Review of physiological changes of pregnancy.

2- Study of warning symptoms &risk factors of pregnancy.

Learning resources 1- Essentials of obstetrics and gynecology – Hacker etal :Saunder USA

; Latest Edition. 2- Obstetrics and Gynecology Recall – Boureois ; Williams &Willkins Baltimore USA . Latest Edition.

Self- assessment question

Antenatal booking investigations include all of the following, EXCEPT:

A. Complete blood count B. Blood sugar C. Hepatitis screening D. Toxoplasmosis E. Thyroid function

Lecture 6

Topic Normal labour (anatomy &physiology)

Tutor Dr. Mohammed Aboelnasr


Specific Objectives 1. List the main factors controlling the process of labour namely , passage & passenger & forces .

2. Describe the physiology of each stage of labour & Interpretation of anatomic principals & Physiologic information to understand the mechanism of normal labour

3. Discuss the principals of Management of normal labour .


1- Study the anatomy of the female pelvic bone & fetal biometry .

2- Review of the physiology of muscle contractions .



Self- assessment questions Which of the following terms best describes the pelvic type of small posterior saggital diameter, convergent sidewalls, prominent ischial spines, and narrow pubic arch?

A. Android. B. Gynecoid. C. Anthropoid. D. Platypelloid. E. Mixed.

Lecture 7

Topic Normal labour (Management.)

Tutor Dr. Mohammed Aboelnasr


Specific Objectives 1. List the main factors controlling the process of labour namely , passage & passenger & forces .

2. Describe the physiology of each stage of labour & Interpretation of anatomic principals & Physiologic information to understand the mechanism of normal labour

Discuss the principals of Management of normal labour .


1- Study the anatomy of the female pelvic bone & fetal biometry .

2- Review of the physiology of muscle contractions .



Self- assessment questions-------------------- Signs of Placental separation after delivery include:

A. Bleeding. B. Changes of uterine shape from discoid to globular.

C. Lengthening of the umbilical cord. D. Presentation of the placenta at the cervical os. E. All of the above.

Lecture 8

Topic Amenorrhea

Tutor Dr. Amal zaman


Specific Objectives 1. Define primary and secondary amenorrhea

2. Enumerate the physiological causes of amenorrhea

3. Recognize cryptomenorrhea, with special emphasis on imperforate hymen

4. List the hypothalamic causes of amenorrhea

5. List the pituitary causes of amenorrhea with emphasis on Sheehan’s syndrome

6. List the ovarian causes of amenorrhea with emphasis on polycystic ovarian syndrome

7. List the uterine causes of amenorrhea with emphasis on Asherman’s syndrome

8. Discuss the investigations of amenorrhea.


1- Review of the physiology of the endocrine system .

2- Review of the embryologic development of the female genital system .




Recognized feature of Sheehan syndrome

: A. Menorrhagia B. Galactorrhea C. Insulin resistance D. Hypothyroidism E. Dwarfism

Lecture 9

Topic Bleeding in early pregnancy

Tutor Dr. Waleed maher


Specific Objectives 1. Define miscarriage and differentiate between symptoms and signs of each type of miscarriage

2. Define causes and risk factors of miscarriages

3. List complications of each type and,describe first aid and actual management of each type of miscarriage

4. List causes of and investigations for recurrent miscarriage

5. Define, know the incidence of, and list the causes of ectopic pregnancy

6. List the main symptoms, signs, and differential diagnosis (DD) of ectopic pregnancy and correlate S&S withdiagnosis of a case of bleeding in early pregnancy

7. List available methods for management


1- Study of early pregnancy physiologic changes . 2- Review of surgical & medical causes of abdominal

pain during pregnancy . 3- Study of principals of management of shock .

Learning resources 1- Essentials of obstetrics and gynecology – Hacker etal :Saunder USA ; Latest Edition. 2- Obstetrics and Gynecology Recall –Boureois ; Williams &Willkins Baltimore USA . Latest Edition.

Self- assessment questions In patients with three consecutive spontaneous abortion in the second trimester

the most useful investigation is: A. Chromosomal analysis B. Hysterosalpingogram C. Endometrial biopsy D. Post coital test E. Prolactin level

Lecture 10

Topic Infertility



Specific Objectives 1. Define and list types of infertility mention etiology of male and female factors mention Normal parameters of semen analysis

2. list Tests for detection of ovulation

3. list Tests for tubal patency (HSG and endoscopy)

4. describe Guidelines for the treatment of infertility

5. describe how to take history and how to Perform a relevant physical examination and provide information about infertility

6. Assess infertility with basic diagnostic techniques (semen analysis, hystero-salpingography, and mid- luteal progesterone level)

7. Recognize ART techniques, counsel couples about their efficacy, and refer them to qualified specialists in the field, as needed


1- Review of female gental infections . 2- Study of embryology of gonadal development . 3- Review of the reproductive endocrinology .


Self- assessment questions - All the following are possible causes of anovulation, EXCEPT:

A. High body mass index B. Anorexia nervosa C. Polycystic ovarian syndrome D. Premature ovarian failure E. Sickle cell trait

Lecture 11

Topic Fetal malpresentation &malposition

Tutor Dr.Maged-eldin


Specific Objectives 1. List the different types of malpositions and malpresentaions.

2. List the causes of malpresentations/positions.

3. Recognize the conditions in which the mechanism of vaginal labor is impossible.

4. Recognize the conditions in which vaginal labor is possible

5. Determine the complications that may be associated with difficult labor in these cases.

6. Describe the diagnostic clinical landmarks in the commonest malpresentions/posions: occipito- posterior, transverse lie and breech presentations.

7. List the indications of CS in breech presentation. 8. State the role of ECV in transverse lie and breech

presentations.


1- Understanding properly the mechanics of normal labour .

2- Review the passage , power & passenger variables controlling labour process .


Self- assessment questions A transverse lie of the fetus is least likely in the presence of:

A. Placenta previa. B. Pelvic contraction. C. Preterm fetus. D. Grand multiparity. E. Normal term fetus

Lecture 12

Topic Hypertensive disorders with pregnancy

Tutor Dr.Waleed maher


Specific Objectives 1. Define the various hypertensive disorders,

prevalence and risk factors

2. Describe pathophysiology and effects of PE

3. list symptoms, signs and complications

4. outline management of PE/Eclampsia


1- Review of the cardiovascular changes during labour .


Self- assessment questions - Immediate appropriate response to an initial eclamptic seizure include all of

the following, EXCEPT: A. Ultrasound for fetal growth B. Maintain adequate oxygenation C. Administer magnesium sulphate D. Prevent maternal injury E. Monitor the fetal heart rate

Lecture 13

Topic Diabetes mellitus with pregnancy

Tutor Dr.Waleed maher


Specific Objectives 1. Define different types of DM during

pregnancy

2. List fetal and maternal complications during pregnancy, labor, and puerperium

3. list the indications of glucose tolerance testing during pregnancy

1. outline the management during pregnancy, labor, and puerperium


1- Review the physiology of blood sugar control .

2- Study of medical basis of diabetes .


Self- assessment questions -------------------- The best screening test for gestational diabetes A. Fasting blood sugar B. Random blood sugar C. Glucose challenge test D. Glucose tolerance test E. Blood sugar series

Lecture 14

Topic Heart diseases with pregnancy

Tutor Prof.Fawzia


Specific Objectives 1. List the cardiovascular physiologic changes

during pregnancy

2. Explain the principals of Preconception counseling & Impact of heart disease on pregnancy and Impact of pregnancy on heart disease& magnitude of the problem

3. Design the main diagnosis modalities & management of this problem

4. Plan the mode of delivery of pregnant cardiac patient

5. Describe the precautions during stages of labor

6. Identify the principals of follow –up, postpartum care, subsequent contraception.


1- Study of the cardiovascular changes during pregnancy .

2- Medical principals of management of cardiac patients .


Self- assessment questions Which of the following is the commonest heart disease in pregnancy ?

A. Cardiomyopathy B. Previous myocardial infarction C. Hypertension D. Thyroid disease E. Rheumatic heart disease .

Lecture 15

Topic Contraception

Tutor Dr. Waleed


Specific Objectives 1. Enumerate the types of oral contraceptives and injectables

2. List the advantages disadvantages and side effects of COP, POP, injectables and Norplant implants

3. Describe the methods of administration of COP, POP, injectables, and Norplant implants

4. Enumerate types of intrauterine contraceptives devices (IUCD)

5. List advantages, disadvantages, and side effects of IUCD

6. Describe the technique of insertion and mention the timing of IUCD insertion

7. List the complications and contraindications of IUCD

8. Enumerate advantages and disadvantages of the lactational amenorrhea method

9. List advantages, disadvantages, and side effects of male and female sterilization


1- Study of the reproductive endocrinology .

2- Review of the anatomy of male & female

genital sytem .


Self- assessment questions The following conditions are aggravated by oral contraceptive pills:

A. Hirsutism B. Endometriosis C. Dysmenorrhea D. Pre-menstrual syndrome E. Genital fungal infection

Lecture 16

Topic Renal diseases with pregnancy

Tutor Dr : Amr elfayomy


Specific Objectives 1. Describe the predisposing factors and

clinical picture of asymptomatic bacteruria, cystitis and pyelonephritis

2. Evaluate the complications of each condition

3. Identify the investigations

4. select the proper antibiotics for patients with pyelonephritis


1- Review of the urologic physiologic changes during pregnancy .


Self- assessment questions UTI in pregnancy : A. Rare condition during pregnancy. B. Can be easily diagnosed when there is more than 1000 bacteria per ml on culture. C. Is commoner in multigravida when compared with primigravida.

D. May lead to preterm labor. E. If it's reoccurring, it does not need investigations after delivery

Lecture 17

Topic Anemia with pregnancy

Tutor Dr. Nada


Specific Objectives 1. Define and list the different types of anemia

during pregnancy

2. List fetal and maternal complications of anemia during pregnancy, labor, and puerperium

3. List the diagnostic indices of iron deficiency anemia in pregnancy.

4. Describe the management of iron deficiency anemia and the role of routine iron supplementation

5. plan a management approach for a case of anemia during pregnancy


1- Physiology of haemopoiesis .

2- Medical principals of management of anemia


Self- assessment questions Folic acid deficiency results in : A. Microcytic anemia. B. Megaloblastic anemia. C. Aplastic anemia. D. G6PD deficiency. E. WBC stippling.

Lecture 18

Topic Multiple pregnancy

Tutor Prof. Fawzia


Specific Objectives 1. Discuss the definition, incidence, and risk

factors of multiple pregnancies

2. Identify complications in pregnancy and labor

3. Evaluate the methods of diagnosis during pregnancy

4. plan the lines of management during pregnancy and labor


1- Study of oogenesis & physiology of fertilisation , implantation.


Self- assessment questions In twin deliveries: Which is true? A. The first twin is at greater risk than the second B. They usually go post date C. Epidural analgesia is best avoided D. Commonest presentation is cephalic and second breach

E. There is increased risk of postpartum hemorrhage

Lecture 19

Topic Intra-uterine growth retardation

Tutor Dr. Nada


Specific Objectives 1. Identify causes of IUGR

2. Enumerate the complications of IUGR 3. Discribe the appropriate method for

diagnosis

4. Identify the management of IUGR


1- Study of placental function & transport

2- Review of medical disorders that may affect fetal growth .



IUGR may occur in all of the following EXCEPT:

A. Pre-eclampsia. B. Congenital anomaly. C. Gestational diabetes mellitus. D. Sickle cell anemia. E. Maternal smoking

Lecture 20

Topic RH-isoimmunization

Tutor Dr. Tameem


Specific Objectives 1. List types of blood groups, their prevalence,

and inheritance

2. List causes of Rh iso-immunization and sequelae of antigen antibody reaction

3. Describe the pathologic and clinical effects of hemolysis on the fetus and neonate

4. Interpret methods of antenatal diagnosis

5. Describe prophylaxis against Rh iso- immunization

6. Recognize the importance of history taking from Rh iso-immunization patient

7. Recognize the importance of counseling Rh –ve pregnant woman during ANC


1- Study of the physiology of blood groups, their prevalence, and inheritance.


Self- assessment questions Fetal RBCs can be distinguished from maternal RBCs by their :

A. Shape B. Resistance to acid elution C. Lack of Rh factor D. Lower amounts of hemoglobin E. All of the above

Lecture 21

Topic Genital prolapse

Tutor Dr.Magdeldin


Specific Objectives 1. Recognise the anatomic , embryologic

correlations between the lower urinary tract & genital system . ( 10 % )

2. Explain the different forms of genital displacement , terminology used . ( 10 % )

3. List of the main etiologic factors , various clinical presentations ,differential diagnosis and main lines of management . ( 40 % )

4. Correlate the clinical findings , patients data to select the best surgical approach . ( 40 % )


1- Review of the anatomic support of the female genital system .

2- Study of the anatomic , embryologic correlations between the lower urinary tract & genital system


Self- assessment questions Which of the following factors predispose to genital prolapse:

A. Repeated LSCS B. Multiparty C. Pelvic inflammatory disease D. Endometriosis E. Repeated Candidiasis

Lecture 22

Topic Abnormal uterine bleeding

Tutor Dr .Nada


Specific Objectives 1. Describe of the main etiologic factors of

AUB

2. Describe the clinical picture of each type of AUB

3. Interpret the diagnostic procedures

4. interpret the management of each type


1- Review of the hemostatic system .

2- Medical causes of generalized bleding tendency or genital bleeding .


Self- assessment questions All the following are possible causes of menorrhagia, EXCEPT

A. Uterine fibroid B. Adenomyosis C. Pelvic inflammatory disease D. Endometrial hyperplasia E. Combine oral contraceptive pills

Lecture 23

Topic Menopause ,HRT



Specific Objectives 1. Define types of menopause

2. Describehormonal changes with menopause 3. Describe effect of menopause on different

body systems

4. DescribeDiagnosis and treatment of menopause


1- Review of the anatomic and physiologic changes in the female genital system during menopause



the main risk of hormone replacement therapy after menopause is:

A. Fracture the neck of femur B. Cancer colon C. Hirsutism D. Cancer breast E. Genital atrophy

Lecture 24

Topic Ovarian neoplasms

Tutor Dr. Nada


Specific Objectives 1. Classifyovarian tumors according to site of

origin (WHO)

2. Discusspathological characteristics of each type of ovarian tumors and mode of spread

3. Discussstaging of malignant ovarian neoplasm

4. Discussrisk factors and screening of ovarian malignancies

5. Discussrole of tumor markers 6. Describe diagnosis and treatmentof ovarian

neoplasm

7. Discussadjuvant therapy for malignant ovarian neoplasm.


1- Review the pathology of ovarian tumors .


Self- assessment questions Which of the following tumors produces estrogen:

A. Endodermal sinus tumors B. Choriocarcinoma C. Granulosa-cell tumors D. Dysgerminoma E. Serous cyst adenoma

Lecture 25

Topic Endometrial carcinoma

Tutor Dr. waleed


Specific Objectives 1. Discussincidence, risk factors, and

pathological types of endometrial cancer

2. Discussstaging of endometrial cancer

3. DescribeClinical picture of endometrial cancer

4- Describeinvestigationsand treatment options of endometrial cancer.


1- Review the different pathological types of endometrial cancer.

2- Review risk factors for genital malignancies .



Endometrial adenocarcinoma is most often preceded by:

A. Cystic hyperplasia. B. Endometrial hyperplasia. C. Endometrial hyperplasia with cytological atypia. D. Arias-stella phenomena. E. Microcytic glandular hyperplasia

Tutorials

Tutorial 1:

Topic Amenorrhea

Tutor DR. Amal zaman


Specific Objectives 1. Define primary and secondary

amenorrhea

2. Enumerate the physiological causes of amenorrhea

3. Recognize cryptomenorrhea, with special emphasis on imperforate hymen

4. List the hypothalamic causes of amenorrhea

5. List the pituitary causes of amenorrhea with emphasis on Sheehan’s syndrome

6. List the ovarian& uterine causes of amenorrhea with emphasis on polycystic ovarian syndrome

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about the different causes and management of amenorrhea

Learning resources 1-Essentials of obstetrics and gynecology – Hacker etal :Saunder USA ; Latest Edition. 2-Obstetrics and Gynecology Recall – Boureois ; Williams &Willkins Baltimore USA . Latest Edition.

Self- assessment questions 2- Enumerate causes of hyperprolactinemia

Tutorial 2:

Topic Pelvic inflammatory disease

Tutor DR. Nada


Specific Objectives 1. Define PID and its types

(acute, chronic)

2. Recognize clinical features of PID

3. Interpret investigations of PID

4. Plan the management of PID

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about the different causes of PID and Plan the management


Self- assessment questions Discuss the etiology of PID in our countries

Tutorial 3:

Topic Abnormal labour.

Tutor DR. mohammed


Specific Objectives 5. Define abnormal uterine action

6. List the different clinical varieties of abnormal uterine action

7. Describe the partograph and list its components and the types of curves obtained in normal and abnormal progress of labor

8. Discuss a case with an abnormal uterine action

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about a case study

of abnormal uterine action


Self- assessment questions 1-Define the clinical presentation of obstructed labour

Tutorial 4:

Topic APH

Tutor Dr. Amal


Specific Objectives 1. Define APH

2. List different causes of APH

3. List symptoms, signs and investigations of APH

4. Describe first aid management and outline the treatment modalities

5. Plan a management approach for a case of APH

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion aboutdifferent causes ,investigations and planof management in a case of APH


Self- assessment questions Mention the most important risk factors for palcentaprevia

Tutorial 5:

Topic Infertility

Tutor Dr . Amal


Specific Objectives 1. Define and list types of infertility mention etiology of male and female factors mention Normal parameters of semen analysis

2. Listtests for detection of ovulation

3. List Tests for tubal patency (HSG and endoscopy)

4. Discussguidelines for the treatment of infertility

5. Describe how to take history and perform a relevant physical examination and provide information about infertility

6. Assess infertility with basic diagnostic techniques (semen analysis, hystero-salpingography, and mid-luteal progesterone level)

Recognize ART techniques, counsel couples about their efficacy, and refer them to qualified specialists in the field, as needed

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about a case study of infertility


Self- assessment questions 1-List causes of anovulation

Tutorial 6:

Topic Contraception

Tutor Dr. waleed


Specific Objectives 1. Enumerate the types of oral contraceptives and injectables

2. List the advantages disadvantages and side effects of COP, POP, injectables and Norplant implants

3. Describe the methods of administration of COP, POP, injectables, and Norplant implants

4. Enumerate types of intrauterine contraceptives devices (IUCD)

5. List advantages, disadvantages, and side effects of IUCD

6. Describe the technique of insertion and mention the timing of IUCD insertion

7. List the complications and contraindications of IUCD

8. Enumerate advantages and disadvantages of the lactational amenorrhea method

9. List advantages, disadvantages, and side effects of male and female sterilization



Self- assessment questions 1- Mention the non contraceptive benefits of OCs.

Tutorial 7:

Topic PROM& PTL .

Tutor Dr. Magdeldin


Specific Objectives 1. List the different causes of pre-term labor and PROM

2. Evaluate the different methods of diagnosis & hazards of PTL and PROM 3. Plain the management of PROM&preterm labor with special attention to

tocolysis and the role of corticosteroids-


of PROM& PTL


Self- assessment questions Plane a scheme for diagnosis of a woman presenting late in pregnancy with sudden gush of fluid per vagina

Tutorial 8:

Topic Endometriosis

Tutor Dr. Amal


Specific Objectives 1. Discussdefinition, types,

pathology, and risk factors of endometriosis

2. Describeclinical presentation and differential diagnosis of endometriosis

3. Discuss the impact of endometriosis on genital function

4. Discussdifferent approaches of treatment

5. Discuss a Case suffering from endometriosis


of endometriosis


Self- assessment questions 1- Mention causes of infertility with endometriosis

Tutorial 9:

Topic Benign Tumors of the uterus .

Tutor Dr. Magdeldin


Specific Objectives 1. IdentifyClassification of

different benign tumors of the uterus and their pathology

2. interpret clinical presentations of benign masses of the uterus

3. Plan Investigations and treatment options for management of benign uterine tumors


of fibroid uterus


Self- assessment questions Give a short account on clinical presentation of uterine fibroid .

Tutorial 10:

Topic Fetal teratogensity

Tutor Prof. Fawzia


Specific Objectives 1. Recognize the clinical importance of

infections during pregnancy.

2. Identify the epidemiology of different infections:CMV,toxoplasmosis,rubella,Her pes simplex ,hepatitis B virus and HIV infections .

3. Compare the clinical manifestations of different infections.

4. Interpret the diagnostic procedures

5. Identify the management of important infections.


The student should prepare a Power Point for discussion about comparison of the clinical manifestations of different infections during pregnancy and its diagnostic procedures


Self- assessment questions Emphasize the clinical importance of viral infections during early pregnancy

Tutorial 11:

Topic Poly& Oligohydramnios

Tutor Prof. Fawzia


Specific Objectives 1- Compare different causes of oligo-

and polyhydramnios

1. Describe the clinical and sonographic diagnosis

2. Interpret the complications of oligo- and polyhydramnio


student should prepare a Power Point for discussion about comparison of

the clinical manifestations and mode of management

ofpoly& oligohydramnios


Self- assessment questions How to assess the amniotic fluid volume .

Tutorial 12:

Topic PPH

Tutor Dr .Amal


Specific Objectives 1. List the difference between

types of postpartum hemorrhage

2. Define causes and risk factors for postpartum hemorrhage

3. Recognize and apply measures for prophylaxis of postpartum hemorrhage

4. Describe first aid management and outline treatment modalities for each type of postpartum hemorrhage

5. Recognize the importance of the fourth stage of labor (the first hour after delivery) in postpartum hemorrhage prevention

6. Use emergency treatment in correct sequence

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about a case of post-partum hemorrhage


Self- assessment questions 1-Discuss the clinical presentation of the commonest type of PPH .

Tutorial 13:

Topic Post-term pregnancy.

Tutor Dr .Tameem


Specific Objectives 1. Define the problem of post-

term pregnancy

2. List the different causes of post-term pregnancy

3. Describe how to determine the duration of pregnancy from clinical data

4. Discussthe management of post-term pregnancy

5. List the hazards of post- maturity

6. Discuss a Case of post-term pregnancy

Should the students do preparatory work before attending? The student should prepare a Power Point for discussion about different causes, hazards, and management of post-term pregnancy


Self- assessment questions Enumerate major clinical features of post-term baby

Tutorial 14:

Topic Induction of labour

Tutor Dr .Tameem


Specific Objectives 1- to determine the duration of pregnancy from clinical data 2-Disscuss the indication forinduction of labour 3-Compare different methods for

Induction of labour 4- Interpret the complications of prematurity



Self- assessment questions 1- Complication of induction of labour

Tutorial 15:

Topic Puerperium .

Tutor Dr Nada


Specific Objectives 1. Define the period of

puerperium

2. Describe change in the genital organs during the puerperium

3. Interpret the symptoms ,signs and complications of puerperal sepsis plan a protocol for management of puerperal sepsis

Should the students do preparatory work before attending? The student should prepare a Power Point about a case of purpural pyrexia for investigation


Self- assessment questions 1-Discuss physiologic changes in the female genitalia during puerperium

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Clinical sessions 1

Practical Sessions

Topic: Antenatal care

Tutor: Staff member according to time table

Location: Department of Obstetrics and Gynecology Maternity &Children Hospital

Maternity and Children Hospital- teaching building

Specific Objectives Every student should be able to :

1. Recognize the value of the first visit correctly and the objectives of subsequent visits with correlated routine investigations for pregnant women

2. Describethe warning symptoms of pregnancy, risk factors for pregnancy and

3. Plan a protocol for antenatal care including determining the frequency of visits

4. Take appropriate history

5. Performphysicalexamination for a pregnant woman during antenatal visit including: general examination, obstetric examination ,and pelvic examination.

6. Interpretobstetric conditions from the results of routine investigations

7. Describe warning symptoms of pregnancy.


The student should prepare himself by studying the principals of ANC


Clinical sessions 2

Topic: Amenorrhea




Specific Objectives every student should be able to:

1. Recognizecryptomenorrhea, with special emphasis on imperforate hymen

2. Identify the other types ofamenorrhea including hypothalamic causes,pituitary causes, ovarian causes, uterine causes.

3. Discuss the updated investigations of amenorrhea


The student should prepare himself by studying the principals of amenorrhea


Clinical sessions 3

Topic: Bleeding in early pregnancy).





1. Discuss the clinical picture of each type of miscarriage.

2. Discusscomplications of each type and,

3. Describethe first aid and actual management of each type of miscarriage

4. Interpret the main symptoms, signs, and differential diagnosis (DD) of ectopic pregnancy

5. InterpretSymptoms&Signs with diagnosis of a case of bleeding in early pregnancy

4. Discussthe updatedtreatment optionsof ectopic pregnancy




Clinical sessions 4

Topic: Infertility





1. Take history and perform a relevant physical examination and provide information about infertility

2. Listthe principal tests for detection of ovulation, tubal patency (HSG)

3. Interpret basic diagnostic techniques (semen analysis, hystero-salpingography, and mid-luteal progesterone level)

4. Counsel the couples about ART techniques, their efficacy, and refer them to qualified specialists in the field, as needed




Clinical sessions 5

Topic: Diabetes mellitus with pregnancy




1. Take proper history and perform a relevant physical examination for the diabetic case

2. Interpret the results of glucose tolerance testing during pregnancy

3. identify different types of diabetes

4. Discuss the fetal and maternal complications during pregnancy, labor, and puerperium with the diabetic patient




Clinical sessions 6

Topic: Antepartum hemorrhage




1. Take proper history and perform a relevant physical examination for the APH case

2. Interpret the relevant symptoms and signs of each type of APH

3. Discuss thefirst aid management and outline the treatment modalities

4. Plan a management approach for a case of APH




Clinical sessions 7

Topic: Preterm labor and premature rupture of fetal membrane




1. Take proper history and perform a relevant physical examinationof PROM case.

2. Identify the relevant symptoms and signs of PTL.

3. Discuss the first aid management of each case

4. Listthe different methods of investigations& hazards of PTL and PROM

5. Discuss aplan of management of PROM &pre-term labor with special attention to tocolysis and the role of corticosteroids




Clinical sessions 8

Topic: Urinary tract infection with pregnancy




1. Take proper history with special attention to symptoms and signs of UTI and perform a relevant physical examination of the UTI case.

2. Discuss the complicationsof asymptomatic bacteruria, cystitis and pyelonephritis with the case

3. List the different methods of investigations and proper antibiotic taking

4. Discussa plan of management of UTI with special attention to timing and mode of delivery




Clinical sessions 9

Topic: Abnormal uterine bleeding



Specific Objectives every student should be able to: 1. Take proper history with special attention to

symptoms and presentation of different types of AUB

2. Discussthe availability of diagnostic procedures and new modalities of treatment with the AUB case




Clinical sessions 10

Topic: Hypertensive disorders with pregnancy


Location : Department of Obstetrics and Gynecology Maternity &Children Hospital

Specific Objectives every student should be able to: 1. Take proper history with special attention to

symptoms and presentation of pre-eclampsia

2. Discussthe availability of antihypertensive drugs with special attension to magnesium sulphateand other antihypertensive drugs

3. Discuss the first aid measures in pr-eclampsia case



Learning resources 1- Essentials of obstetrics and gynecology – Hacker etal

:Saunder USA ; Latest Edition. 2- Obstetrics and Gynecology Recall –Boureois ; Williams &Willkins Baltimore USA . Latest Edition.

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Reading assignment1:

Assignments

Topic Assisted reproductive technology .

Task The student should read about ART and so be able to : Recognize the different types of ART in detail, including definition, indications, steps and complications of each type focusing on IVF-ET, ICSI, ZIFT and GIFT.

Tutor Dr: Tameem

Specific Objectives 1. Assess infertility with basic

diagnostic techniques (semen analysis, hystero-salpingography, and mid-luteal progesterone level).

2. Recognize ART techniques, counsel couples about their efficacy, and refer them to qualified specialists in the field, as needed.

3. Recognize the advanced technologies in this field.

Guidelines

RCOG ., are to be followed

Learning resources

www.medscape.com www. plus. com

WWW.acog.org www.rcog.org. uk

http://www.medscape.com/

http://www.plus.com/

http://www.acog.org/

http://www.rcog.org/

Reading assignment2:

Topic Prenatal diagnosis

Task The student should read about infections during pregnancy and so be able to : Recognizethe different types of infections in detail,including definition, aetiological factors , mode of spread, pathophysiology, symptoms and signs, investigations needed ,fetal effects, preventive measures and maternal complications of each type,focusing on important infection with pregnancy as toxplasmosis,rubella, chlamydia, CMV, HSV, HIV

Tutor: Dr : Magd-eldin

Specific Objectives 1- Recognize the clinical importance of infections during pregnancy.

2- Compare the clinical manifestations of different infections.

3- Interpret the diagnostic procedures

4- Identify the management of important infections.

Guidelines

RCOG ., are to be followed

Learning resources www.medscape.com www. plus. com

WWW.acog.org www.rcog.org. uk





Students' assessment

Clinical Scenarios, MCQ.

Extended Matching Question, EMQ.

OSCE I ( Computer Based Exam ) .

OSCE II (Computer Based Exam)

Clinical OSCE examination

Midterm ( 40 Marks)

20 Marks - OSCE I( Computer Based Exam )

20 Marks - written (Clinical scenarios, extended matching questions, recall questions). Final exams ( 60 Marks)

At the ends of each semester in the form of short objectively structured questions, and multiple

choice questions of different forms including:

15 Marks – -------OSCE II (Computer Based Exam) .

15 Marks - ------- Clinical OSCE Examination.

25 Marks --------- Written (Clinical scenarios, extended matching questions ) .

5 Marks ---------- Tutorial presentation.

Our grading system is as follows:

A+ 95-100

A 90-94

B+ 85-89

B 80-84

C+ 75-79

C 70-74

D+ 65-69

D 60-64

F 60>

Contact details

These are the names and contact details of the academic staff that are involved in teaching the course:

Name e-mail

Tel.

Contact hours Dr. Fawzia Habeeb Professor of

Obstetrics and Gynecology

Head of the department

[email protected] 0505100238

Dr Mohamed Aboelnasr Assoc. Prof. Obstetrics and Gynecology

[email protected] 0543795387 Wednesday 12-1 PM

Dr.Amr Elfayomy Assoc. Prof. Obstetrics and Gynecology& course Coordinator

[email protected] 0532805710 Wednesday 8-10

Dr tameen Aljauosy Assis. Prof. Obstetrics and Gynecology


Dr . Magdeldin gaafar Assis.Prof. Obstetrics and Gynecology


Dr . Amal zaman

Assis. Prof. Obstetrics and Gynecology


Dr .Nada elnugomy Assis. Prof. Obstetrics and Gynecology


mailto:[email protected]





Prescribed resources

(text books, journals, publications, websites ….)

1. Essentials of obstetrics and gynecology – Hacker etal :Saunder USA ; Latest Edition. 2. Obstetrics and Gynecology Recall –Boureois ; Williams &Willkins Baltimore USA . Latest

Edition.

Recommended resources

1. Obstetrics and Gynecology – Mark Mogan and Sam Siddighi, Saunders, Latest Edition.

2. Obstetrics and Gynecology by Ten Teachers Latest Edition- Cambleetal.

Suggested Websites 1. www.medscape.com 2. www. plus. com

3. WWW.acog.org 4. www.rcog.org. uk





Documents

Code: OBGN 501 - · PDF fileThe topics covered will include introduction to the physiology of ... hazards of post-maturity, prematurity, intrauterine fetal death ... Describe the anatomy