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Course aims
Medical knowledge Clinical skills Professionalism
Formative assessment Student feedback
Goals
Every student completes O&G programme successfully Every individual is competent to provide basic care in O&G as a qualified doctor
Objectives
Obstetric history and examination
Antenatal care / Healthy pregnancy Formative assessment
Obstetric history
Components of History
Basics Name - Age Dating of pregnancy Past Obstetric history Past Medical/Surgical/Gynae history Family history Social history Antenatal course Presenting complaint
Dating
Menses regular, length, sure Contraception Naegles rule First trimester ultrasound scan Later ultrasound scan
Family History
Hypertension / Cardiovascular Venous thromboembolism Pregnancy complications Twins Inherited disease Congenital malformations
Social History
Occupation Marital status / support Smoking Alcohol Drugs Domestic violence Childcare / Housing
Antenatal course
When booked Folic acid Screening Bloods Rhesus Downs screening Anomaly / Placental site Visits Previous admissions
Presenting complaint
Vaginal bleeding Colour / mucus Volume Provoked Associated pain Associated contractions Loss of liquor Unwell Fetus
Antepartum haemorrhage
Placenta praevia Placental abruption Local causes Unknown
Intelligent history
Comprehensive but efficient Differential diagnosis Targeted questioning Prioritising diagnosis Focussed examination
Obstetric examination
Obstetric examination
Third trimester
Antepartum haemorrhage
General examination
Appearance Vital signs
Obstetric examination
Inspection Measurement Palpation Auscultation
Inspection
Distension Movement on respiration Scars Linea nigra Striae gravidarum Fetal movement
Measurement
Symphysis- fundal height
Finger breadths below xiphisternum
Palpation
Lie Presentation Engagement Fetal back Liquor Contractions Tenderness / Rigidity
Auscultation
Fetal heart rate
Pinard / Doppler CTG
Further management
Differential diagnosis Revise/Prioritise diagnosis Investigations Treatment / Management Exclude placenta praevia Speculum examination
Objectives
Obstetric history and examination
Antenatal care / Healthy pregnancy Formative assessment
Antenatal care
Antenatal care
Routine Antenatal Care
Healthy Pregnant Woman Evidence-Based Guideline
see handout
Objectives
Obstetric history and examination
Antenatal care / Healthy pregnancy Formative assessment