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Special Tutorial Programme

Special Tutorial Programme. Professor Deirdre J Murphy Trinity College. Course aims. Medical knowledge Clinical skills Professionalism Formative assessment Student feedback. Goals. Every student completes O&G programme successfully

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Special Tutorial Programme

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  1. Special Tutorial Programme Professor Deirdre J Murphy Trinity College

  2. Course aims Medical knowledge Clinical skills Professionalism Formative assessment Student feedback

  3. Goals Every student completes O&G programme successfully Every individual is competent to provide basic care in O&G as a qualified doctor

  4. Introduction to Obstetric Care

  5. Objectives Obstetric history and examination Antenatal care / Healthy pregnancy Formative assessment

  6. Obstetric history Woman in late pregnancy admitted with vaginal bleeding

  7. 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

  8. Dating Menses – regular, length, sure Contraception Naegles rule First trimester ultrasound scan Later ultrasound scan

  9. Past Obstetric History Gravida Parity Outcomes • Gestational age • Mode of delivery • Birth weight • Complications

  10. Past Medical History Medical Surgical Psychiatric Gynaecological Allergies

  11. Family History Hypertension / Cardiovascular Venous thromboembolism Pregnancy complications Twins Inherited disease Congenital malformations

  12. Social History Occupation Marital status / support Smoking Alcohol Drugs Domestic violence Childcare / Housing

  13. Antenatal course When booked Folic acid Screening Bloods Rhesus Down’s screening Anomaly / Placental site Visits Previous admissions

  14. Presenting complaint Vaginal bleeding Colour / mucus Volume Provoked Associated pain Associated contractions Loss of liquor Unwell Fetus

  15. Antepartum haemorrhage Placenta praevia Placental abruption Local causes Unknown

  16. Intelligent history Comprehensive but efficient Differential diagnosis Targeted questioning Prioritising diagnosis Focussed examination

  17. Obstetric examination

  18. Obstetric examination Third trimester Antepartum haemorrhage

  19. General examination Appearance Vital signs pulse blood pressure temp Cardiovascular Respiratory Legs

  20. Obstetric examination Inspection Measurement Palpation Auscultation

  21. Inspection Distension Movement on respiration Scars Linea nigra Striae gravidarum Fetal movement

  22. Measurement Symphysis- fundal height Finger breadths below xiphisternum

  23. Palpation Lie Presentation Engagement Fetal back Liquor Contractions Tenderness / Rigidity

  24. Auscultation Fetal heart rate Pinard / Doppler CTG

  25. Basic Obstetric Skill Careful history Comprehensive examination

  26. Further management Differential diagnosis Revise/Prioritise diagnosis Investigations Treatment / Management Exclude placenta praevia Speculum examination

  27. Objectives Obstetric history and examination Antenatal care / Healthy pregnancy Formative assessment

  28. Antenatal care

  29. Antenatal care Routine Antenatal Care Healthy Pregnant Woman Evidence-Based Guideline see handout

  30. Objectives Obstetric history and examination Antenatal care / Healthy pregnancy Formative assessment

  31. Write short notes

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