Obstetrics and Gynecology

1.The student understands the principles of perinatal care organisation, indicators of quality of care, Latvian legislation of reproductive health, is able to explain anatomy and physiology of the female reproductive system, the process of fertilisation, development of the fetus and placenta, physiology of pregnancy. Knows principles of obtaining reproductive anamnesis and basic methods of the gynecologic examination of women. Can define the basic antenatal care programme, screening of genetic and other diseases, understands the course of normal and pathological pregnancy: spontaneous interruption of pregnancy till 22 weeks of gestation, ectopic pregnancy, trophoblastic disease, normal labour, delivery, physiologic postpartum period, breastfeeding, dystocia during labour and delivery, pre-term and post-term delivery, twin pregnancy, intrauterine growth retardation, fetal antenatal testing, TORCH infections during pregnancy, isoimmunisation during pregnancy, bleeding during pregnancy, delivery and postpartum, birth trauma in mother and newborn, hypertensive disorders during pregnancy, extra-genital pathologies during pregnancy, operative delivery, postpartum septic complications, physiology and pathology of newborns, primary care of newborn and resuscitation. Understands clinical pharmacology of medications used during perinatal care. Knows the regulations and methods of termination of pregnancy till 22 weeks of pregnancy. Understands the role of normal microflora of the genital tract in context of reasons of gynecologic and obstetric pathology: STI, endogen and iatrogenic infection – etiology, diagnostic methods, impact on reproductive health, treatment (also during pregnancy), pelvic inflammatory disease, septic postpartum complications (endometritis, wound infection). Understands the reasons of uterine bleeding: disorders of the menstrual cycle, endometrial precancerous lesions, endometrial cancer, principles of diagnosis and treatment. Understands options of primary and secondary prophylaxis of cervical cancer, pathogenesis and progression of cervical cancer, principles of diagnostics and treatment of cervical cancer. Knows family planning methods and principles of their choice. Understands reasons of female virilization, diagnostics and treatment principles of polycystic ovary syndrome, understands role of estrogens in female body in different periods of woman’s life, pathogenesis of estrogen deficiency and principles of treatment (menopause, hormone replacement therapy). Understands about subspecialties of gynecology – urogynecology, human embryology and reproduction and associated problems – pelvic floor dysfunction, and infertility. Understands main gynecologic operations and manipulations, knows how to prepare the patient, how to manage postoperative period. Understanding about benign and malignant tumors of genitals – uterine myoma, ovarian tumors, reasons of chronic pelvic pain and options of differentiation, endometriosis, primary and secondary dysmenorrhea, premenstrual syndrome.

1.1. Uterine bimanual examination; 2. Pap smear collection (cervical cytology smear); 3. Due date determination; 4. Primary resuscitation of the newborn; 5. Physiological labor; 6. Identification of fundus uteri; 7. Care of the neonate in physiological delivery; 8. Use of the contraceptive tool in contraceptive counselling; 9. Leopold’s maneuvers; 10. The cord cutting; 11. Prevention of postpartum haemorrhage; 12. Reproductive history of gynecological patient; 13.Reproductive history of obstetric patient.

1.Collect reproductive history. Perform a clinical examination on a pregnant woman and a gynecological patient. To determine the time of delivery.

2.Understand physiological delivery and principles of delivery management. Demonstrate hand techniques in the acceptance of physiological births and in the care of a newborn. Assess the state of the fetus – sound fetal heartbeats with fetal doppler.

3.Know what parameters of a newborn should be evaluated after birth to decide a newborn’s health status, know how to provide a newborn with a safe environment after birth and understand if any support is needed.

4.Is familiar with the principles of evidence-based antenatal care, able to identify high-risk pregnancies: fetal genetic abnormalities, asymptomatic bacteriuria, gestational diabetes, iron deficiency anaemia, hypertensive complications, abnormal fetal growth, multi-fruit pregnancy, TORCH infection, etc.

5.Can explain the nature of primary and secondary prevention of cervical cancer, explain how cervical cancer screening examinations should be taken, interpret cervical cancer screening results. Is competent to advise a woman on the choice and application of family planning methods.

6.Symptoms of reproductive diseases, investigative possibilities and informativeness of investigative methods and disease prevention possibilities and treatment options can be explained to the woman. Understands and is able to apply the principles of drug selection during pregnancy and lactation.