Obstetrics and Gynecology / Women's Health
Core concepts
OB/GYN content spans prenatal care, labor, contraception, and gynecologic pathology. Know prenatal visit cadence and screening timelines: first-trimester labs, 11–14 week nuchal translucency/cell-free DNA, 24–28 week glucose tolerance testing, and group B strep screening at 36–37 weeks. Understand hypertensive disorders of pregnancy-chronic hypertension, gestational hypertension, preeclampsia (new hypertension after 20 weeks with proteinuria or end-organ dysfunction), and eclampsia. Contraception counseling requires matching method efficacy (LARC highest), contraindications (e.g., estrogen-containing methods in migraine with aura or prior VTE), and patient preference. Cervical cancer screening intervals and abnormal-result management (colposcopy thresholds) are high-yield.
Traps
- Treating preeclampsia with delivery timing errors: severe features or ≥37 weeks generally warrant delivery; magnesium sulfate is for seizure prophylaxis, not blood pressure control.
- Confusing postpartum hemorrhage causes (the four Ts: tone, trauma, tissue, thrombin).
- Missing ectopic pregnancy in a patient with a positive pregnancy test and pelvic pain-obtain quantitative hCG and ultrasound.
- Overlooking that estrogen-containing contraceptives are contraindicated in breastfeeding early postpartum (higher VTE risk).
Worked example / rule of thumb
A 32-week patient with BP 158/104 and headache: this is preeclampsia with severe features-admit, start magnesium sulfate for seizure prophylaxis, treat BP with labetalol or nifedipine, and plan delivery. Rule of thumb: new hypertension after 20 weeks is preeclampsia until proven otherwise.