Obstetrics and Gynaecology
What you must understand
Obstetrics questions cluster around the safe mother and the safe baby. Know the diagnosis and management of hypertensive disorders of pregnancy, with severe pre-eclampsia requiring magnesium sulphate for seizure prophylaxis and controlled blood pressure reduction; know that eclampsia is treated with magnesium sulphate, not with antihypertensives alone. Understand postpartum haemorrhage as a sequence of causes (tone, trauma, tissue, thrombin) with a stepwise response: uterine massage, uterotonics, tranexamic acid, balloon tamponade, and surgical measures. Learn the partograph, the stages of labour, and the indications for operative delivery.
Antenatal care questions test the schedule of visits, the components of each visit, and the detection of risk factors. Know the physiology of pregnancy that alters laboratory values - dilutional anaemia, lower blood pressure in mid-pregnancy, and increased glomerular filtration.
In gynaecology, master abnormal uterine bleeding by age group, the evaluation of a cervical smear, the classification of ovarian masses, contraception including emergency methods, and the recognition of ectopic pregnancy as a time-critical diagnosis. Understand menopause and hormone therapy risks.
Traps that appear
Vignettes often describe a normal pregnancy variant as pathology, or vice versa. Distinguish antepartum from intrapartum haemorrhage, and primary from secondary postpartum haemorrhage by timing. A common trap is offering delivery when expectant management is correct, or the reverse in severe disease. In ectopic pregnancy, a negative or low beta-hCG does not exclude the diagnosis.
Worked rule of thumb
For any bleeding in pregnancy, localise by timing and pain: painless third-trimester bleeding suggests placenta praevia (avoid digital examination), while painful bleeding suggests abruption. For hypertension in pregnancy, ask whether there are severe features; if present, the answer is magnesium sulphate plus delivery planning.
Study strategy
Build a timeline from conception to puerperium and place each condition on it; timing alone eliminates many distractors.