Obstetrics and Gynecology
Antenatal care
Know the schedule of antenatal visits, screening (ultrasound timing, biochemical screening), and risk stratification. Understand the management of hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, eclampsia), gestational diabetes, and anemia. Recognize the danger signs requiring urgent referral: severe headache, visual disturbance, epigastric pain, bleeding, reduced fetal movements, rupture of membranes.
Labor and delivery
Stages of labor and normal progress, fetal monitoring (CTG interpretation basics), and management of postpartum hemorrhage (uterine atony is the leading cause). Know the principles of managing shoulder dystocia and fetal distress.
Gynecology
Common conditions: menstrual disorders, pelvic inflammatory disease, ectopic pregnancy, fibroids, and contraception counseling. Recognize ectopic pregnancy as a surgical emergency (pain, amenorrhea, positive test, hemodynamic compromise).
Traps
- Confusing preeclampsia with chronic hypertension; the key is new onset after 20 weeks with organ involvement.
- Misidentifying the first action in postpartum hemorrhage (uterine massage and uterotonics before escalation).
- Forgetting that ectopic pregnancy can present without classic triad.
Rule of thumb
In any pregnant patient with bleeding, severe headache, or abdominal pain, treat as an emergency until proven otherwise. For postpartum hemorrhage: massage the uterus, give uterotonics, and call for help - in that order.
Worked example
A woman at 34 weeks with new hypertension and proteinuria plus headache: this is preeclampsia with severe features. The correct answer is urgent hospitalization, antihypertensive treatment, magnesium sulfate for seizure prophylaxis, and planning delivery - not outpatient monitoring.