Maternal, Neonatal, dan Anak
Core concepts
Obstetrics: antenatal care, hypertensive disorders of pregnancy (pre-eclampsia, eclampsia, HELLP), antepartum and postpartum haemorrhage, and normal labour progress. Know the causes of postpartum collapse and the management of pre-eclampsia with magnesium sulphate for seizure prophylaxis. Paediatrics: growth and development milestones, immunisation schedules, neonatal jaundice and sepsis, respiratory distress in the newborn, and common childhood infections. Understand dehydration grading, fluid resuscitation, and the danger signs in a sick child.
Traps
Do not treat pre-eclampsia with antihypertensives alone - delivery is definitive, and magnesium sulphate prevents seizures. Postpartum haemorrhage management follows a stepwise sequence: uterine massage, uterotonics, then mechanical or surgical measures. In neonatal jaundice, distinguish physiological from pathological by timing and rate of rise. In children, weight-based dosing and the recognition of sepsis are frequently tested.
Worked example
A 32-week pregnant woman has a blood pressure of 165/110 mmHg, headache, visual disturbance, and proteinuria. Diagnosis: severe pre-eclampsia. Rule of thumb: control blood pressure, give magnesium sulphate for seizure prophylaxis, and plan delivery; the only cure is delivery of the fetus and placenta.