Obstetrics and Gynaecology
What you must understand
Obstetrics and gynaecology questions test antenatal care, labour, delivery and gynaecological pathology. Know the stages of labour, the partogram, and the causes of postpartum haemorrhage (the four T's: Tone, Trauma, Tissue, Thrombin). Understand hypertensive disorders of pregnancy (pre-eclampsia, eclampsia), gestational diabetes, and ectopic pregnancy. For gynaecology, know the menstrual cycle, common infections, and the approach to abnormal uterine bleeding and pelvic masses.
Traps that appear in questions
- Confusing pre-eclampsia (hypertension plus proteinuria after 20 weeks) with chronic hypertension.
- Forgetting that magnesium sulphate is the treatment of choice for eclampsia and severe pre-eclampsia.
- Mixing up antepartum vs postpartum haemorrhage definitions and causes.
- Overlooking ectopic pregnancy in any woman of reproductive age with abdominal pain and amenorrhoea.
Worked example (rule of thumb)
A woman at 34 weeks with blood pressure 160/110 mmHg, proteinuria and headache has severe pre-eclampsia. Admit, control blood pressure, give magnesium sulphate for seizure prophylaxis and plan delivery. Rule of thumb: hypertension after 20 weeks plus proteinuria = pre-eclampsia.
Exam strategy
For obstetric stems, note gestational age, blood pressure, proteinuria and fetal status. For gynaecology, establish age, menstrual history and pregnancy status first.