Obstetrics and Gynecology
What OMRSE tests
Obstetrics and Gynecology covers pregnancy complications, labor, contraception, and gynecologic emergencies. The exam tests time-critical recognition: hemorrhage, hypertension, sepsis, and fetal compromise.
Core rules
- Preeclampsia is new hypertension after 20 weeks plus proteinuria or maternal organ dysfunction.
- Severe features include BP at least 160/110, platelets below 100, rising liver enzymes, creatinine elevation, pulmonary edema, or cerebral/visual symptoms.
- Magnesium sulfate prevents and treats eclampsia; monitor reflexes, respiratory rate, and urine output; calcium gluconate is the antidote.
- Delivery is the definitive treatment for severe preeclampsia, after maternal stabilization.
Worked example
A 30-year-old at 34 weeks has headache, BP 165/110, platelets 90, AST 120 U/L, creatinine 1.2 mg/dL, and proteinuria. This is severe preeclampsia with HELLP features. Admit to a monitored bed, start magnesium sulfate, give labetalol or hydralazine for BP control, administer antenatal corticosteroids, and plan delivery after stabilization. Do not give ACE inhibitors or ARBs in pregnancy. Avoid fluid overload; use strict input/output charts.
Traps that cost marks
- Diagnosing migraine and missing hypertension in pregnancy.
- Waiting for a seizure before starting magnesium.
- Treating hypertension with an ACE inhibitor or diuretic.
- Delaying delivery for a borderline platelet count when severe features are present.