Obstetrics and Gynecology: Safety of Two Patients
OB/GYN questions are built around maternal and fetal safety. Divide your preparation into antenatal care, labor and delivery, postpartum complications, and gynecology.
Obstetrics essentials
Understand the physiology of pregnancy - increased plasma volume, dilutional anemia, hypercoagulability, and altered drug handling. Know the hypertensive disorders: gestational hypertension, preeclampsia (after 20 weeks), eclampsia, and HELLP. Magnesium sulfate prevents seizures; antihypertensives treat severe hypertension; delivery is definitive. Learn postpartum hemorrhage causes (tone, trauma, tissue, thrombin), and the management ladder from uterine massage and uterotonics to surgery. Recognize ectopic pregnancy and its risk factors; a positive pregnancy test with abdominal pain and no intrauterine pregnancy on ultrasound is ectopic until proven otherwise.
Gynecology essentials
Abnormal uterine bleeding requires a structured approach by age and pattern. Know cervical cancer screening principles, contraception options, and the evaluation of a pelvic mass. Understand endometriosis, PCOS, and menopause physiology.
Traps
Questions frequently confuse preeclampsia with chronic hypertension, or offer imaging before a pregnancy test in a woman of reproductive age. Beware of prescribing contraindicated drugs in pregnancy. Also distinguish antepartum from postpartum hemorrhage timing.
Rule of thumb
Any woman of childbearing age with abdominal pain gets a pregnancy test first. In preeclampsia, the cure is delivery; magnesium is for seizure prevention, not blood pressure control.
Worked example
A 34-week pregnant woman with severe headache and BP 170/110 mmHg needs urgent blood pressure control and magnesium sulfate prophylaxis, then delivery planning - not outpatient follow-up.