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OBGY713 Pregnancy Care in the Community

Content and rationale of antenatal and postnatal visits, relevant anatomy and physiology of pregnancy, hypertension in pregnancy, medical disorders of pregnancy, bleeding in pregnancy, thrombophilias in pregnancy, malpresentations late in pregnancy, obstetric trauma, episiotomy, breast feeding, common disorders of the puerperium, well baby check, common neonatal disorders to include jaundice, respiratory distress, seizures, infection, intracranial bleeding, hypothermia.

OBGY 713 covers antenatal, birthing and postnatal care, including the care of pregnant women with chronic medical conditions. It also covers the care of the newborn, including common neonatal disorders, well baby checks and immunisation.

Paper title Pregnancy Care in the Community
Paper code OBGY713
Subject Obstetrics and Medical Gynaecology
EFTS 0.1500
Points 18 points 18 points
Teaching period(s) 1st Non standard period (31 March 2020 - 10 June 2020), 2nd Non standard period (25 August 2020 - 11 November 2020)
Domestic Tuition Fees (NZD) $1,714.50
International Tuition Fees (NZD) $6,217.80

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Restriction
OBGX 713
Limited to
PGCertWHlth, PGDipOMG
Notes
(i) This paper is designed for the continuing professional education of health professionals involved in the provision of women's health care, and is also a compulsory paper for the Postgraduate Diploma in Obstetrics and Medical Gynaecology. (ii) Limited to 30 students per semester. (iii) For more information: www.otago.ac.nz/womens-health-postg
Eligibility

Recommended for general practitioners (GPs) and GP registrars and sexual health physicians, and those doctors considering a future in sexual and reproductive health, general practice, obstetrics and gynaecology, paediatrics or emergency medicine. Suitable for midwives, practice nurses, family planning and public health nurses.

Enrolments for this paper are limited and require departmental permission. View more information about limitations of enrolment.

Contact
Amanda Phillips: Women's and Children's Health Distance Learning Co-ordinator
Email wch.distancelearning@otago.ac.nz
Tel 03 470 9688
Teaching staff

Convenor: Dr Celia Devenish
Teaching Staff : Dr Celia Devenish, Dr Jane McDonald, Dr Jo Gullam, Dr Judy Ormandy, Dr Su Chandru

Paper Structure
One of four distance-taught papers that are offered as part of Postgraduate Certificate in Women's Health (PGCertWHlth) and Postgraduate Diploma in Obstetrics and Medical Gynaecology (PGDipOMG) programmes
Teaching Arrangements

Consists of six 2-hour Tuesday evening audioconferences on Zoom conducted fortnightly over twelve weeks

N1: Tuesday, 31 March- Tuesday, 9 June 2020
Examination: Wednesday, 17 June 2018, in the evening, in the town/city you enrolled as your semester address.

N2: Tuesday, 25 August - Thursday, 22 October 2020
Examination: Wednesday, 11 November 2020, in the evening, in the town/city you enrolled as your semester address

Textbooks
Introduction to Obstetrics and Gynaecology, by Professor Cindy Farquhar and Associate Professor Helen Roberts
Graduate Attributes Emphasised
Interdisciplinary perspective, Lifelong learning, Scholarship, Communication.
View more information about Otago's graduate attributes.
Learning Outcomes

Pregnancy Care in the Community

  • Undertake risk assessment of pregnant women and arrange appropriate specialist referral
  • Management of hyperemesis: Assess risk factors, Arrange appropriate referral to inpatient services, manage the use of medication and intravenous fluids in women with hyperemesis
  • Antenatal Care: Select the appropriate model of antenatal care — midwife, hospital clinic, private specialist, etc; explain the do's and don’t's of pregnancy - xrays, surgery for unrelated issues, immunisations, travel
  • Prescribing in Pregnancy: outline the principles of prescribing in pregnancy, list medications that shuld never be used in pregnancy, know where to access additional information
  • Identification of growth problems in pregnancy: define the terms small for gestational age (SGA) and fetal (intrauterine) growth restriction(IUGR), list the causes of SGA pregnancies, describe how to use customised birthweight centiles, describe how to use a customised antenatal fetal growth chart (GROW-Chart) to aid recognition of SGA pregnancies, outline the general management principles for pregnancies suspected to be SGA, utilising the NZMFMN guideline
  • Recognise complications with multiple pregnancies, need for early referral, and need to establish chorionicity: Describe the causes and mechanisms of the twinning process, Outline the maternal complications of multiple pregnancy, Outline the fetal complications of multiple pregnancy, Appreciate the impact of chorionicity on pregnancy complications, Appreciate the importance of establishing chorionicity by 16 weeks gestation
  • Post term pregnancy: Appreciate maternal and fetal risk, outline management options, appreciate risks for women of different ages/BMI and how this may impact on management
  • Attitudes/ Referrals: Sympathetically accept complaints from patients and staff about the service, Recognise inappropriate staff and patient attitudes, Respect the privacy of patients and seek ways to ensure this, Coordinate consultation and investigation at clinics

Obstetric Emergencies

  • Recognise the causes of obstetric collapse
  • Detail the causes of obstetric collapse
  • Detail the causes of non-obstetric collapse
  • Recognise, manage and prevent fetal cord prolapse
  • Recognise, manage and prevent shoulder dystocia
  • Manage massive obstetric haemorrhage
  • Recognise and manage severe PET syndromes and eclampsia
  • Recognise, manage and prevent pulmonary embolism

Common Disorders in Pregnancy

  • Describe the common disorders in early pregnancy, including hyperemesis
  • Describe and assess the exposure risk of pregnant women to common childhood illnesses, including varicella, rubella, and parvovirus
  • Describe the effects of infectious diseases — for example, H1N1 influenza, HIV, and Hepatitis B and C — on pregnant women
  • Assess and manage a pregnant woman at risk from venous thromboembolism, varicosities
  • Describe the management of an obese pregnant woman
  • Assess and manage a pregnant woman with: heartburn, cholecystitis, musculoskeletal pain, varicose veins, pruritis, diabetes, hypertension, history of urinary tract infections, epilepsy, asthma, thyroid disorders, heart disease, lupus, or other connective tissue disorders, a history of mental health problems
  • Recognise the risks of sickle cell disease and thalassaemia
  • Arrange the management of a pregnant woman with an incidental ovarian cyst found on routine USS

Birth Matters

  • Counsel a woman with a multiple pregnancy about delivery options and general details of intrapartum management and delivery
  • Counsel a woman about methods for induction of labour
  • Counsel a woman about mode of delivery after a Caesarean section
  • Counsel a woman regarding pain relief available for labour
  • Counsel a primigravida who requests a primary elective Caesarean section
  • Describe the recognition and general management of preterm labour
  • Describe the indications for instrumental delivery, the methods commonly used, and in general their possible maternal and fetal complications
  • List the indications for Caesarean section, and describe in general the possible complications and their management
  • Describe types of perineal trauma, their management, complications, and long-term sequelae
  • Describe management of the third stage of labour
  • Describe the causes and management of a secondary postpartum haemorrhage

Maternal Wellbeing and Lactation

  • Describe care of wounds of the perineum caused by tears or episiotomy
  • Describe the normal process of uterine involution and the characteristics of lochia
  • Describe causative factors, diagnosis, and management of postpartum haemorrhage and endometrial infection, and define puerperal infection
  • Discuss management of severe puerperal sepsis
  • Diagnose and manage superficial and deep vein thrombosis and pulmonary embolism
  • Describe postnatal depression, predisposing factors, diagnosis (including differentiating this from “baby blues”), and initial management
  • Describe the advantages and disadvantages of different methods of feeding the baby
  • Describe the preparation and care of breasts and nipples for breast-feeding
  • List drugs which should not be used by breast-feeding women
  • Diagnose and describe management of breast engorgement, sore nipples, and breast infection
  • Outline the basic physiology of lactation and apply this knowledge to promote or suppress lactation
  • Counsel about postnatal contraception
  • Describe the relationship between fertility control and breast-feeding

The Newborn

  • Describe the major cardiovascular and respiratory changes that normally take place at birth
  • Identify those infants who require resuscitation
  • Initiate and continue neonatal resuscitation until assistance arrives
  • Perform competent bag and mask ventilation
  • Discuss postnatal vitamin K prophylaxis
  • Describe the elements of a full examination of the newborn and 6-week-old infant, describe the milestones relevant to this period, and recognise abnormalities which require referral
  • List the conditions tested for by the newborn blood spot screening programme in New Zealand
  • List immunisations currently given at birth and the 6-week check, provide information that supports their use, and describe possible adverse events and their management
  • Advise parents on safe sleep practices, transporting their infant, and how to decrease the risk of sudden infant death syndrome
  • List the sequelae that may be found in a newborn after a traumatic delivery and advise the parents of the infant on the likely outcome for these abnormalities
  • List the causes of neonatal jaundice and describe the role of the LMC or GP in its management
  • Outline the reasons for respiratory distress in the neonate
  • Describe the presentation of congenital heart disease in the first few weeks of life
  • Describe the presentation and early management of infection in the neonate
  • Outline the causes and management of hypoglycaemia in the neonate, and in particular, the management of the growth-retarded infant and the infant of a diabetic mother
  • Recognise the presentation of the more common major and minor congenital anomalies that may be found antenatally or during the newborn examination or that can present in the first week of life
  • Support and advise parents through common problems such as colic and sleeping difficulties, and offer advice as to when and how to treat gastro-oesophageal reflux
  • Be aware of “non-accidental” injuries and what to do if these are suspected

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Timetable

1st Non standard period (31 March 2020 - 10 June 2020)

Location
Dunedin
Teaching method
This paper is taught through Distance Learning
Learning management system
Blackboard

2nd Non standard period (25 August 2020 - 11 November 2020)

Location
Dunedin
Teaching method
This paper is taught through Distance Learning
Learning management system
Blackboard

Content and rationale of antenatal and postnatal visits, relevant anatomy and physiology of pregnancy, hypertension in pregnancy, medical disorders of pregnancy, bleeding in pregnancy, thrombophilias in pregnancy, malpresentations late in pregnancy, obstetric trauma, episiotomy, breast feeding, common disorders of the puerperium, well baby check, common neonatal disorders to include jaundice, respiratory distress, seizures, infection, intracranial bleeding, hypothermia.

OBGY 713 covers antenatal, birthing and postnatal care, including the care of pregnant women with chronic medical conditions. It also covers the care of the newborn, including common neonatal disorders, well baby checks and immunisation.

Paper title Pregnancy Care in the Community
Paper code OBGY713
Subject Obstetrics and Medical Gynaecology
EFTS 0.15
Points 15 points 15 points
Teaching period(s) 1st Non standard period (30 March 2021 - 8 June 2021), 2nd Non standard period (24 August 2021 - 21 October 2021)
Domestic Tuition Fees Tuition Fees for 2021 have not yet been set
International Tuition Fees Tuition Fees for international students are elsewhere on this website.

^ Top of page

Restriction
OBGX 713
Limited to
PGCertWHlth, PGDipOMG
Notes
(i) This paper is designed for the continuing professional education of health professionals involved in the provision of women's health care, and is also a compulsory paper for the Postgraduate Diploma in Obstetrics and Medical Gynaecology. (ii) Limited to 30 students per semester. (iii) For more information: www.otago.ac.nz/womens-health-postg
Eligibility
Recommended for general practitioners (GPs) and GP registrars and sexual health physicians, and those doctors considering a future in sexual and reproductive health, general practice, obstetrics and gynaecology, paediatrics or emergency medicine. Suitable for midwives, practice nurses, family planning and public health nurses.

Enrolments for this paper are limited and require departmental permission. View more information about limitations of enrolment.
Contact

Amanda Phillips: Women's and Children's Health Distance Learning Co-ordinator
Email wch.distancelearning@otago.ac.nz
Tel: Ask Otago 0800 808 098

Teaching staff

Convenor: Dr Celia Devenish
Teaching Staff : Dr Celia Devenish, Dr Jane McDonald, Dr Jo Gullam, Dr Judy Ormandy, Dr Su Chandru

Paper Structure
One of four distance-taught papers that are offered as part of Postgraduate Certificate in Women's Health (PGCertWHlth) and Postgraduate Diploma in Obstetrics and Medical Gynaecology (PGDipOMG) programmes
Teaching Arrangements

Consists of six 2-hour Tuesday evening audioconferences on Zoom conducted fortnightly over twelve weeks

N1: Tuesday, 30 March - Tuesday, 8 June 2021
Examination: Wednesday, 9 June 2021, delivered online

N2: Tuesday, 24 August - Thursday, 21 October 2021
Examination: Wednesday, 10 November 2021, delivered online

Textbooks

There is no single textbook for this paper. Readings will be provided for students to access via the Library, with additional readings and other multimedia material provided via Moodle.

Graduate Attributes Emphasised
Interdisciplinary perspective, Lifelong learning, Scholarship, Communication.
View more information about Otago's graduate attributes.
Learning Outcomes

Pregnancy Care in the Community

  • Undertake risk assessment of pregnant women and arrange appropriate specialist referral
  • Facilitate referral for an appropriate model of antenatal care in alignment with MOH guidelines— midwife, hospital clinic, private specialist,
  • Explain the dos and don’ts of pregnancy including the use of radiological examinations, surgery for unrelated issues, immunisations, and travel
  • Outline how to safely prescribe in pregnancy and breast-feeding
  • Describe how to identify and refer fetal growth restriction
  • Recognise significant findings in first trimester scanning which will require referral
  • Be able to:
  • Sympathetically accept complaints from patients and staff about the service
  • Recognise inappropriate staff and patient attitudes
  • Respect the privacy of patients and seek ways to ensure this
  • Coordinate consultation and investigation at clinics

Obstetric Emergencies

  • Recognise and detail the causes of obstetric collapse.
  • Detail the causes and management of non-obstetric collapse.
  • Recognise, manage and prevent fetal cord prolapse.
  • Recognise and manage shoulder dystocia.
  • Manage massive obstetric haemorrhage.
  • Recognise and manage severe pre-eclampsia and eclampsia.

Common Disorders in Pregnancy

  • Describe and assess the exposure risk of pregnant women to common childhood illnesses, including varicella, rubella, and parvovirus.
  • Assess and manage infectious diseases in pregnancy including: HIV, and Hepatitis B and C.
  • Assess and manage a pregnant woman at risk from venous thromboembolism.
  • Describe the management of a pregnant woman with BMI>40.
  • Assess and manage a pregnant woman with diabetes, hypertension, a history of urinary tract infections, epilepsy, asthma, thyroid disorders, heart disease, connective tissue disorders, and/or a history of a mental health disorder.

Birth Matters

  • Describe and assess the exposure risk of pregnant women to common childhood illnesses, including varicella, rubella, and parvovirus.
  • Assess and manage infectious diseases in pregnancy including: HIV, and Hepatitis B and C.
  • Assess and manage a pregnant woman at risk from venous thromboembolism.
  • Describe the management of a pregnant woman with BMI>40.
  • Assess and manage a pregnant woman with diabetes, hypertension, a history of urinary tract infections, epilepsy, asthma, thyroid disorders, heart disease, connective tissue disorders, and/or a history of a mental health disorder.

Maternal Wellbeing and Lactation

  • Describe care of wounds of the perineum in the post-partum period.
  • Describe the normal process of uterine involution and the characteristics of lochia.
  • Discuss management of severe puerperal sepsis.
  • Describe postnatal depression, predisposing factors, diagnosis (including differentiating this from “baby blues”), and initial management.
  • Describe the advantages and disadvantages of different methods of feeding the baby.
  • Diagnose and describe management of breast engorgement, sore nipples, and breast infection.
  • Outline the basic physiology of lactation and apply this knowledge to promote or suppress lactation.

Maternal Mental Health and Well-being

  • Identify health promotion
  • Critically appraise evidence based screening and assessment
  • Outline interventions including case management, transition planning and referrals
  • Evaluate access to respite care and specialist inpatient care for mothers and babies
  • Recommend consultation and liaison services within the health system and with other agencies.
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^ Top of page

Timetable

1st Non standard period (30 March 2021 - 8 June 2021)

Location
Dunedin
Teaching method
This paper is taught through Distance Learning
Learning management system
Moodle

2nd Non standard period (24 August 2021 - 21 October 2021)

Location
Dunedin
Teaching method
This paper is taught through Distance Learning
Learning management system
Moodle