Midwifery And Gynecological Nursing

Unit No.

Learning Objectives

Contents

Hours

I

Describe the scope and trends in midwifery

Introduction:

a)  Definition of midwifery and obstetrical nursing

b)  Scope of midwifery

c)  Basic competencies of a midwife

d)  History of midwifery

e)  Trends of maternity services in India

f)   f) Vital statistics related to maternal health in India.

(04)

II

Describe the anatomy and physiology of female reproductive system

Reproductive System

a)  Review of structure and function of female reproductive system

b)  Female pelvis –structure, types and diameters

(05)

III

Describe the stages of Embryological and fetal development.

Embryology and Foetal Development

a)  Oogenesis, spermatogenesis, fertilization and implantation.

b)  Embryology and Fetal development

c)  Placenta and membranes:

-      Structure

-      Functions

-      Abnormalities

-      Liquor amni

-      Umbilical cord

d)  Fetal skull:

-      Structure

-      Diameters

-      Fontanels and sutures

e)  Fetal circulation

(08)

IV

Describe the physiological changes in pregnancy and

the management of normal pregnancy

Demonstrate skill is caring for pregnant women

Normal Pregnancy and its Management

a)  Pre-conception care

b)   Genetic counseling

c)  Physiological changes in pregnancy

d)  Diagnosis of pregnancy

-      History

-      Signs & symptoms

e)  Antenatal care:

-      History taking

-      calculation of expected date of delivery,

-      Examination and investigations

-      Health Education and counselling

-      Drugs and immunizations

f)   Minor disorders and their management

(12)

V

Describe the various stages of labour and the role of the

midwife in caring for a woman in labour.

Demonstrate skill in conducting the normal delivery

Normal Labour and its Management

a)  Definition and stages

b)  Causes and signs of onset of labour

c)  True and false labour

d)  First stage of labour:

-      Physiology

-      Monitoring using partograph and its interpretation

-      Care of mother: physical and psychological

-      Pain management

-      Setting up of the labour room including newborn corner

e)  Second stage:

-      Physiology and mechanism

-      Monitoring

-      Conduction of normal delivery

-      Episiotomy

-      Essential newborn care

f)   Third stage:

-      Physiology and signs

-      Active management of third stage

-      Examination of the placenta

-      Episiotomy suturing

g)  Fourth stage:

-      Physiology

-      Care of the mother and baby

-      Postpartum family planing

(15)

VI

Describe the management of

normal newborn

Development of skill in caring for the normal newborn

Management of Newborn

a)  Assessment

b)  Physiological adaptation

c)  Apgar scoring

d)  Examination for defects

e)  Breast feeding- BFHI

f)   Care of newborn -Skin, eyes, buttocksetc

g)  Bonding and rooming in

h)  Minor disorders of new born:

-      Birth marks, rashes, skin

-      Infections, sore buttocks,

-      Infection of eyes.

(14)

VII

Describe normal pureperium and the role of midwife in the caring for woman in puerperium

Management of Normal Puerperium

a)  Definition and objectives of care

b)  Physiological changes

c)  Postnatal counselling

d)  Lactation and feeding

e)  Care during puerperium – breast and perineal care postnatal exercise, postnatal examination, follow up, family welfare

f)   Minor ailments and management.

g)  Family planning

(10)

VIII

Describe the complications of pregnancy

Demonstrate skills in providing care for women with complicated pregnancy

Management of Complications during Pregnancy

a)  Bleeding in pregnancy- early and late

-      Ectopic pregnancy

-      Abortion

-      Antepartum hemorrhage

-      Vesicular mole

b)  Hyperemesis gravidarum

c)  Gestational diabetes mellitus

d)  Pregnancy inducedhypertension

-      Pre eclampsia and Eclampsia

e)  Hydromnios– poly and oligo

f)   Pelvic inflammatory diseases

g)  Intra uterine growth retardation

h)  Post maturity

i)    Intra uterine death

High Risk Pregnancy:

-     Monitoring- NST, USG

-     Anemia

-     Jaundice

-     Viral

-     Urinary tract infections

-     Hearts diseases

-     Diabetes

-     AIDS and STD’s

-     Osteomalacia, STD

-     Teenage pregnancy

-     Elderly Primigravida

-     Multipara

-     Multiple pregnancy

(12)

IX

Describe the management

high risk labour

Demonstrate skills in early

detection and prompt management of high risk labour

Management of High Risk Labour

a)  Malposition, malpresentations

b)  Contracted pelvis

c)  Abnormal uterine actions

d)  Cervical Dystocia

e)  Premature rupture of membranes, precipitate and prolonged labour, induction of labour obstructed labour,

f)   Obstetrics Emergencies-Cord prolapse, cord presentation, amniotic fluid embolism, obstetric shock, rupture of uterus, shoulder dystocia, vasa previa.

g)  Complications of third stage

-      Postpartum Hemorrhage

-      Atonic uterus

-       Injuries to the birth canal

-      Retained placenta and membranes

-      Inversion of uterus

(10)

X

Describe the puerperal

Complications

Demonstrate skill in the

management of complications of puerperium

Management of Complications of Puerperium

-     Puerperal pyrexia

-     Puerperal Sepsis

-     Thrombophlebitis and Embolism

-     Breast engorgement, Mastitis, Breast abscess

-     Puerperal psychosis

(4)

XI

Describe the management of

high risk and sick newborn

Demonstrate skills in caring

for high risk and sick newborns

High Risk and Sick Newborn

a)  Assessment

b)  Nursing care

c)  Management of newborn with:

-      Hyperbilirubinaemia

-      Neonatal hypoglycemia

-      Hypothermia

-      Neonatal Convulsions

-      Rh incompatability

-      Small for dates

-      Low birth weight

-      Preterm

-      Asphyxia, RDS

-      Sepsis

-      Birth injuries

Cephal hematoma Caput succedaneum Facial &Erb’s palsy Torticollis

Hemorrhage

-      Congenital anomalies

d)  Newborn of HIV positive mother, diabetic mother