Physiological Obstetrics

Study Course Description

Course Description Statuss:Approved

Course Description Version:11.00

Study Course Accepted:16.08.2023 15:35:25

Study Course Information
Course Code:		MDAK_040		LQF level:		Level 6
Credit Points:		4.00		ECTS:		6.00
Branch of Science:		Clinical Medicine; Obstetrics and Gynaecology		Target Audience:		Midwifery
Study Course Supervisor
Course Supervisor:		Ilze Ansule
Study Course Implementer
Structural Unit:		Department of Nursing and Obstetric Care
The Head of Structural Unit:
Contacts:		Riga, 26a Anninmuizas boulevard, mdakrsu[pnkts]lv, +371 67061568
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		1	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		2
Classes (count)		15	Class Length (academic hours)		2	Total Contact Hours of Classes		30
Total Contact Hours								32
Full-Time - Semester No.2
Lectures (count)		1	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		2
Classes (count)		15	Class Length (academic hours)		2	Total Contact Hours of Classes		30
Total Contact Hours								32
Study course description
Preliminary Knowledge:
Anatomy, physiology, pharmacology and managing of physiological pregnancy.
Objective:
To create awareness about the female reproductive system, the ability to manage a physiological birth and the early postpartum period.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Organisation of maternity care in Latvia. Designations used in obstetrics.			Lectures		1.00	auditorium
2	Female genital anatomy and physiology.			Classes		1.00	auditorium
3	Female pelvic bones. Evaluation methods.			Classes		1.00	auditorium
4	Foetus as an object of child delivery. Possibilities of fetal evaluation in labour.			Classes		1.00	auditorium
5	Beginning of labor.			Classes		1.00	METC
6	Labour periods. Labour I, II, III period management. Signs of placental abruption.			Classes		1.00	auditorium
7	Fetal waters.			Classes		1.00	METC
8	Biomechanism of delivery in case of frontal type of vertex delivery.			Classes		2.00	auditorium
9	Biomechanics of delivery in the case of the back of the head.			Classes		2.00	auditorium
10	The biomechanism of the anus			Classes		1.00	auditorium
11	Deflections lie down. The couple sleeps in front. Forehead. Face forward. Types of asynclitism.			Classes		2.00	auditorium
12	The help of the midwife's hands in removing the head and shoulders. Management of the placental period.			Classes		2.00	METC
13	Women's care in physiological childbirth. Possible involvement / cooperation of the labour partner. Family care after the loss of a child.			Classes		1.00	auditorium
14	Protection of the perineum during childbirth. Maternal ruptures. Episiotomy. Tear stitching.			Classes		1.00	auditorium
15	Evaluation of the course of labour. Current WHO guidelines. Friedman and Zhang labour curves.			Classes		1.00	auditorium
16	Non-pharmacological methods of labor analgesia. Labour postures. Water - labour..			Classes		1.00	auditorium
17	Conduction of placental period. History of labour - basic principles of documentation.			Classes		1.00	auditorium
18	CTG record.			Lectures		1.00	auditorium
19	Evaluation of CTG.			Classes		1.00	auditorium
20	Physiological birth (clinical situations and simulation).			Classes		2.00	METC
21	Fetal waters. Opening of the amniotic sac, possible complications. Fracture of the amniotic sac during pregnancy.			Classes		1.00	auditorium
22	Uterine dystocia, shoulder dystocia, fetal and maternal pelvic disproportion. (clinical situations and simulations)			Classes		1.00	auditorium
23	Preparation for operative labour, assistance, women and family care in their process. (situation tasks and simulation)			Classes		1.00	METC
24	Childbirth management tactics in cases of gestational diabetes, increased BMI and drug addiction.			Classes		1.00	auditorium
25	Pharmacological methods of analgesia in obstetrics.			Classes		1.00	METC
26	Healthy newborn. The Apgar score. Newborn transition period. Assessment of state of the newborn. Newborn primary resuscitation.			Classes		1.00	auditorium
27	Stress during childbirth; work with yourself, the woman, her partner and colleagues. Psychological hygiene in childbirth and ethics at midwife's work.			Classes		1.00	auditorium
Assessment
Unaided Work:
Get acquainted with the literature sources indicated in e-studies and course description for each specific practical lesson. Independent work and timely preparation, submission and successful completion. Timely and successful passing of the test. Independent training on simulators and mugs. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
Students' attendance (100% in classes is required) and active participation in classes will be evaluated (during remote classes, those classes are counted, during which the student is visible on camera and actively participates in the class), timely submitted and successfully evaluated independent works in e-studies, successful and a test passed on time. Students who have submitted independent works in e-studies within the specified deadlines, who have successfully assessed and successfully passed the test/-s, are admitted to pass the final examination (exam). At the end of the study course an exam with theoretical questions and situational tasks. The evaluation of the study course consists of: timely submitted and successfully evaluated independent and test papers in e-studies (50%), final test - exam (50%), receiving at least a passing grade in both sections.
Final Examination (Full-Time):		Exam
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		As a result of the completion of the study course, students gain understanding and are able to report on the following: • Foetus head peculiarities; • Hip planes and their sizes; • Progress of physiological delivery; • Delivery biomechanism in frontal and dorsal types of vertex delivery; • Delivery biomechanisms at foetus attitude of deflexion; • Biomechanism of breech position; • The graphic records of the delivery process and assessment possibilities of foetus antenatal state; • Complications caused by ineffective delivery techniques.
Skills:		As a result of the completion of the study course, students will know how to: • apply the terms used in obstetrics; • specify the foetus posture by pelvic examination; • explain the physiological process of delivery; • illustrate the foetal movement during normal delivery, foetal attitude of deflexion and at breech position; • illustrate graphically the process of delivery and assess foetus posture during delivery; • differentiate between ineffective delivery technique and physiological process; • take labour; • provide care for women and newborn during childbirth; • work with the woman and her birth partner.
Competencies:		As a result of the completion of the study course the students get understanding of physiological and pathological delivery process, know to illustrate graphically the delivery process, know to monitor the frontal and dorsal types of vertex delivery.
Clinical Skills:
No.	Skill					Level
1	Per speculum examination of cervix and vagina after birth.					C1 - High level
2	Administration of Medication by i/v Route using a Syringe with a Needle					B2 - Intermediate level
3	Administration of Medication using a PVC (System)					B1 - Basic level
4	Administration of Medication using a PVC (Syringe)					B1 - Basic level
5	Antenatal care planning according Republic of Latvia program					C1 - High level
6	Asking questions					B2 - Intermediate level
7	Assessing Apical pulse					A - Beginner level
8	Assessing Blood Pressure					B1 - Basic level
9	Assessing Peripheral Pulse					B1 - Basic level
10	Assessment of the health condition of the newborn					A - Beginner level
11	Bimanual pelvic (gynaecological) examination					A - Beginner level
12	Bimanual pelvic (gynaecological) examination					B1 - Basic level
13	Bimanual uterine examination					B1 - Basic level
14	Biochemical tests in clinical genetics. Biochemical screening for pregnancy.					C2 - Expert level
15	Blood components transfusion - Cryoprecipitate transfusion					A - Beginner level
16	Blood components transfusion - Cryoprecipitate transfusion					B1 - Basic level
17	Blood components transfusion - plasma					A - Beginner level
18	Blood components transfusion - plasma					B1 - Basic level
19	Blood components transfusion - Platelet mass transfusion					A - Beginner level
20	Blood components transfusion - Platelet mass transfusion					B1 - Basic level
21	Blood sampling					A - Beginner level
22	Blood sampling					B1 - Basic level
23	Building of newborn and infant feeding plan					C2 - Expert level
24	Detecting Respiratory Rate					A - Beginner level
25	Discrepancies					B2 - Intermediate level
26	Donati suture					B1 - Basic level
27	Donning and doffing of disposable gloves					A - Beginner level
28	Donning of surgical attire					B2 - Intermediate level
29	Donning Sterile Gloves					B1 - Basic level
30	Donning Sterile Gloves					B2 - Intermediate level
31	Due date estimation					B1 - Basic level
32	Encouraging					B2 - Intermediate level
33	Ensuring “skin-to-skin” contact with the newborn					C1 - High level
34	Evaluation of fetal heart tones					C1 - High level
35	Female perineal care					B1 - Basic level
36	Fundus uteri identification					A - Beginner level
37	Fundus uteri identification					B2 - Intermediate level
38	Fundus uteri measurement during pregnancy					C1 - High level
39	Glucosuria and ketonuria measurement					C2 - Expert level
40	High O2 concentrations masks					B1 - Basic level
41	Hygienic Hand Disinfection					B1 - Basic level
42	Hygienic Hand Washing					B2 - Intermediate level
43	Indwelling female catheterisation					B1 - Basic level
44	Insertion of Peripheral Venous Catheter					B1 - Basic level
45	Insertion of Peripheral Venous Catheter					B2 - Intermediate level
46	Installation of the face mask					C1 - High level
47	Intermittent female catheterisation					B2 - Intermediate level
48	Intradermal suture					B1 - Basic level
49	Intramuscular injection					B2 - Intermediate level
50	Leopold maneuvers					B2 - Intermediate level
51	Local infiltration anaesthesia					A - Beginner level
52	Local infiltration anaesthesia					B1 - Basic level
53	Low O2 concentration masks					B1 - Basic level
54	Management of physiological first labor					C1 - High level
55	Management of physiological second labor					C1 - High level
56	Microlax Enema					B1 - Basic level
57	Monitoring					A - Beginner level
58	Newborn primary resuscitation					A - Beginner level
59	Newborn primary resuscitation					B1 - Basic level
60	Oxygen supply providing by nasal prongs					B2 - Intermediate level
61	Percussion and palpation of bladder					A - Beginner level
62	Performing and interpretation of fetal CTG.					C1 - High level
63	Physiological labor					A - Beginner level
64	Physiological labor					B1 - Basic level
65	Physiological labor					B2 - Intermediate level
66	Planes of the pelvis					B2 - Intermediate level
67	Positioning of twins during breastfeeding					C1 - High level
68	Pregnant women’s blood pressure measurements					C1 - High level
69	Prevention of the postpartum haemorrhage (PPH)					A - Beginner level
70	Prevention of the postpartum haemorrhage (PPH)					B1 - Basic level
71	Prevention of the postpartum haemorrhage (PPH)					B2 - Intermediate level
72	Primary care of the neonate in physiological labor					A - Beginner level
73	Primary care of the neonate in physiological labor					B1 - Basic level
74	Primary care of the neonate in physiological labor					B2 - Intermediate level
75	Removal of personal protective equipment in case of health-related infections					B1 - Basic level
76	Simple interrupted skin suture					B1 - Basic level
77	Simple interrupted skin suture					B2 - Intermediate level
78	Structured history taking					A - Beginner level
79	Surgical Hand Disinfection					B1 - Basic level
80	The cord cutting					A - Beginner level
81	The cord cutting					B1 - Basic level
82	The cord cutting					B2 - Intermediate level
83	The use of personal protective equipment in case of health-related infections					B1 - Basic level
84	Urine Sampling for Clinical Examination					B1 - Basic level
85	Usage of blood glucose meter					A - Beginner level
86	Vaginal rupture suturing after childbirth					C1 - High level
87	Withdrawing Medication from a Vial into a Syringe					B1 - Basic level
88	Women’s examination per speculum					C1 - High level
89	Women’s rectovaginal examination					C1 - High level
Bibliography
No.	Reference
Required Reading
1	Dzemdniecība. D. Rezebergas redakcijā, 2016.
2	Simkin, Penny, et al. The Labor Progress Handbook : Early Interventions to Prevent and Treat Dystocia, John Wiley & Sons, Incorporated, 2017.
3	Snow S., Taylor K., Carpenter J. "Rapid midwifery". John Wiley & Sons, Incorporated, 2016.
4	Edwin Chandraharan. "Handbook of CTG Interpretation : from Patterns to Physiology". 2017.
5	Dudenhausen, Joachim W. Practical Obstetrics, 2014, De Gruyter, Inc.
Additional Reading
1	Lewis L. "Fundamentals of Midwifery : A Textbook for Students". John Wiley & Sons, Incorporated, 2015.
2	Davis E. "Heart and hands", Berkeley, 2012.
3	Raynor M. Marshall J. "Midwifery Practice : Critical Illness, Complications And Emergencies Case Book". McGraw-Hill Education, 2012
4	Maternal Newborn Nursing Care Plans / edited by Carol J. Green. 3rd edition. Burlington, MA : Jones & Bartlett Learning, 2016. ix, 472 lpp.
Other Information Sources
1	WHO recommendations: intrapartum care for a positive childbirth experience. 2018
2	http://www.medicalaidfilms.org/
3	Standards of Care for Women’s Health in Europe. 2014