METHODICAL INSTRUCTIONS
TO PRACTICAL LESSON VI YEAR STUDENTS FOR TEACHERS
FACULTY OF FOREING STUDENTS
LESSON 1 (PRACTICAL - 6 HOURS)
THEME 1: Physiology of pregnancy, labor, and postpartum period.
THEME 2: Perinatal care of the fetus.
THEME 3: Pharmacotherapy in obstetrics. Medical ethics and deontology.
Professional orientation of students: Each physician
should assist in physiological birth. So it must be able to ascertain their
origin, to assess progress, to know the methods of anesthesia, as well as own
methods of " perineal protecting manuvers." Biomekhanism delivery is
an important component of the maternity act. Ability to determine the progress
of the fetal head through the birth canal provides an estimate obstetric
situation and to use the event to correct deviations from the normal course of
labor. Proper diagnosis stage of labor, good management of their reduces
maternal and perinatal mortality, the number of puerperal complications.
Therefore, timely diagnosis, the correct decision on the mode of delivery, the
ability to provide expert assistance in childbirth is an important reserve for
reducing perinatal mortality, birth trauma.
On the mechanism of puerperal pain affects between subcortical violation
neurodynamic processes and the functional state of the cerebral cortex, as well
as individual characteristics of mothers, her emotional state to the future of
motherhood. All these features determine the need of an individual approach
with respect to pain relief during labor.
Postpartum is a very responsible due to the significant changes taking place at
this time in the genitals, breasts and all over the woman's body. Normal course
of uterine involution, lactation, and the general state of health of the woman
is highly dependent on proper treatment in the postpartum period. It is important
to diagnose early signs of complications of puerperium and prevent the disease.
Neonatal period is a very responsible transition from fetal to post-uterine
existence of the child's primary adaptation to environmental conditions.
Perinatal system of the fetus and newborn include the knowledge and ability to
identify factors risk to the fetus and newborn, their prevention , more
rational organization of prenatal care, if necessary, to improve it, successful
labor and providing adequate medical newborn care ¬ Nome.
Most important to the use of medicines (drugs) during pregnancy. A significant
number of complications during pregnancy, and often occurring extragenital
diseases require the use of drug therapy, sometimes multi. The main problem
with this drug therapy is to determine the correct ratio of the degree of the
risks and potential benefits of a particular drug.
Of particular importance in the medical profession acquire such universal
communication standards such as the ability to respect and listen carefully to
the interlocutor, to demonstrate the interesting in the content of
conversation and patient opinion, correct and affordability of the re-chi. Also
important and external tidy kind of medical personnel: a clean gown and cap,
removable shoes, manicured hands with short fingernails.
1.Methodology of Practical Class from 9.00 till 12.00.
THEME 1: Physiology of pregnancy, labor, and postpartum period.
Work 1. To make external obstetrical examination, auscultation of pregnant woman.
Work 2. Determine presence of labor activity, give its appreciation.
Work 3. Using case records draw parthogramme.
Work 4. Demonstrate perineum protection on phantom.
Work 5. To perform primary care of infant
Work 6. Appreciate presence of signs of placental separation .
Work 7. Calculation of hemorrhage in partum.
Work 8.Student under the guidance of a teacher is working with, conducts palpation of the uterus and mammary glands, and the toilet holds the newborn. Evaluate the postpartum period. Holds a conversation about health postpartum.
Work 9. Evaluation of fetal well-being, evaluation of the newborn according to Apgar score.
27. Classification of drugs according to their permeability through the placental barrier.
28 The meaning of the main ethical principle of medicine.
3. Seminar discussion of theoretical issues from 12.30-14.00 (90 minutes).
4. Test evaluation and situational tasks
1. How many points of biophysical profile is considered to be normal?
A – 1-2
B – 3-4
C – 5-6
D – 7- 8
E – 8 - 10
2. Cordocentesis – is:
A – puncture of amniotic sac
B - percutaneous umbilical blood sampling
C – skin sample
D – chorionic villus sampling
E – fetoscopy
3. Most important diameter of pelvis during labour is -
A. Interspinal diameter
B. Oblique diameter of inlet
C. AP diameter of oulet
D. Intertubercular diameter
E. none
5. Student's individual work from 14.15 till 15.00.
Students, who have not passed control in «MOODLE» system, should stay for individual work and write test control. Students work with thematic training tables, train in computer class, work with license examination test "KROK" and the department database tests, in-depth study of topics according to an individual study program, etc.
6. A student should know:
1. Definition of labor, causes of beginning partum, regulation of labor activity.
2. Biological readiness of organism to partum.
3. Forerunners of partum, preliminary period.
4. Changing in uterus (lower uterine segment, contractional ring), mechanism of opening neck of the uterus in primapara and multipara.
5. Clinical course of 1-th, 2-end, 3-d period of partum.
6. Peculiarities course of partum when there is multiple pregnancy.
7. Direction of 1-th, 2-end , 3-d period of partum
8. Signs of placental detachment.
9. External methods of ablation placenta.
10. Course and direction of postpartum period.
11. Peculiarities course and direction of partum when there are different variant of cephalic presentation.
12. Biomechanism of partum when there are different variant of cephalic presentation.
13. The principles of active management of the postpartum
period. Criteria and deadlines discharge from the hospital clinic. (Order ¹ 503
of 28.12.2002). 163 p.)
14. Anatomical and physiological characteristics of the neonatal period. Y and
feeding infants. Organization of the Department of newborns.
15. Determination of risk to the fetus by prenatal factors
16. Classification of drugs according to their permeability through the
placental barrier.
17. The meaning of the main ethical principle of medicine.
7. A student should be able:
1. To make external obstetrical examination.
2. Auscultative pappitation of fetus.
3. Determine presence of labor activity, give its appreciation, to put plan of delivery.
4. Motivate necessity of painless of labor, choose adequate methods of painless.
5. Using case records draw parthogramme.
6. Demonstrate perineum protection on phantom.
7. If the child born appreciates him by Apgar scale.
8. To make processing of umbilical cord on phantom.
9. Appreciate presence of signs of placental detachment.
10. Motivate necessity to use external methods of ablation placenta.
11. Look and appreciate afterbirth.
12. Calculation of hemorrhage in partum.
13. To show the biomechanism of childbirth (on a phantom).
14. To make a plan of delivery.
15. To manage the I period of childbirth, to reveal complications.
16. To substantiate indications for Cesarean section.
8. Correct answers of test evaluations and situational tasks
1. E, 2.B, 3.A.
9. References:
A – Basic: 1. Obstetrics. – Edited by Ventskivska. – Kyiv “Medicine” – 2008. – 336p.
2.Obstetrics and gynaecology. Williams & Wilkins Waverly Company. – Third Edition.-2001-980ð.
2. Essentials of obstetrics and gynecology. – W.B. Saunders Company. – Third edition – Neville F. Hacker, M.D., J. George More, M.D. – 737p.
B – Additional:
1. Order ¹ 503 from 28.12.2002 «Improvement of ambulatory obstetric-gynecological help».
2. Order ¹ 582 from 15.12.2003 «Clinical protocols from the obstetric and gynecological help».
3. Order ¹ 620 from 29.12.2003 «Organization of grant of stationary obstetric-gynecological and neonatal manuals».
4. Order ¹ 676 from 31.12.2004 «Clinical protocols from the obstetric and gynecological help».
5. Order ¹ 782 from 29.12.2005 «Clinical protocols from the obstetric and gynecological help».
6. Order ¹ 234 from 10.05.2007 «Instruction of organization bacteriological laboratories in the infectious checking system in obstetric permanent establishments».
7. Order ¹ 899 from 27.12.2006 «Breech presentations ».
8 Order ¹ 906 from 27.12.2007 the «Perinatal infections».
9. Order ¹ 901 from 27.12.2006 «Postdate pregnancy».
10. Order ¹ 900 from 27.12.2006 «Fetal distress at pregnancy and during births».
11. National program for prevention HIV- infection, treatment care and supporting HIV – patients in 2009-2013years – adopted 19.02.2009.
12. Order ¹ 716 from 14.11.2007 “Prevention of HIV transmission from mother to infant” .
13. National program “Bases of transplantology”
Methodical instruction was discussed and adopted at the Department sitting
27.05.2011. Minute ¹ 13
Methodical instruction was reviewed and adopted at the Department sitting
24.05.2012. Minute ¹ 13
Methodical instruction was discussed and adopted at the Department sitting
23.05.2013. Minute ¹ 10
Methodical instruction was adopted and reviewed at the Department sitting
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Methodical instruction was adopted and reviewed at the Department sitting
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Methodical instruction was adopted and reviewed at the Department sitting
__________20__. Minute ¹ __
Methodical instruction was adopted and reviewed at the Department sitting
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