Curriculum standards
Knowledge guides
LG17: Obstetric medicine
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.
Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.
Presentations
- Abnormal blood results
- Cardiac murmur
- Changes to vision
- Constipation
- Contraception advice
- Cough
- Dizziness
- Dysglycaemia
- Dyspnoea
- Excessive gestational weight gain
- Facial droop
- Fatigue
- Fever
- Haematuria
- Headache
- Medication safety advice
-
Mental health presentations:
- anxiety
- birth trauma
- depression
- grief and bereavement
- psychosis
- suicidal ideation
- Nausea
- Oedema
-
Pain:
- acute
- chest
- chronic
- Palpitations
- Proteinuria
- Seizures
- Sensory disturbance
- Substance misuse
- Syncope
- Thrombocytopenia
- Vomiting
- Weakness
- Weight loss
Conditions
- Amniotic fluid embolism
- Anaemia
- Bell's palsy
- Carpal tunnel syndrome
-
Diabetes:
- gestational
- type 1
- type 2
- Gastro-oesophageal reflux
-
Hypertensive disorders:
- chronic
- eclampsia
- gestational
- haemolysis, elevated liver enzymes and low platelets (HELLP)
- pre-eclampsia
-
Infections:
- genitourinary tract
- skin and soft tissue
- upper and lower respiratory tract
- Intrahepatic cholestasis of pregnancy
- Pre-conception counselling
- Sepsis
- Thromboembolic disease
- Varicosities
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- for less common or more complex presentations and conditions the trainee must also seek expert opinions
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Pruritus
Conditions
- Autoimmune disease
- Cardiac disease
- Epidural complications
- Epilepsy
- Hyperemesis gravidarum
- Infections:
- chorioamnionitis
- cytomegalovirus (CMV)
- human immunodeficiency virus (HIV)
- listeria
- syphilis
- viral hepatitis
- Kidney failure
- Liver disease – gestational
- Medical complications of tocolytic therapy
- Mental health disorders:
- generalised anxiety disorder
- major depressive disorder
- postpartum psychosis
- post-traumatic stress disorder
- Meralgia paraesthetica
- Nausea and vomiting of pregnancy
- Ovarian hyperstimulation syndrome
- Thyroid disorders
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- for less common or more complex presentations and conditions the trainee must also seek expert opinions
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Contraception:
- alternatives to oestrogen-containing contraception, in the context of:
- hypertension
- liver disease
- thrombophilia
- thrombosis
- effects of contraception on medical disorders, such as:
- cardiac disease
- hypertension
- liver disease
- migraine
- previous thrombosis
- thrombophilia
- interactions between the oral contraceptive pill and other drugs, such as:
- antibiotics
- anticonvulsants
- alternatives to oestrogen-containing contraception, in the context of:
- Difference between normal altered physiology and disease states
- Pharmacology, such as:
- altered pharmacokinetics in pregnancy
- fetal effects of drugs
- risks of medications in pregnancy and lactation
- Physiology of a normal pregnancy, including changes and adaptations to:
- cardiovascular system
- electrolyte maintenance
- endocrine function
- hepatic function
- immunology of pregnancy
- kidney function
- other physiological factors
- respiratory function
- Range of normal symptoms experienced during pregnancy
- Widened range of normality for findings of physical examinations due to pregnancy
- Alterations in laboratory normal values imparted by pregnancy and the interpretation of the significance of abnormal tests:
- blood gases
- coagulation
- D-dimer
- electrocardiogram
- haemoglobin
- liver function tests (LFTs)
- platelets
-
serology, such as:
- CMV
- HIV
- listeria
- rubella
- syphilis
- toxoplasmosis
- varicella
- viral hepatitis
- thrombophilia bloods
- thyroid function tests (TFTs)
- urinalysis
- Impact of pregnancy on radiographic findings, such as kidney ultrasound
- Risks and benefits of radiological imaging in pregnancy and lactation to patients and other healthcare professionals
- Fetal implications of disease, such as thyroid disorders
- Impact of pregnancy on pre-existing medical disorders
- Long-term effects on maternal and paternal health following pregnancy complications
- Medical contributors to infertility
- Potential intrapartum and postpartum complications
- Pre-existing maternal and paternal medical disorders and their impact on pregnancy
General management considerations
- Consideration of clinical indications to determine patients’ needs, including comorbidities, and the most appropriate approach to investigations and care
- Consideration of the patient holistically, including cultural background, ethnicity, family and psychosocial support, geographic location, and socioeconomic status, and the considerations when managing and following up these patients, such as community-based decision making and travel from rural to metropolitan areas
- Cost, implications, and scope of healthcare-related adverse outcomes
- Family violence awareness and screening
- Goals of therapy
- Individual patient clinical indications to determine patients’ needs, including comorbidities, and the most appropriate approaches to investigations and care
- Informed consent
- Medication review and polypharmacy management
- Principles of trauma-informed, patient-centred care
- Relationship between primary care and specialist health services
- Role of allied health professionals in holistic care of patients and families affected by illness
- Tailoring treatment and management to the setting in which care is being provided, such as clinical and workforce resources