- Through history, examination, appropriate investigations and referrals, formulate a management plan (with the patient) for the following presentations:
- unplanned pregnancy: discuss non-directive counselling, the available termination of pregnancy options (medical and surgical) and the legal aspects of termination
- subfertility/infertility: discuss support services, ways to optimise fertility for males and females, when to refer and in vitro fertilisation (IVF) considerations (psychological support, legal aspects, etc).
- After completing a history and examination, conduct a pre-conception consultation, including a discussion of:
- genetic diseases and the available pre-conception tests
- screening and any ethical considerations
- managing chronic diseases prior to and during pregnancy
- preventive health, including advice about diet, supplements, medication, lifestyle, smoking, alcohol and substance avoidance, weight management and immunisations.
- After completing a history and examination, identify what needs to be covered in an antenatal consultation and include the following:
- confirming pregnancy
- identifying women who may need additional medical, social or cultural support
- managing routine pregnancy, including arranging investigations, screening tests and education about diet, lifestyle, supplements, immunisations, and delivery and care options
- managing normal symptoms of pregnancy, including physiological changes, nausea, vomiting, back pain and pubic symphysis pain
- managing (and referring if appropriate) minor intercurrent problems of pregnancy, including breast disorders, screening for gestational diabetes and infections during pregnancy (eg urinary tract infections, pelvic inflammatory disease, vaginal thrush)
- types of antenatal care (eg shared care, midwifery-led care, private versus public hospital care, rural models)
- types of delivery (vaginal birth – unassisted, vacuum and forceps; caesarean section).
- After completing a history and examination and arranging investigations (if appropriate), identify, and know when and where to refer, the following complications of pregnancy:
- bleeding in early pregnancy
- foetus small for gestational age
- ultrasound abnormalities
- premature labour
- deep vein thrombosis
- undocumented breech presentation.
- After completing a history and examination, identify, and know when and where to refer, the following emergencies in pregnancy, including:
- bleeding in early pregnancy (threatened miscarriage, miscarriage, ectopic pregnancy)
- bleeding after 20 weeks
- puerperal infection
- injury affecting pregnancy
- hypertension
- pre-eclampsia
- eclampsia
- premature labour
- mental health.
- After completing a history and examination, identify what needs to be covered in a 6-week postnatal consultation. Include the following:
- breastfeeding concerns: mastitis, breast pain, nipple trauma, thrush
- sleep issues
- mental health, including postnatal depression and psychosis
- screening for intimate partner violence
- deep vein thrombosis
- postpartum bleeding
- complications or perineal and abdominal (caesarean) wounds
- postnatal contraception
- cervical screening, if required
- advice on the need for babies to be checked.
- Be able to undertake the following procedures according to recognised best practice:
- female pelvic examination
- pelvic speculum examination, including cervical screening
- urine pregnancy testing
- collection of pathology specimens (vaginal swabs).
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