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).