Academic Year 2024

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 1

 REPRODUCTION MODULE
Placement In the Curriculum 4th Module in 4th Year
Module Duration 4 Weeks
Pre-Requisite All Modules of 1st Spiral
SUPERVISED BY
DEAN FHMS / Principal IIMC Lt. Gen. Retd. Prof. Azhar Rashid HI(M)
Vice Principal IIMC Brig. Retd. Prof. Maqsood-ul-Hassan
Chairperson Curriculum Committee Prof. Saadia Sultana
MODULE TEAM
Module Director Prof. Saadia Sultana saadia.sultana@riphah.edu.pk
Module Coordinator Dr. Wajiha Shahdab wajiha.shadab@riphah.edu.pk
Module Co-coordinator Dr. Beenish Khurram beenish.khurram@riphah.edu.pk
CURRICULUM COMMITTEE
Chairperson Prof. Saadia Sultana saadia.sultana@riphah.edu.pk
Curriculum Committee
Prof. Obstetrics & Gynecology
Member Curriculum Committee Prof. Madiha Sajjad madiha.sajjad@riphah.edu.pk
Prof. of Pathology
Member Curriculum Committee Prof. Tahira Sadiq tahira.sadiq@riphah.edu.pk
Assoc. Prof. Comm. Medicine
Member Curriculum Committee Dr. Nighat Qamar nighat.qamar@riphah.edu.pk
Assoc. Prof. ENT
Member Curriculum Committee Dr. Uzma Naeem uzma.naeem@riphah.edu.pk
Assoc. Prof. Pharmacology
Member Curriculum Committee Dr. Wajiha Shadab wajiha.shadab@riphah.edu.pk
Assoc. Prof. OBGYN
Member Curriculum Committee Dr. Saddaf Ayub saddaf.ayub@riphah.edu.pk
Assist. Prof. Biochemistry
ACADEMIC TEAM
OBSTETRICS & GYNECOLOGY Prof. Fareesa Waqar
Prof. Saadia Sultana
Dr. Shumaila Sharif
Dr. Wajiha Shadab
Dr. Beenish Khurram
Dr. Sadaf Afzal

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 2

CHEMICAL PATHOLOGY Prof. Dr. Nadeem Akbar
Prof. Shazia Qayum
MICROBIOLOGY Prof. Shahina Yasmin
HISTOPATHOLOGY Prof. Samina Iltaf
Prof. Madiha Sajjad
MEDICINE Brig. Retd. Prof. Muhammad Farooq
Prof. Asim Zulfiqar
Dr. Shamaila Burney
Dr. Samia Kausar
Dr. Kiran Fatima
PHARMACOLOGY Brig. Retd. Prof. Akbar Waheed
Dr. Uzma Naeem
COMMUNIYY MEDICINE Prof. Ayaz Bhatti
Prof. Tahira Sadiq
Dr. Shahzad Akhtar Aziz
Dr. Nadia Zohair

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 3

 INTRODUCTION/ RATIONALE
Gynecology and Obstetrics marks the beginning of life. The medical graduates should have
a sound knowledge of pathogenesis, clinical presentation, investigations, and
management of all the diseases related to the reproductive system. This module aims to
provide students with the opportunity to recall essential knowledge of anatomy,
physiology as well as the pathological processes involving the female genital tract and
fertility related female /male issues. It intends to give an elaborative insight into
fertilization, pregnancy, labor & puerperium, and their problems.
The student will understand & apply the concepts & principles of the basic sciences in the
diagnosis of commonly occurring diseases afflicting genital tract and will be able to
outline the principles of management. Possessing knowledge skill and attitude of
gynecology and obstetrics is the essence for intelligent and safe clinical practice including
understanding and management of problems and acute life-threatening emergencies.

OUTCOMES
By the end of the module the student should be able to:
Knowledge
• Distinguish obstetrics & gynecology jargons with their appropriate usage.
• Describe common clinical gynecological and obstetrical conditions based on their
background basic sciences’ knowledge.
• Outline the management plan of common gynecological conditions.
• Delineate a prenatal, intrapartum & postnatal management plan for normal
Pregnancy
• Outline a prenatal, intrapartum & postnatal management plan for high-risk
pregnancies.
• Formulate a problem-solving approach for various obstetrical emergencies.
• Explain the important clinical aspects of gynecological problems while adopting a
problem-solving approach.
• Outline of management of gynecological issues specially their impact on daily life
Skills
• Perform OBS/Gyn emergency drills while keeping in mind the steps of basic life

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 4

 support
• Interpret and manage normal and abnormal cardiotocographs and portograms
• Demonstrate mechanism of normal labor on dummy.
• Identify and manage malposition and malpresentations during labor.
• Identify the gross and histological features of common female genital tract tumors
• Perform identified obstetrical/gynecological procedures according to checklists
keeping in mind the mnemonics
Attitude
• Demonstrate effective communication skill strategies.
• Display the professional attitude of altruism, compassion, honesty, and integrity in
relationships with patients, families, communities, & the medical professionals.
• Demonstrate team building through effective participation in collaborative problem-
solving sessions (especially in small group exercises directed towards understanding
of the obstetric & gynecological disorders).

TABLE OF CONTENT

Block 1 Early Pregnancy

Block 2 Antenatal
Block 3 Labor
Block 4 Menstrual Disorders
Block 5 Fertility
Block 6 Gynaecological Neoplasia

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 5

 Topic Discipline Learning Objective Teaching Assessment
Strategy Tool
BLOCK A: EARLY PREGNANCY
Miscarriage OBGYN • Define Miscarriage Interactive MCQ
• Compare clinical features of Lecture
different types of miscarriages.
• Formulate a management plan
for various types of
miscarriages.
Ectopic OBGYN • Discuss differential diagnosis of CBL MCQ
Pregnancy first trimester lower abdominal
pain & vaginal bleeding.
• Correlate risk factors of ectopic
pregnancy with its
pathophysiology.
• Formulate a management plan
for a patient with ectopic
pregnancy
Gestational Pathology • Compare different gestational Interactive MCQ
Trophoblastic trophoblastic diseases based Lecture
Disease on their clinical presentation
(GTD) and morphological features
• Identify the underlying
cytogenetic abnormalities of
the molar pregnancy occurring
during fertilization
Gestational OBGYN • Correlate clinical features of Interactive MCQ
Trophoblastic GTD with its pathogenesis Lecture
Diseases • Choose the investigations
(GTD) essential for the diagnosis and
follow up of patient of molar
pregnancy & choriocarcinoma
• Formulate a management plan
for molar pregnancy and
choriocarcinoma
Prenatal OBGYN • Describe the importance of Interactive MCQ
Diagnosis prenatal diagnosis. Lecture
• Identify the indications for
prenatal diagnosis.
• Compare the non-invasive and
invasive fetal tests.
Neural Tube OBGYN • Correlate types of neural tube CBL MCQ
Defects defects with the developmental
(NTD) stages of neural tube
development

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 6

 • Identify various neural tube
defects on a given
specimen/photograph.
• Describe the significance of folic
acid in the prevention of NTD.
• Develop a management plan for
anencephaly
BLOCK B: ANTENATAL
Antenatal OBGYN • Discuss the importance of early CBL MCQ
Care booking and regular visits in
antenatal care.
• Develop an antenatal plan of
care on the antenatal card for a
pregnant lady
• Discuss the significance of
multidisciplinary care in high-
risk pregnancies
Fetal Growth OBGYN • Differentiate between Intra Interactive MCQ
Restriction Uterine Growth Restriction and Lecture
(FGR) Small for Gestational Age
(IUGR/ SGA).
• Compare symmetrical and
asymmetrical fetal growth
restriction based on etiology,
risk factors and complications
• Justify the merits and demerits
of different screening methods
for identification of FGR
• Formulate a management plan
for SGA fetus
Obstetric OBGYN • Perform obstetric abdominal Skill Lab OSCE
Abdominal examination demonstrating:
Examination ➢ Inspection
➢ Symphysio-fundal height
measurement
➢ Fundal grip
➢ Lateral grip
➢ Pawlik’s grip
➢ Bimanual pelvic grip
➢ Fetal heart auscultation
• Articulate findings of
abdominal examination
Rh OBGYN • Identify the risk factors and Interactive MCQ
Incompatibility complications Lecture

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 7

 • Correlate clinical features of Rh
isoimmunization with its
pathogenesis
• Outline management plan of
Rh isoimmunization in
pregnancy
Propose the preventive measures
to be taken for Rh
incompatibility
Fetal OBGYN • Compare different modes of Interactive MCQ
Surveillance fetal surveillance (FKC, CTG, Lecture
BPP, Fetal biometry and
Doppler ultrasonography)
based on their merits &
demerits
➢ Describe the four main
characters of CTG
➢ Identify the abnormality & its
cause in each of the character
➢ Describe the components of
biophysical profile.

Anemia in OBGYN • Define anemia in pregnancy Interactive MCQ

Pregnancy • Differentiate between Lecture
different forms of anemia
• Correlate the pathophysiology
of anemia in pregnancy with
the maternal & perinatal
complications
• Describe the preventive
measures that can be adopted
• Outline the management plan
for prenatal, intra-partum&
postnatal care of such patients.
Hypertensive OBGYN • Differentiate between PIH, Pre- Interactive MCQ
Disorders of eclampsia and eclampsia Lecture
Pregnancy • Correlate the pathophysiology
with clinical features
• Justify the investigations
required.
• formulate the management
plan of a patient with pre-
eclampsia

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 8

Complications OBGYN • Discuss the complications of CBL MCQ
of hypertensive disorders of
Hypertensive pregnancy
Disorders of • Justify the investigations
Pregnancy required in Eclampsia
• Construct the management
plan of Eclampsia
Labwork and Chemical • Explain the pathophysiology of Interactive MCQ
Diagnosis of Pathology GDM Lecture
Diabetes in • Propose a lab investigation
Pregnancy plan for the screening,
diagnosis and follow up of
gestational diabetes mellitus
• Explain the protocol of 75 g
OGTT for the diagnosis of GDM
including procedure and its
interpretation
Diabetes in OBGYN • Identify the risk factors for Interactive MCQ
Pregnancy gestational diabetes mellitus Lecture
(GDM)
• Correlate the maternal and
fetal complications with the
pathophysiology of gestational
diabetes
• Describe the various
approaches to screen for
gestational diabetes
• Formulate a management plan
for a patient with gestational
diabetes
Antepartum OBGYN • Differentiate abruptio CBL MCQ
Hemorrhage placentae from placenta previa
(APH) clinically
• Identify the risk factors for APH
• Correlate the pathophysiology
with complications of abruptio
placentae/placenta previa
• Develop an algorithm (flow
chart) of management of APH
Multiple OBGYN • Compare the Zygosity of twins Interactive MCQ
Pregnancy • Identify the predisposing factor Lecture
for multiple pregnancy
• Correlate the clinical
presentation with the
physiological changes

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 9

 • Describe the Feto-maternal
complications
• Justify the investigations
required during management
• Formulate a management plan
for a patient with multiple
pregnancy
Vertically Microbiology • Classify the microbes causing Interactive MCQ
Transmitted vertically transmitted Lecture
Infections infections with the diseases
caused by these.
• Relate the morphological and
biochemical characteristics
with the Lab diagnosis of
Listeria Monocytogenes
• Relate the pathogenesis of
Listeria Monocytogenes with
clinical features of diseases
caused.
• Describe the important
characteristics of Toxoplasma
gondii.
• Relate the pathogenesis of
Toxoplasma gondii with clinical
features of diseases caused.
• Diagnose Toxoplasma gondii
infections with the help of
various tests
• Compare the important
characteristics of Cytomegalo
and Parvo Viruses
• Relate the pathogenesis of
Cytomegalo Virus with clinical
features of diseases caused.
• Relate the pathogenesis of
Parvo Virus B19 with clinical
features of diseases caused.
• Differentially diagnose
Cytomegalo Virus and Parvo
Virus infections with the help
of various tests
Vertica- OBGYN • Describe the feto maternal Interactive MCQ
Transmission effects of vertically transmitted Lecture
of Infection infections
(VTI)

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 10

 • Correlate the importance of
gestational age with the
consequences of VTI
• Compare the consequences of
VTI in immune/nonimmune
lady
• Justify the importance of
preventive measures
Teratogenesis OBGYN • Differentiate between the Interactive MCQ
teratogenic effects caused by Lecture
TORCH infections & drugs
(alcohol/thalidomide)
highlighting the importance of
timing of exposure.
BLOCK C: LABOR
Labour & OBGYN • Define labor and its stages CBL MCQ
Partogram • Describe the mechanism of
normal labor
• Interpret the CTG & partogram
of a laboring patient
Preterm Labor OBGYN • Identify factors predisposing to Interactive MCQ
& Preterm preterm labor Lecture
Pre- Labor • Describe the diagnostic criteria
Rupture of of PTL & PPROM
Membranes • Outline the management plan
(PTL for preterm labor
& PPROM) • Compare risks and benefits of
expectant management versus
immediate delivery
• Outline the methods for
fetomaternal assessment
during expectant
management.
Uterine Pharmacology • Classify drugs that effects Interactive MCQ
Relaxants uterine contractility based on Lecture
& Uterine their mechanism of action.
Stimulants • Select and justify the use of
these drugs in different clinical
situations.
• Compare the safety profile of
these drugs.
1st Stage of OBGYN • Describe the phases of first Interactive MCQ
Labour and Its stage of labor Lecture
Problems • Describe the abnormalities of
first stage.

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 11

 • Construct the management
plan according to the type of
abnormality and its cause
• Describe the maternal & fetal
complications resulting from
abnormal labor
2nd Stage of OBGYN • Describe the phases of second Interactive MCQ
Labour and Its stage of labor Lecture
Problems • Describe the abnormalities of
second stage of labor
• Identify obstructed labor
• Outline a management plan of
second stage and its problems
Shoulder OBGYN • Diagnose shoulder dystocia SKILL LAB OSCE
Dystocia • Demonstrate the delivery of a
baby with shoulder dystocia
keeping the mnemonic
“HELPERR” in mind
-including the following
maneuvers on a dummy
• Describe the 3rd line
maneuvers
Malposition / OBGYN • Identify various Flipped MCQ
Malpresentati malpresentations/ malposition classroom
ons • Discuss the associated
complications
• Outline a management plan for
various malposition/
malpresentations
Assisted OBGYN • Identify Breech presentation Skill Lab OSCE
Vaginal • Demonstrate types of breech
Breech presentation on a mannequin
Delivery • Demonstrate the steps of
(AVBD) AVBD (mnemonic- BE
CAREFUL) including the
following maneuvers’:
➢ Pinnard
➢ Louvsetts
➢ Maurice Smellie Veit
➢ Burn Marshall
Instrumental OBGYN • Discuss the pre-requisites of SKILL LAB OSCE
Delivery operative vaginal delivery
• Compare the indications &
contra-indications for ventose
and forceps delivery

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 • Demonstrate the steps of
application of vacuum &
forceps (mnemonic A to J)
Episiotomy OBGYN • Discuss the prerequisites of Skill Lab OSCE
episiotomy repair
• Demonstrate the steps of
episiotomy repair including the
following:
• Selection of suture material
and instruments
• Layer repair technique
• Counsel a recently delivered
patient regarding care of
episiotomy
3rd Stage of OBGYN • Describe the third stage of Interactive MCQ
Labour labor Lecture
• Compare the physiological/
active management of third
stage
• Describe the active
management of 3rd stage in
various clinical scenarios
Problems of OBGYN • Describe the problems of 3rd Interactive MCQ
3rd Stage of stageof labor Lecture
Labour • Outline the management of
third stage of labour
• Define Postpartum
hemorrhage
• Categorize the causes of PPH
• Develop an algorithm for the
management of PPH
Obstetric OBGYN • Describe on a diagram the Interactive MCQ
Trauma various tissues incised in an Lecture
episiotomy
• Differentiate the degrees of
perineal tears
• Outline the indications &
principles of repair/ care of
episiotomy & perineal tears
Safe Community • Differentiate between Interactive MCQ
Motherhood Medicine maternal mortality rate and Lecture
& Maternal ratio.
Mortality • Describe application of WHO
Statistics strategies for safe motherhood
in Pakistan.

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 13

 • Compare the demographic
indicators of maternal
mortality in Pakistan with
developed countries.
• Identify the risk factors for
maternal mortality.
• Describe the medical, social
and lifestyle related Risk
factors for maternal mortality
Maternal OBGYN • Differentiate between Interactive MCQ
Mortality & maternal mortality & near miss Lecture
Morbidity • Describe the causative factors
in Pakistan
• Describe steps to reduce it by
addressing the 3 delays
BLOCK D: MENSTRUAL DISORDERS
Menstrual OBGYN • Compare amenorrhea & Interactive MCQ
Irregularities oligomenorrhoea based on Lecture
(Oligo/Ameno underlying etiology and clinical
rrhe A) presentation
• Develop an algorithm (flow
chart) of clinical assessment of
such patients
• Develop a management plan to
treat common causes (thyroid
disease, hyperprolactinemia,
premature menopause,
outflow obstruction)
• Describe the effects of lifestyle
modifications in the treatment
of menstrual disorders.
Pelvic OBGYN • Demonstrate the steps of Skill Lab OSCE
Examination pelvic examination on
dummy/patient including:
➢ Inspection
➢ Speculum examination
➢ Bimanual pelvic examination
Prolactin Pharmacolo • Enlist prolactin antagonists. Interactive MCQ
Antagonists gy • Relate the pharmacological Lecture
actions of these drugs with
their clinical uses and adverse
effects.
• Describe the contraindications
of these drugs.
Heavy OBGYN • Differentiate between HMB Interactive MCQ
Menstrual and AUB Lecture

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 14

Bleeding • Describe DUB
(HMB) • Describe the differential
/Abnormal diagnosis for HMB & AUB in
Uterine various age groups
Bleeding • Justify investigations required
(AUB) in HMB & AUB
• Develop an algorithm for the
management of HMB and AUB
Endometrial Pathology • Differentiate the benign Interactive MCQ
Disease structural and functional Lecture
endometrial disorders based
on, patient age and
morphological features in
patients presenting with
abnormal uterine bleeding.
• Relate the clinical and
morphological features of
diseases with ectopic
endometrial tissue
(Endometriosis and
adenomyosis).
• Relate the enteropathogenic
mechanisms of endometrial
hyperplasia and endometrial
carcinoma with abnormal
uterine bleeding.
• Differentiate between
endometrial hyperplasia and
types of endometrial
carcinoma based on
pathogenic mechanisms and
morphological features.
Chronic Pelvic OBGYN • Categorize the gynecological CBL MCQ
Pain and and non-gynecological causes
Dysmenorrhe of chronic pelvic pain
a • Differentiate between primary
and secondary dysmenorrhea
• Describe the principles of
management of endometriosis
• Describe the effects of lifestyle
modifications in the treatment
of endometriosis.
• Correlate the complications of
endometriosis with
pathophysiology
• Define dysmenorrhea

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 15

 • Outline the principles of
management of dysmenorrhea
Synthetic Pharmacology • Relate the mechanism of Interactive MCQ
Preparations action of synthetic Lecture
of Gonadotrophic hormones with
Gonadotropic their:
Hormones ➢ Pharmacological actions
➢ Clinical uses
➢ Adverse effects
Menopause & OBGYN • Define menopause Interactive MCQ
its Problems • Correlate pathophysiology of Lecture
menopause with the clinical
features.
• Formulate a management plan
for complications of
menopause.
Female Sex Pharmacology • Classify synthetic preparations Interactive MCQ
Hormones of estrogen and progestins Lecture
based on their mechanism of
action.
• Relate the pharmacological
actions of these hormonal
preparations with their clinical
uses and adverse effect.
BLOCK E: FERTILITY
Family Community • Differentiate between family Interactive MCQ
Planning Medicine planning, CPR, eligible couple, Lecture
and target couple
• Relate objectives of family
planning with its scope.
• Describe the effects of lifestyle
modifications in the treatment
of endometriosis.
• Describe health aspects of
family planning
• Identify contraceptive
methods along with its
advantages and disadvantages.
Contraception OBGYN • Categorize methods of Interactive MCQ
contraception Lecture
• Compare and contrast
different methods of
contraception based on their
mechanism of action, duration,
efficacy, failure rates and
appropriateness

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 16

Hormonal Pharmacology • Classify hormonal Interactive MCQ
Contraceptive contraceptives based on their: Lecture
s ➢ Route of administration
➢ Therapeutics
• Relate the mechanism of
action of hormonal
contraceptives with their
clinical uses.
• Compare the safety profile of
different classes of hormonal
contraceptives.
• Describe the contraindications
of hormonal contraceptives.
Poly Cystic OBGYN • Describe the Rotterderm’s Interactive MCQ
Ovarian criteria for diagnosis of PCOS Lecture
Syndrome • Correlate the pathophysiology
of PCOS with clinical
presentation.
• Justify investigations required
for PCOS
• Outline a treatment plan
according to clinical
presentation
• Describe the associated
complications
• Devise a management plan of
complications of PCOS
Lab Work and Chemical • Propose a plan for the lab Interactive MCQ
Diagnosis of Pathology diagnosis of primary infertility Lecture
Infertility and • Select and justify the
Poly Cystic biochemical lab tests used for
Ovarian the diagnosis of PCOS
Syndrome • Relate the etiopathogenesis of
PCOS with its clinical features
• Explain the significance of
biochemical lab tests used for
the diagnosis of PCOS
Androgens & Pharmacology • Enumerate different androgen Interactive MCQ
Anti- and anti-androgen Lecture
Androgens preparations.
• Relate the pharmacological
actions of these drugs with
their clinical uses and adverse
effects.
Subfertility OBGYN • justify the need to investigate Interactive MCQ
infertility in a married couple Lecture

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 17

 • Correlate the causes with the
required investigations
• Justify the appropriate timing
for different investigations
• Outline the treatment plan
according to etiology
• Describe the role of
laparoscopy in the
management
• Describe the effects of lifestyle
modifications in the treatment
of infertility.
Estrogen & Pharmacology • Classify estrogen and Interactive MCQ
Progestin progesterone antagonists Lecture
Antagonists therapeutically.
• Relate their pharmacological
actions with their clinical uses
and adverse effects.
Sexually Microbiology • Classify the microbes causing Interactive MCQ
Transmitted genital tract and sexually Lecture
Infections-I transmitted infections and
diseases
• Relate the important
characteristics of Treponema
pallidum with Lab diagnosis by
various tests
• Relate the pathogenesis of
Treponema pallidum with
clinical features of diseases
caused by it.
• Describe the important
characteristics of Human
Papilloma virus
• Correlate the pathogenesis of
Human Papilloma virus with
clinical features of diseases
caused by it.
• Diagnose Papilloma virus
infection with the help of
various tests
Sexually Community • Describe epidemiology and Interactive MCQ
Transmitted Medicine mode of transmission of STDs Lecture
Diseases-II • Discuss interventional
strategies in all levels of STDs
prevention.

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 18

 • Describe the effects of lifestyle
modifications on sexual health.
Sexually OBGYN • Categorize the organisms Interactive MCQ
Transmitted causing STI Lecture
Diseases-III • Describe the risk factors for STI
• Describe the associated
complications
• Formulate a management plan
of STI
Chlamydiae Microbiology • Classify the important Interactive MCQ
Species pathogenic species of Lecture
Chlamydiae genus
• Relate the important
characteristics with Lab
diagnosis of Chlamydiae
infections by various tests
• Correlate the pathogenesis
with clinical features of
infections caused by
Chlamydiae species
Pelvic OBGYN • Correlate clinical features with Interactive MCQ
Inflammatory the pathogenesis of PID Lecture
Disease • Describe the associated
complications
• Outline the management plan
of a patient with PID
Vaginal OBGYN • Classify the causes of vaginal Interactive MCQ
Discharges discharge Lecture
• Correlate the patho-
physiology, with the clinical
features of various types of
vaginal discharge
• Summarize methods of
diagnosis of various types of
vaginal discharge
• Formulate the management
plan
• Describe the gynecologic and
obstetric complications of
bacterial vaginosis
HIV and Aids Medicine • Enlist Risk factors for HIV Interactive MCQ
transmission Lecture
• Differentiate stages of HIV
based on clinical features

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 19

 • propose diagnostic workup of
AIDS
• Formulate the treatment plan
for AIDS
Aids Community • Describe epidemiology and Interactive MCQ
Medicine mode of transmission of AIDS Lecture
• Describe the preventive
strategies of AIDS
BLOCK F: GYNAECOLOGICAL NEOPLASIA
Fibroid Uterus OBGYN • Compare different types of CBL MCQ
fibroids based on their
location, clinical presentation,
and complications
• Identify the risk factors for
uterine fibroids
• justify the investigations for
fibroid uterus
• Choose between conservative
and surgical treatment option
and justify your selection
• Develop the management
protocol for a patient with sub-
fertility and fibroid uterus
Malignant OBGYN • Describe the risk factors Interactive MCQ
Tumors of • Describe the clinical Lecture
Uterus presentations
• Describe the role of
endometrial sampling and
hysteroscopy in its
management
• Outline the management plan
for endometrial carcinoma
according to the stage of the
disease
Cervix Pathology • Discuss the role of HPV in Interactive MCQ
(Cervical causing cervical intraepithelial Lecture
Intraepithelial neoplasia and cervical
Neoplasia) carcinoma.
• Compare the premalignant and
malignant cervical lesions
based on their morphological
features.
Pre-Invasive& OBGYN • Describe the risk factors and Interactive MCQ
Malignant clinical features of pre- Lecture
Disease of
Cervix

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 20

 invasive& malignant disease of
cervix
• Describe the role of cervical
smear and colposcopy in the
management cervical cancer
• Outline the principles of
management according to the
stage of the disease
• Enlist the complications of
radiotherapy
Pap Smear OBGYN • Describe the pre-requisites of SKILL LAB OSCE &
taking a pap smear MCQ
• Identify the squamo-columnar
junction on a model
• Demonstrate the steps of
taking a pap smear
• Prepare the slides for cytology
• Demonstrate the steps of
dispatching the smear slides
for cytological examination
Ovarian Pathology • Relate different benign and Interactive MCQ
Tumors malignant ovarian tumors with Lecture
patient age, clinico-
morphological features, and
tumor markers
Benign & OBGYN • Describe the clinical features of Interactive MCQ
Malignant ovarian tumor Lecture
Tumors of • Describe the screening and
Ovary diagnostic modalities
• Formulate a management plan
according to the type and stage
of the disease
• Enlist the complications of
chemotherapy
Neoplasia of Pathology • Identify common genital tract SGA OSPE
the Genital abnormalities / diseases on
Tract image:
➢ cervical neoplasia
➢ endometrial carcinoma
➢ Adenomyosis
➢ Leiomyoma
➢ Serous cystadenoma/
carcinoma
➢ Mucinous cystadenoma/
carcinoma
➢ Teratoma

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 21

 ➢ Thecoma
➢ Molar tissue
• Justify your findings based on
morphologic features

TEACHING HOURS
KNOWLEDGE SKILL
INTERACTIVE SGD SGA SKILL LAB
SUBJECTS FLIPPED TOTAL
LECTURE /CBL
CLASSROOMS HOURS

No. Hours (2) No. Hours (2) No.

OBGYN 31 8 0 0 7 14 1 54
COMMUNITY 4 0 0 0 0 0 0 4
MEDICINE
PHARMACOLOGY 7 0 0 0 0 0 0 7
PATHOLOGY 4 0 1 2 0 0 0 6
CHEMICAL 2 0 0 0 0 0 0 2
PATHOLOGY
MICROBIOLOGY 3 0 0 0 0 0 0 3
MEDICINE 1 0 0 0 0 0 0 1
LIFE AND LIVING 4 0 0 0 0 0 0 4
TOTAL HOURS 56 8 1 2 7 14 1 81

LEARNING RESOURCES

Gynecology Gynecology by Ten Teachers, 20th edition

Obstetrics Obstetrics by Ten Teachers, 20th edition
Community Textbook of Preventive and Social Medicine by K. Park
Pharmacology
Medicine Katzung & Lippon WH Latest Edition
Pathology Pathologic Basis of Disease by Robbins And Cotran, 9th Edition
Medicine Davidson’s Principles and Practice of Medicine, 20th Edition, Chapter 14

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 22

 CHECK LIST FOR PATHO IMAGE SESSION
At the end of session student should be able to;
1. Identify the tissue. name 2 points of identification
2. Describe the gross morphological changes in the structure
3. Name the pathological term given to the macroscopic
appearances
4. Describe the microscopic appearance
5. Draw /sketch and label the diagram
6. Name main types of cells in the given photomicrograph
7. Name the pathological name for the disease process seen in
photomicrograph
8. Correlate with signs and symptoms produced by pathological
process.
9. Name the most likely diagnosis, justify your answer.
10. At what age is this disease process commonly encountered?
11. Enlist the investigation which will support your diagnosis

OBSTETRIC ABDOMINAL EXAMINATION- CHECKLIST Marks

• Makes Rapport with the patient
• Greets the patient 0.25
• Introduces self to the patient 0.25
• Explains the procedure to the patient 0.25
• Takes informed verbal consent from the patient 0.25
• Enquires about voiding 0.25
PERFORMS INSPECTION OF ABDOMEN CORRECTLY ON A SUBJECT/MODEL
• Helps patient in proper exposure 0.25
• Makes proper position for examination 0.25
• Spends at least 30 seconds in observing the abdomen from foot end &/or side of
the bed.
• Comments regarding 0.25
• Shape of abdomen. 0.25
• Symmetry of abdomen. 0.25
• Localized / General, (distention, swelling) 0.25
• Position and shape of umbilicus 0.25
• Movement of abdominal wall 0.25
• Visible fetal movements 0.25
• Visible Pulsation 0.25
• Presence of Scar / Striae 0.25
• Presence of prominent superficial viens 0.25
• Pigmentation / De-pigmentation of abdominal wall 0.25
• Presence of Hernias 0.25
PERFORMS PALPATION OF ABDOMEN CORRECTLY ON A SUBJECT/MODEL
• Steps
• Tells the patient to relax 0.25
• Enquires about the site of pain 0.25
• Makes her hands warm before palpation (in cold weather) 0.25
• Positions her wrist and forearm in the horizontal plane while palpating abdomen 0.25
0.25

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 23

 • Makes superficial palpation in all nine quadrants of abdomen correctly looking at 0.25
face of patient
OBSTETRIC EXAMINATION
• Measures SFH in centimeters 1.5
• Places both hands correctly on the side for fundal grip 0.25
• Places both hands correctly on the side with fingers pointing towards the rib for 0.5
lateral palpation.
• Demonstrates Pollick’s grip 0.5
• Demonstrates bimanual pelvic grip 0.5
AUSCULTATION OF FETAL HEART SOUNDS
• The fetoscope should be placed on anterior fetal shoulder along with the palpation 1.0
of maternal radial pulse for 1 minute
CLOSING THE SESSION
• Thanks the patient 0.25
• Covers the patient back 0.25
• Tells her to lie in left lateral position 0.25
• Keeps count of fetal movements 0.25

Roll No
VACUUM DELIVERY – Checklist Total Marks 10
(Many of the steps can be performed simultaneously)
GETTING READY 3
1. Prepare and test the necessary equipment
2. Explain the whole procedure to the patient and get an informed
verbal consent
3. Provide continual support and reassurance during the whole
procedure
4. Review and ensure the following conditions for vacuum
application
a. Vertex presentation
b. Term fetus
c. Fully dilated cervix
d. Head at 0 station or no more than 1/5 palpable above
pubic symphysis
5. Make sure an assistant is available
PRE-PROCEDURE TASKS 2
6. Wash hands with antiseptic solution and wear sterile gloves
7. Clean vulva with antiseptic solution
8. Empty the bladder or catheterize if necessary
9. Check all connection on extractor and test the vaccum on the
gloved hand
VACUUM EXTRACTION 5
10. Assess the position of the fetal head by checking sagittal suture
line and the fontanalle
11. Identify the posterior fontanalle
12. Apply the largest cup that will fit, with the center of the cup
over the flexion point, 1 cm anterior to the posterior fontanalle
13. Check the application for any maternal soft tissue within the
rim of the cup. If any release the cup and reapply
14. Ask the assistant to create vaccum of 0.2kg/cm2 negative
pressure with the pump and check the cup.
15. Increase the vacuum to 0.8kg/cm2 negative pressure and check
application of the cup. Do not exceed 600 mm of Hg in red zone.

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 24

 16. After maximum negative pressure has been applied, start
traction in the line of pelvic axis perpendicular to the cup.
17. With each contraction apply traction
a. Place finger of the non dominant hand on the scalp next to
the cup during traction to prevent potential slippage and
descent of the vertex.
b. Do not pull between contractions
18. Between each contraction check
a. Fetal heart rate
b. Application of cup
19. With progress and in the absence of fetal distress, continue the
“guiding” pulls for a maximum of 30 mins (2 pulls).
20. We can perform the Episiotomy for the application of the cup
or we can perform it when the head stretches the vulva
21. When the head delivers, release the vacuum, remove the cup
and deliver the newborn’s body.
22. Clamp and cut the cord
23. Hand over the baby to the pediatrician
24. Perform active management of the third stage of labor
a. Give 10 IU of oxytocin intramuscularly
b. Perform controlled cord traction
c. Massage uterus
25. Check birth canal for any tears and repair if required
26. Repair the Episiotomy if one was performed
27. Give immediate postpartum and new born care
28. If the cup and tubing are reusable, decontaminate it with 0.2%
chlorine solution for 10 minutes.
29. Record procedure and findings on the women record.

Roll No
FORCEPS DELIVERY – Check list Total Marks 10
1. Calls for help (Senior, anesthetist, peadiatrition, all on floor) 0.5
2. Takes informed verbal consent 0.5
3. Advises lithotomy position, left tilt, pull to edge of table 1
4. Fulfills the prerequisites 2
a. Presenting part 0/5
b. Bladder Empty
c. Analgesia / Anesthesia
d. Cervix fully dilated
e. Membranes absent
5. Ascertain position of P/P 0.5
6. Checks forceps are a pair 0.5
7. Lubricates the forceps 0.25
8. Applies when uterus relaxed, in between contractions 0.25
9. Applies left blade first, with the left hand guiding the blade in, 0.5
while the right hand protects the maternal soft tissue
10. Applies the right blade similarly 0.5
11. Checks the blades lock together easily 0.5
12. Applies traction during a contraction following the pelvic curve, 0.5
using Pajot’s maneuver
13. Episiotomy should be given at the time of crowning 0.5
14. Assistant should apply perineal support 0.5
15. Check for genital trauma and repair if needed 0.5

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 25

 16. Digital rectal examination 0.5
17. Documentation and de-briefing 0.5

Roll No
SHOULDER DYSTOCIA - CHECK LIST Total Marks 10
CallS for help 1
Asks someone to document maneuvers with time. 0.5
Counsels patient to co-operate. 0.5
Checks fetal heart rate 0.5
Demonstrates Mac-Robert’s position. 1
Demonstrates supra-pubic pressure(Rubin 1) 0.5
Demonstrates Rubin 2 o.5
Demonstrates Woodscrew’s (&reverse woodscrew) method. 1
Mentions All fours. 0.5
Tells about third order maneuvers.
Zavanellis method. 0.5
Cleidotomy. 0.5
Symphysiotomy 0.5
Emergency LSCS. 1
Handover the baby to Paediatrician. 0.5
Check for PPH and vaginal/perineal tears 1

Roll No
Assisted Vaginal Breech Delivery Total Marks- 10
Ensures patient with breech presentation must be thoroughly evaluated 0.5
by an experienced obstetrician
Ensures patient is counseled & consented for vaginal breech delivery. 0.5
(Counseled regarding the risk to the mother and to the fetus, especially
entrapment of fetal head during breech delivery)
Confirms AVBD is conducted in a hospital where emg LSCS facilitations 1
are available and ideally conducted in operation theater in the presence
of anesthetist, senior obstetrician and pediatrician
Confirms pre-requisites for vaginal breech delivery are fulfilled. 0.5
Performs clinical pelvimetry to rule out any gross pelvic deformity 0.5
Ensures adequate analgesia is given ideally epidural 0.5
Empties bladder 0.5
Ensures mother is encouraged to push down but only after cervix is fully 0.25
dilated
Observes hands off policy (Unnecessary tractions should be avoided) 0.5
Keeps the sacrum anterior throughout assisted vaginal breech delivery 0.25
Indicates the need for epsiotomy when buttocks distend the vulva, 0.5
either the legs will deliver spontaneously, if not apply pinnard maneuver
in which thigh is abducted, pressure is applied in the popliteal fossa with
middle finger to flex the fetal knee joint
Highlights once the umbilicus is visible loosen the cord only if tightly 0.25
stretched
Allows the delivered part of the baby to hang down till inferior angle of 0.25
scapula is visible, shoulders and arm may deliver spontaneously
Applies Lovset maneuver if arms are extended 0.5
Demonstrates the delivery of the after-coming head of breech should be 2
performed either by application of the supra-pubic pressure, Mauricau
Smellie Veit maneuver, application of Piper’s forceps, Burn’s Marshall
technique

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 26

Indicates active management of 3rd stage of labour 0.5
Explores the vagina for any vaginal and cervical tear 0.5
Documents all the events of delivery 0.5

Roll No
REPAIR OF EPISIOTOMY - CHECK LIST Total Marks 10
Selects appropriate suture material. 1
Wears gloves. 1
Starts repair behind the apex of mucosal incision. 1
Takes continuous stitches in mucosa. 1
Repair muscles in two layers (interrupted stitches). 1
Skin repair with mattress sutures. 1
Mentions alternative continuous suture technique 1
Identifies structures incised in episiotomy. 1
Vaginal examination for other tears. 0.5
Per rectal examination at the end. 0.5
Documentation 1

Roll No
GYNAECOLOGICAL PELVIC EXAMINATION
Makes rapport with the patient
1. Greets the patient
2. Introduces her/himself to the patient
3. Explains the procedure to the patient
4. Takes verbal consent from the patient
5. Enquires about voiding / or any area of tenderness
Vaginal Examination
1. Indicates need for dorsal position, hips flexed and abducted and knee flexed
2. Identifies features to be observed on inspection of the vulva under good light
3. Inserts the bivalve (cuscos) speculum with lock at 12 ‘0 clock to visualize the cervix
4. Indicates that Pap smear is taken after inspection of cervix
5. Performs bimanual digital vaginal examination using right hand and left hand is
placed on abdomen. Both hands are used to palpate size, shape position, mobility
and tenderness of uterus. Place fingers in both fornices to examine the adenexae
6. Make the patient comfortable and counsel for rectal examination
Closing the session
1. Thanks the patient
2. Encourages her to lie in a comfortable position

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 27

Roll No
PAP SMEAR
Makes rapport with the patient
1. Greets the patient
2. Introduces self to the patient
3. Explains the procedure to the patient
4. Takes informed verbal consent from the patient
5. Labels the slides with name of patient, date & time
6. Wears gloves
7. Swab cleans the area
8. Selects cuscos speculum
9. Takes smear from squamocolumnar junction
circumferentially
10. Spreads smear on two slides
11. Ensures Single layer cytology (by using single stroke on side)
12. Fixs with the alcohol
13. Confirms air drying of slides
14. Fills request form with name, age, LMP, test required and
use of hormones, history of PCB/IMB (if any)
Closing the session
1. Thanks the patient
2. Covers the patient back

REPRODUCTION MODULE – ISLAMIC INTERNATIONAL MEDICAL COLLEGE 28