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E.S.COLLEGE OF NURSING.

VILLUPURAM
MIDWIFERY AND OBSTETRICAL NURSING
Placement: Third year Time Allotted: Theory-90 Hours Practical-180 Hours

UNIT

TIME
(Hrs)

03

CONTENT

Introduction to midwifery and obstetrical Nursing


Introduction to concepts of midwifery and obstetrical nursing.
Trends in midwifery and obstetrical nursing.
Historical perspectives and current trends
Legal and ethical aspects
Pre-conception care and preparing for parenthood
Role of nurse in midwifery and obstetrical care.
National policy and legislation in relation to maternal health and welfare.
Maternal ,morbidity,mortality and fertility rates.
Perinatal, morbidity and mortality rates.

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Review of anatomy and physiology of female reproductive system and foetal


development
Female pelvis-general description of the bones joints,ligaments,planes of the pelvis
diameters of the true pelvis,important land marks,variations in pelvis shape.
Female organs of reproductions-External genetalia,internal genetal organs and their
anatomical relations,musculature-blood supply,nerves,lymphatics,pelvic cellular
tissue,pelvic peritoneum.
Physiology of menstrual cycle

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Human sexuality
Foetal development
Conception

Review of fertilization ,implantation(embedding of the ovum),development


of the embryo and placenta at term function , abnormalities ,the foetal
sac ,amniotic fluid ,the umbilical chord
Foetal circulation, foetal skull, bones, sutures and
measurements Review of genetics

III

Assessment and management of pregnancy(ante-natal)


Normal pregnancy
Physiological

changes

during

pregnancy Reproductive system


Cardio vascular system
Respiratory system

Urinary system
Gastro intestinal system
Metabolic changes
Skeletal changes
Skin changes

Endocrine system
Psychological changes
Discomforts of pregnancy
Diagnosis of pregnancy
Signs

Differential diagnosis
Confirmatory tests

Ante-natal

care

Objectives
Assessment

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History & physical examination


Ante-natal examination

Signs of previous child birth


Relationship

of

foetus

to

uterus

pelvis:lie,attitude,presentation ,position
Per vaginal examination
Screening and assessment for high risk
Risk approach
History & physical examaination
Modalities

of

diagnosis;invasive&non

sonics,cardio tomography,NST,CST
Ante-natal preparation
Ante-natal
counseling Antenatal exercises Diet
Substance use
Education for child-birth
Husband and families
Preparation for safe confinement
Prevention from radiation

Psycho-social and cultural aspects of


pregnancy Adjustment to pregnancy
Unwed mother
Single parent
Teenage pregnancy
Sexual violence

adoption

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Assessment and management of intranatal period


Physiology of labour and mechanism of labour
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invasive,ultra

and

Management

of

labour First stage


o Signs and symptoms of onset of labour,normal and
abnormal o Duration
Preparation of labour room and women

o Assessment & observation of women in labour;partogram-maternal


and foetal monitoringactive management of labour,induction of labour

Pain relief and comfort of

labour Second stage


o Signs & symptoms,normal and
abnormal o Duration
o

Conduct of delivary
; principles and techniques
Episiotomy(only if required)

Receiving the new born


Neonatal resuscitation;initial steps and subsequent resuscitation
Care of umbilical cord
Immediate assessment including screening for congenital anomalies
Identification
Bonding
Initiate feeding
Screening and transportation of the

neonate Third stage


o

Signs and symptoms, normal and abnormal

Duration

Method of placental expulsion

o Management;principles& techniques
o Examination of the placenta

Examination of the perineum

Maintain

records

reports Fourth stage

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and

Assessment and management of women during post natal period


Normal puerperium;physiology duration
Post natal assessment and management
o

Promoting physical and emotional wellbeing

o Lactation management
o Immunization
Family dyanamics after child birth
Family welfare services;methods , counseling
Follow-ups
Records and reports

VI

Assessment and management of normal neonates


Normal neonate;
o Physiological adaptation
o

Initial & daily assessment

Essential new born care; thermal control

o Breast feeding, prevention of infections


Immunization
Minor disorders of new born and its management
Levels of neonatal care(level1,2&3)
At primary, secondary and tertiary levels
Maintenance of reports and records

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10

High risk pregnancy-assessment and management


Screening and assessment
o Ultrasonics,cardio tomography,NST,CST,non-invasive&invasive
o Newer modalities of diagnosis
High-risk approach
Levels of care;primary,secondary and tertiary levels

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o

Hyper-emesis gravidarum,bleeding in early pregnancy,abortion,ectopic


pregnancy,vesicular mole,ante-partum hemorrhage

Uterine abnormality and vesicular mole

o Ante-partum hemorrhage
Uterine abnormality and displacement
Diseases complicating pregnancy

o Medical and surgical conditions


o

Infections , RTI(STD),UTI,HIV,TORCH

Gynaecological Diseasescomplicating Pregnancy

Pregnancy Induced Hypertension&Diabetes,Toxemia Of


Pegnancy,hydramnios

Rh incompatability

o Mental disorders
Adolescent pregnancy,elderly primi and grand multi
para Multiple pregnancy
Abnormalities of placenta and cord
Intra-uterine-growth retardation

Nursing management of mothers with high risk


pregnancy Maintenance of records and reports

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10

Abnormal labour-assessment and management


Disorders in labour
o

CPD and contracted pelvis

o Malpositions and mal presentations


o

Premature labour,disorders of uterine actions-precipitate labour,prolonged


labour

o Complication of third stage;injuries to birth canal


Obstetrical emergencies and their management
o Presentation and prolapsed of cord,vasa praevia,amniotic fluid
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embolism,rupture of uterus,shoulder dystocia,obstetrical shock


Obstetrical procedures and operations ;
o

Induction of labour,forceps,vaccum version,manual removal of


placenta,caesarean section,distructive operations

Nursing management of women undergoing obstetrical operations and procedures

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Abnormalities during postnatal periods


Assessment and management of women with post natal complications
o

Puerperial infections,breast engorgement&infections,UTI,thrombo-embolic


disorders,post partum hemorrhage,eclamptia and sub involution

o Psychological complications;
Post partum blues
Post partum depression
Post partum psychosis

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Assessment and management of high risk new born


Admission of neonate in the neonatal intensive care unit-protocols
Nursing management of ;
o

Low birth weight babies

o Infections
o Respiratory problems
o Haemolytic disorders
o Birth injuries
o Mal formations
Monitoring of high risk neonates
Feeing of high risk neonates
Organization and management of neonatl intensive care units
Infection control in neonatal intensive care units
Maitenance of reports and records

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Pharmaco-therpeutics in obstetrics
Indication,dosage,action,contra indication and side effects of
drugs Effects of drugs on pregnancy,labour & puerperium
Nursing responsibilities in the aministration of drugs in obstetricsoxytoins,ante hypertensives,diuretics,tocolytic agents,ante convulsants;
Analgesics and anesthesics in obstetrics
Effects of maternal medication on foetus and neonate

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Family welfare programme


Population trends and problems in india
Concepts,aims,importanc and history of family welfare programme
National population;dyanamics,policy and education
National family welfareprogramme;RCH,ICDS,MCH,safe mother hood
Organization and administration;at national,state,district,block and village

levels
Methods

contraception;spacing,temporary

permanent,emergency contraception
Infertility and its management
Councelling for family welfare
Latest research in contraception
Maintenance of vital statistics

Role of national,international and voluntary organizations


Role of a nurse in family welfare programme

Training /supervision/collaboration with functionaries in community like


ANMs,LHVs,anganwadi workers,TBAs(traditional birth attendant dai)

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and

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