Kolegij
Studiji
Medical Studies in EnglishStudijska godina
6ISVU ID
239409ECTS
12.00
Gynecology and Obstetrics is a compulsory course in the sixth year of the Integrated undergraduate and graduate university study of Medicine in English and consists of 90 hours of lectures, 30 hours of seminars and 80 hours of practicals, which totals 200 hours (12 ECTS). Lectures are held for the entire generation of students in a lecture room (online if necessary), seminars are held also for entire generation of students, and practicals are held at different locations of the Clinic (11 sites) with four to five students per one group. During the first week of exercises in the morning shift, according to the schedule, students will do exercises at 11 workplaces. After the first week of exercises, each student will do two (2) 24-hour shifts at the Clinic for Gynecology and Obstetrics, new hospital on Sušak These forms of teaching are mandatory. Classes are held entirely at the Department of Gynecology and Obstetrics and the Clinic for Gynecology and Obstetrics of the Clinical Hospital Center Rijeka, address is Vjekoslava Dukića 7 on Sušak.
Course aim: Acquisition of basic knowledge and skills in the fields of gynecology, obstetrics, fetal medicine, neonatology, gynecologic cytology, and human reproduction. Special emphasis is placed on the diagnosis of a normal pregnancy and management of normal labor, participation in antenatal and postpartum care within primary health care. Identification of pathologic conditions during pregnancy and puerperium and timely referral of pregnant women to institutions of higher healthcare levels. Counseling and preventive measures aimed at the protection of women’s general and reproductive health. Identification of basic gynecologic disorders and raising awareness of the importance of early diagnosis and early initiation of appropriate treatment. Organization and expediency of screening for cervical cancer and knowledge of basic principles and methods in gynecologic cytology. Knowledge of basic family planning methods such as the prevention of unwanted pregnancies. In the field of human reproduction, timely consideration of the problem in couples with reduced fertility is determined so that appropriate treatment can be started immediately. Acquisition of the basics for postgraduate training through study, specialization, continuing medical education and lifelong learning. Acquisition of the basics for conducting scientific and research work.
Course content:
Obstetrics: Fertilization, implantation, and early pregnancy diagnosis. Development and functions of the placenta. Antenatal care and supervision of normal pregnancy. Prenatal diagnostics and fetal therapy. Normal labor and mechanisms of labor. Pathology of labor and obstetric surgery. Fetal surveillance in pregnancy and labor. Physiology and pathology of puerperium. Spontaneous abortions and gestational trophoblastic disease. Pregnancy infections and intraamniotic infection (IAI). Hematological, vascular, and surgical disorders in pregnancy. Postpartum hemorrhage – causes, diagnostics, and treatment. Gestational diabetes. Placental insufficiency and fetal growth restriction. Hypertensive disorders in pregnancy. Rh isoimmunization.
Neonatology: Newborn medical care.
Gynecology: Periods in a woman’s life. Anatomy of the pelvis and perineum. Menstruation and menstrual disorders. Disorders of the vulva, vagina, cervix and body of the uterus, fallopian tubes and ovaries. Gynecologic surgeries. Gynecologic oncology. Gynecologic urology. Pelvic inflammatory disease and endometriosis. Sexually transmitted infections in gynecology.
Human reproduction: Features of human reproduction. Family planning and fertility regulation. Diagnosis and treatment of infertility. Medically assisted reproduction. Endocrine disorders in reproductive age. Perimenopause and menopause.
Gynecologic cytology: cytology in gynecology and obstetrics.
Course teaching: Classes are held in the form of lectures, seminars and practicals. Lectures are the first teaching activity held throughout 15 days. Lectures are held in the lecture room of the Clinic for Gynecology and Obstetrics, Clinical Hospital Center Rijeka (fifth floor). This is followed by the first test in the form of a written midterm exam (theoretical knowledge) (November 2024). Practicals and seminars are held at 11 sites according to the teaching plan. Students are required to wear a white coat and a skirt/trousers when entering operating rooms at the Clinic and the delivery room. During teaching, the teacher demonstrates and briefly explains the skills planned for each practical related to the preparation unit. In the Skills Lab, supervised students practice the skills according to the teaching plan. During the practicals is scheduled oral midterm exam (practical knowledge). Seminars are held in the lecture room of the Clinic (online if necessary). For seminars, students need to prepare topics published in the course schedule and are expected to actively participate. Assessment during classes consists of a written midterm exam (theoretical knowledge) and an oral midterm exam (practical knowledge). At the end of the course, the student takes an oral final exam. The first date for the oral final exam is December and the second date is in February. By completing all course activities and passing the mandatory midterm exams and the oral final exam, the student acquires 12 ECTS credits.
1. Charles RB Beckmann et. al. Obstetrics and Gynecology, Seventh edition.Lippincott Williams & Wilkins, 2013.
2. Obstetrics by Ten Teachers, 20th Edition, LCKenny, JEMyers. CRC Press 2017.
1. F. Gary Cunningham et al. Williams Obstetrics. Twenty-third edition. McGraw-Hill Companies, 2010.
2. Jonathan S. Berek. Gynecology. Fourteenth edition. Lippincott Williams & Wilkins, 2007.
3. Jonathan S. Berek & Neville F. Hacker. Practical Gynecology Oncology. Fifth edition. Lippincott Williams & Wilkins, 2010.
4. Hugh S Taylor, Lubna Pall, Emre Seli. Speroff's Clinical Gynecologic Endocrinology and Infertility, Ninth edition. Lippincott Williams & Wilkins, 2020.
Students are obligated to regularly attend and actively participate in all forms of classes. They must bring a clean ironed white coat to the practicals. For attending practicals in the operating rooms, students must change into official clean uniforms in the locker rooms of the operating room. Students must bring a white coat and skirt/trousers to attend practicals in the delivery room.
Evaluation (ECTS credit system):
Student grading is conducted according to the current Ordinance on Studies of the University of Rijeka and the Ordinance on Student Assessment and Evaluation at the Faculty of Medicine in Rijeka (approved by the Faculty Council).
Student work is assessed and evaluated during classes and on the final exam. Students can obtain 50 grade points during classes and 50 grade points on the final exam, which totals 100 grade points. Students are graded according to the ECTS (A–E) and numerical system (1–5). Grading within the ECTS system is performed according to absolute distribution.
Out of a maximum of 50 grade points possible to obtain points during classes, the student must obtain a minimum of 25 grade points in order to take the final exam.
A student who doesn’t obtain 25 grade points during classes cannot take the final exam and must retake the course.
Students who don’t obtain 25 grade points during classes and students who aren’t satisfied with the grade obtained on the written and oral midterm exam will have the opportunity to retake the midterm exam in the scheduled time before the third exam period in July 2025.
- Attendance at lectures, seminars and practicals is mandatory but not evaluated with grade points. The student obtains the grade points by taking two midterm exams.
I. A maximum of 50 grade points can be obtained during classes:
- Attendance at lectures, seminars and practicals – not evaluated by grade points.
- Compulsory written midterm exam (theoretical knowledge) – up to 25 points. The test is comprised of up to 100 questions.
- Compulsory oral midterm exam (practical knowledge) – up to 25 points. The student is evaluated with a grade 1–5.
a. Attendance at lectures, seminars and practicals
Attendance at lectures, seminars and practicals is compulsory, but it isn’t evaluated with grade points. Attendance will be checked and recorded in specially prepared forms. A student can be absent from up to 30% of classes provided they have a justifiable cause, which is justified by a medical certificate or another document. If a student is justifiably or unjustifiably absent from more than 30% of theoretical classes – lectures, they cannot continue to attend the course and cannot take the final exam. In that case, the student obtains 0 ECTS credits and an F grade.
b. Compulsory written midterm exam (theoretical knowledge)
After attending lectures (48), the student is obligated to take a written midterm exam (theoretical knowledge), on which they can obtain up to 25 points. The midterm exam will be held on November 6th, 2024. in the premises of the Department of Gynecology and Obstetrics, that is, the Hospital for Women and Children, Vjekoslava Dukića 7 and ev. additional spaces considering the total number of students attending the course.
Based on the 60-question test, the distribution of points is the following:
- correct answers:
31–33 12.5 grade points
34–36 13 grade points
37-38 14 grade points
39-40 15 grade points
41-42 16 grade points
43-44 17 grade points
45-46 18 grade points
47-48 19 grade points
49-50 20 grade points
51-52 21 grade points
53-54 22 grade points
55-56 23 garde points
57-58 24 grade points
59-60 25 grade points
In case the student receives the grade insufficient or isn’t satisfied with the grade obtained (which they must reject by signing a specially prepared form), they can retake the written midterm exam in December 2024 or January 2025, when the date will be agreed upon and announced (before taking the final oral exam).
c. Compulsory oral midterm exam (practical knowledge)
After attending practicals and seminars an oral midterm practical exam will be held on the November 19th and 20th 2024. at the Department of Gynecology and Obstetrics (Clinic for Gynecology and Obstetrics). The student will be evaluated with a grade 1–5 and grade points as follows:
sufficient (2) 12.5 grade points
good (3) 17 grade points
very good (4) 20 grade points
excellent (5) 25 grade points
In case the student receives the grade insufficient or isn’t satisfied with the grade obtained on the oral midterm practical exam (which they must reject by signing a specially prepared form), they can retake the oral midterm exam in December 2024 or January 2025, when the date will be agreed and announced (before taking the final oral exam).
In case the student doesn’t pass one of the two midterm exams in the second attempt or doesn’t obtain at least 25 grade points in the second attempt, they cannot take the final exam. The student can retake the midterm exam(s) on one of the final exam terms (July and September 2024). In that case, the student cannot register for that final exam term but can register for the next exam term.
II. Final exam (a maximum of 50 grade points)
The final exam is oral. The student can obtain a maximum of 50 grade points on the final exam.
The final exam can be taken by:
▪ students who have obtained a minimum of 25 grade points or more during the course.
The following students cannot take the final exam:
▪ Students who didn’t obtain a single grade point during classes don’t have the right to take the final exam (they must re-enroll in the course in the next academic year).
▪ Students who obtained up to 24 grade points and failed to pass the retaken midterm exams during the academic year don’t have the right to take the final exam (they must re-enroll in the course in the next academic year).
▪ Students who, according to the attendance record, missed more than 30% of classes don’t have the right to take the final exam (they must re-enroll in the course in the next academic year).
Students who obtained at least 25 grade points during classes and didn’t successfully pass the oral final exam have the right to reapply for the final exam in the next exam term.
Success in the oral final exam is converted into grade points as follows:
Insufficient (1) 0
Sufficient (2) 20
Good (3) 30
Very good (4) 40
Excellent (5) 50
To pass the oral final exam and acquire the right to final assessment (including the addition of previously obtained grade points during the course on midterm exams), the student must be positively assessed in the oral exam (at least 20 grade points) with a total score of 50%.
According to the recommendation of the University, the student can reject a positive grade in the oral final exam. In that case, the student signs a specially prepared form by which they accept the grade insufficient and commits to take the exam on one of the three possible exam terms.
Assessment in the ECTS system is performed by absolute distribution, i.e., based on the final result, and grade points and grades are transferred into numerical system in accordance with the Decision on Amendments to the Ordinance on Studies of the University of Rijeka (Article 29):
A 90.0–100.0% excellent (5)
B 75.0–89.9% very good (4)
C 60.0–74.9% good (3)
D 50.0–59.9% sufficient (2)
F 0–49.9% insufficient (1)
Teaching content and all information regarding the course and exam terms can be found on the website of the Faculty of Medicine in Rijeka (http://www.medri.uniri.hr/).
Ishodi učenja
Learning outcomes: Overview and anatomy of the pelvis, pelvic bones, and peritoneum. Pelvic and urogenital diaphragm. Blood vessels, nerves and lymphatic vessels of the pelvis. Female reproductive organs. Planes and spaces of the pelvis. Developmental stages in embryology
Ishodi učenja
Learning outcomes: Neuroendocrinology, hypothalamus, pituitary gland, reproductive hormones, physiology of the menstrual cycle, cyclic changes of the endometrium, and follicle development.
Ishodi učenja
Learning outcomes: Stages of normal puberty. The most common disorders and diseases in childhood and puberty. Symptoms, diagnostic methods and treatment in pediatric and adolescent gynecology
Ishodi učenja
Learning outcomes: Physiology of fertilization and implantation of a fertilized egg. Early pregnancy diagnosis. Formation, development, and function of the placenta.
Ishodi učenja
Learning outcomes: Physiological changes of genital and extragenital organs and organ systems during pregnancy, including changes in normal laboratory values in normal pregnancy. Physiology of pregnancy and nutrient metabolism, endocrinology of pregnancy.
Ishodi učenja
Learning outcomes: Basic principles of antenatal care, examinations, and all diagnostic and other procedures used to supervise normal pregnancy. Standard laboratory tests run in normal pregnancy and how to interpret them. Basic organization of health care for women and pregnant women (laboring women and midwives) in the Republic of Croatia.
Ishodi učenja
Learning outcomes: Definition and diagnosis of disorders, specifics of prenatal screening and monitoring, clinical significance and prevention. Human karyotype, numerical chromosomal abnormalities, structural chromosomal abnormalities, monofactorial disorders according to Mendel’s laws of inheritance, polygenic and multifactorial disorders. Definition, methods, and goals of prenatal diagnosis of fetal chromosomopathies and malformations. Biochemical screening of Down syndrome, biochemical screening of neural tube defects.
Ishodi učenja
Learning outcomes: Types of miscarriage, their causes, identification of risk factors, clinical presentation, diagnostic and therapeutic procedures, possible complications, and consequences.
Ishodi učenja
Learning outcomes: Causes, symptomatology, treatment. Screening, public health significance of STD.
Ishodi učenja
Learning outcomes: Clinical presentation of the lower and upper female reproductive system, routes of transmission, and symptoms of the diseases. Diagnostic modalities and options in the therapeutic approach. Chronic pelvic inflammatory disease.
Ishodi učenja
Learning outcomes: Symptomatology of acute gynecologic conditions that require immediate intervention and surgical care. Emergency surgical procedures in gynecology.
Ishodi učenja
Learning outcomes: Cervical cancer screening – significance, organization, and implementation. Proper collection and handling of cytology specimens. Definition and classification of the Pap test. Application of Pap test in screening, diagnosis, and monitoring of cervical lesions. Cytology in the diagnosis of endometrial changes. Cytology in the diagnosis, staging, and monitoring of gynecologic malignancies.
Ishodi učenja
Learning outcomes: Principles of normal labor, factors affecting labor (birth canal, uterine contractions, and fetus), and the mechanism of physiologic labor. Different stages of labor. Interpretation of all fetal movements during physiologic labor in the cephalic presentation. Clinical assessment of labor, the effect of uterine contractions on the course of delivery. Third labor stage, signs of placental abruption, examination of the placenta, fourth labor stage, complications of the third and fourth labor stages-bleeding, uterine atony, uterine inversion, peripartum hysterectomy, maternal mortality.
Ishodi učenja
Learning outcomes: Physiologic processes in the postpartum period, midwife’s postpartum monitoring, and the most significant complications and diseases in that period. Pathologic processes in the postpartum period. Postpartum hemorrhage, puerperal infections, mastitis, thrombosis and thromboembolism, urinary tract infections postpartum psychiatric disorders – causes, diagnosis, and treatment.
Ishodi učenja
Learning outcomes: Epidemiology and etiology of endometriosis, its pathogenesis, pathohistology, and symptoms. Critical approach to diagnosis and classification of the disease. The importance of endometriosis in human reproduction. Treatment options for endometriosis.
Ishodi učenja
Learning outcomes: Normal menstruation, abnormal menstruation, dysfunctional uterine bleeding, and juvenile metrorrhagia. Pathophysiology of dysfunctional uterine bleeding. Diagnosis and treatment. Fractional curettage, endometrial ablation, IUS, and hysterectomy
Ishodi učenja
Learning outcomes: Definition, objectives and principles of family planning (FP). Individual FP counseling, group work. Benefits of FP for mother and child. Public health significance of FP. Family planning methods. Natural FP methods. Barrier methods. Chemical contraception. Intrauterine contraception. Hormonal contraception. Emergency contraception. Permanent contraception methods. Laws and policies.
Ishodi učenja
Learning outcomes: The principles of choosing contraceptive methods depending on the patient’s age and needs, and the main limitations of certain contraceptive methods. Counseling and behavioral methods that help the couple to accept and successfully continue using the chosen contraception method. Symptoms and signs associated with contraception, with special emphasis on patients who require the assessment of a gynecology specialist or subspecialist for the safety of contraceptive use and the patients’ future health.
Ishodi učenja
Learning outcomes: Definition, endocrinologic and clinical features of premenopause and postmenopause, effects of postmenopause on a woman’s body, urogenital atrophy. The mechanism of menopausal hot flashes. Osteoporosis. Cardiovascular diseases. Hormone replacement therapy, indications and contraindications.
Ishodi učenja
Learning outcomes: Basic pathophysiology of fetal growth restriction. Distinguish between different types of fetal growth restrictions. Diagnostic procedures for detection of fetal growth restriction and procedures performed in pregnant women with detected fetal growth restriction.
Ishodi učenja
Learning outcomes: Definition, risk factors, treatment, and complications of premature labor. Definition, clinical significance, and procedures for post-term pregnancy.
Ishodi učenja
Learning outcomes: Causes and treatment of bleeding in late pregnancy (placenta previa, placental abruption, rupture of the marginal sinus) and labor (uterine rupture). Blood clotting disorders during pregnancy and puerperium, basic mechanisms and therapeutic guidelines.
Ishodi učenja
Learning outcomes: Indications for caesarean section, how caesarean section is perfomed, elective and emergency caesarean section
Ishodi učenja
Learning outcomes: Human papilloma virus. Classification of cervical intraepithelial neoplasia. Guidelines in the diagnosis and treatment of premalignant cervical lesions. Risk factors for malignancy. Etiopathogenesis and natural history of the disease, symptoms, diagnosis, treatment. Survival rate, prognosis and patient monitoring, quality of life. Treatment modalities, surgical treatment, radiotherapy, and chemoradiation. Survival rate, prognosis and patient monitoring, quality of life. Cervical cancer in pregnancy.
Ishodi učenja
Learning outcomes: Types, symptoms, diagnosis, and treatment of benign ovarian tumors. Epithelial benign ovarian tumors, functional ovarian cysts, follicular cysts, corpus luteum cysts. Benign uterine tumors. Pathogenesis of fibroids, histologic structure, types of fibroids, diagnosis and treatment. Endometrial hyperplasia, disease mechanism, classification, clinical presentation, diagnosis. Endometrial polyps.
Ishodi učenja
Learning outcomes: Risk factors for malignancy, etiopathogenesis, and natural history of the diseases, symptoms, diagnosis, treatment. Survival rate, prognosis and patient monitoring, quality of life.
Ishodi učenja
Learning outcomes: The concept of Rh-isoimmunization and the etiology and pathophysiology of hydrops fetalis. Monitoring of isoimmunized pregnant woman and fetus. Treatment.
Ishodi učenja
Learning outcomes: Definition, screening, diagnostic criteria, complications, and treatment of this gestational diabetes
Ishodi učenja
Learning outcomes: Abnormal labor due to abnormal fetal position and presentation, rotation and flexion of the fetal head.
Ishodi učenja
Learning outcomes: Epidemiology, classification and specificities of multiple pregnancies and birth of twins.
Ishodi učenja
Learning outcomes: Basic concept and definition of intrahepatic cholestasis, fat liver; etiology, differential diagnosis, treatment and prognosis
Ishodi učenja
Learning outcomes: Causes of dystocia. Identification of irregular contractions, narrowed pelvis, cephalopelvic disproportion. Fetal shoulder dystocia.
Ishodi učenja
Learning outcomes: The most common infections in pregnancy and their effect on the course and outcome of pregnancy. Definition, diagnosis, treatment, and prevention of TORCH and IAI.
Ishodi učenja
Learning outcomes: Hyperandrogenism, PCOS – theories on the causes of polycystic ovaries, genetic factors, fetal programming. Symptoms and signs of PCOS. Diagnostic criteria. Treatment of PCOS, treatment risks. Long-term health risks of PCOS.
Ishodi učenja
Learning outcomes: Definition of ovarian reserve. Methods for ovarian reserve testing. Premature ovarian aging. Definition of reproductive aging. Disorders associated with reproductive aging. Cushing’s syndrome, congenital adrenal hyperplasia, androgen-secreting ovarian and adrenal tumors. Stromal hyperplasia and stromal hyperthecosis. Virilization during pregnancy and virilizing adrenal tumors. Disorders of prolactin secretion.
Ishodi učenja
Learning outcomes: Basic surgical principles and surgical procedures in gynecology. Basics of preoperative preparation of patients for gynecologic surgical procedures and postoperative care. Hysterectomy indications and techniques and other surgical techniques in gynecology, complications after surgery.
Ishodi učenja
Learning outcomes: Definition and classification of amenorrhea. Four levels of disorders that cause amenorrhea. Diagnostic algorythms of individual levels: I – uterus and vagina, II – ovary, III – pituitary gland, IV – hypothalamus. Hormone tests for the diagnosis of certain disorders. Principles of treatment.
Ishodi učenja
Learning outcomes: Evaluation of Pituitary and Hypothalamic function, disorders and treatment
Ishodi učenja
Learning outcomes: Definitions of reproductive period, monthly and annual fecundity. Stages and processes of human reproduction. Relationship between age and fertility. Factors affecting fertility. Decreased fertility in women and men.
Ishodi učenja
Final meeting of the theoretical part of the course. Making arrangements for writing the midterm exam.
Ishodi učenja
Learning outcomes: Definition, classification, epidemiology, etiology, pathophysiology, clinical presentation, and treatment of hypertensive disorders in pregnancy
Ishodi učenja
Learning outcomes: Recommended methods and tests foe detecting high-risk pregnancies
Ishodi učenja
Learning outcomes: Physiologic changes in the coagulation system during pregnancy, laboratory testing, prevention of pregnancy complications.
Ishodi učenja
Learning outcomes: Classification and incidence of gestational trophoblastic disease. Mechanism of complete and partial molar pregnancy, diagnosis, treatment. Patient follow-up after molar pregnancy. Diagnosis, classification, and treatment of gestational trophoblastic neoplasia. Pregnancy after gestational trophoblastic disease.
Ishodi učenja
Learning outcomes: Definition of infertility. Diagnostic procedure and scedule of tests. Semen analysis. Detection of ovulation. Evaluation of fallopian tube function. Ovarian reserve testing. Procedures and methods for diagnosis of infertility. Other affected organs that cause infertility.
Ishodi učenja
Learning outcomes: Principles of ovulation induction. Monofollicular growth and controlled ovarian hyperstimulation. Microsurgical principles of treatment of affected fallopian tubes. Corrective uterus surgery. Other surgical procedures affecting fertility. Medical insemination procedures. Freezing, storing and preserving biological samples. Gamete donation.
Ishodi učenja
Learning oucomes: Options for intentional termination of pregnancy. Advantages and disadvantages of certain methods of termination of pregnancy. Laws and policies.
Ishodi učenja
1. Medical records. Pregnancy logbook. Partogram. Labor logbook. Birth certificate.
2. Admission and preparation of the woman in labor. Admission cardiotocography, cardiotocographic
monitoring during labor. Typical sites for external transducers placement on the pregnant woman’s
abdomen.
3. Assessment of labor progress. Clinical assessment of labor. Labor documentation.
4. Vaginal examination of a woman in labor. Stages of cervical dilation. Description of a finding in active
labor. The position of the woman in the first stage of labor. Alternative childbirth delivery methods.
5. Expulsion of the fetus (optional): head-down delivery, head movements in expulsion (breech, vacuum
extraction, cesarean section).
6. Episiotomy. Method of performing the procedure. Surgical care of the perineal incision. Suturing kit.
Postpartum perineal care.
7. Placental stage of labor. Spontaneous delivery of the placenta. Signs of placental abruption. Examination of the placenta.
8. pH-metry. Equpment for performing the procedure. Fetal scalp blood sampling technique.
9. Newborn. APGAR score. Clamping and ligation of the umbilical cord. Examination and primary care of the newborn.
10. Early puerperium. Monitoring of the mother in labor in the delivery room. Vital signs. Fundal height.
Postpartum hemorrhage.
11. Puerperium. Medical documentation in the puerperium. General status of puerpera, monitoring of
puerpera. Physiological functions. Breastfeeding. The most common breastfeeding problems.
Ishodi učenja
1. Preparation of a pregnant woman for examination. Blood pressure measurement. Detection of albumin in urine. Weighing. Weight gain.
2. Appearance/Shape of the abdomen (size, shape). Measurement of abdominal circumference. Symphysisfundus height measurement.
3. Fetal assessment. Auscultation of the fetal heartbeats. Pinard’s aural fetoscope.
4. Cardiotocography. Imaging technique and equipment. Normal cardiotocogram – description of a finding.
5. Internal (bimanual) examination of a pregnant woman
6. Clinical assessment of labor. Cardiotocographic assessment of labor.
7. Diagnosis of emergencies (optional, depending on daily cases). Latent phase of labor. Bleeding in the
early stages of pregnancy. Bleeding in late pregnancy.
8. Ultrasound examination in the first trimester of pregnancy.
9. Ultrasound examination in the third trimester of pregnancy. Fetal biometry (BPD, AC, FL).
10. Physical basics of Doppler ultrasound, application in perinatology. Description of a sonogram. Typical
blood vessels for assessment of fetal circulation. Ultrasound indices.
Ishodi učenja
1. Infertility diagnostic algorithm. Criteria, basic tests. Specifics of history-taking in women and men.
2. Follicular monitoring (folliculometry). Documentation of ultrasound findings.
3. Hormonal assay tests in the assessment of ovarian function.
4. Preparation of the couple for the medically assisted reproduction (MAR) treatment.
Ishodi učenja
1. PAP test – eltion of ements of a cytologic finding.
2. Examination with a speculum. Inspecthe vagina and cervix – macroscopically visible changes
(normal and pathologic, depending on the cause).
3. Colposcopy – goal, principle, preparation of the field, performance. Schiller test.
4. Cervical biopsy and endocervical excochleation.
Ishodi učenja
1. Patient admission for minor procedures, preparation of medical documentation (daily case reports).
2. Preparation of the staff for surgery. Surgical hand scrubbing. Sterile dressing and putting on gloves.
3. Preparation of the patient for surgery. Surgical positioning, vaginal approach. Preparation of the operating field (vagina and perineum).
4. Surgical instruments for minor procedures. Kit. Diathermy incision loop, electrocautery with a ball tip.
5. Hysteroscopy – diagnostics and treatment
Ishodi učenja
1. Preparation of the staff for surgery. Surgical hand scrubbing. Sterile dressing and putting on gloves.
2. Preparation of the patient for surgery. Preparation of the operating field (abdomen, vagina, and
perineum).
3. Surgical instruments for abdominal, vaginal, and laparoscopic procedures.
4. Equipment for laparoscopic surgery.
5. Assistance in surgical procedures (optional)
Ishodi učenja
1. Gynecologic history. Organization and constituents of the Department.
2. Morning rounds. Postoperative monitoring of gynecologic patients. Preoperative monitoring and
preparation of patients for the operating room.
3. Patient admission to the Department. Preoperative findings and diagnostics. Screening and
categorization of patients scheduled for surgery (general gynecology, gynecologic urology and gynecologic oncology).
4. Gynecologic ultrasound diagnostics. Typical scanning planes. Examination of the uterus. Examination of the ovaries. Echogenicity, differences in echogenicity of gynecologic organs. Pathologic pelvic formations (optional).
5. Termination of unwanted pregnancy (medical and surgical).
Ishodi učenja
1. Perinatologic history, specifics of history-taking. Daily case reports (optional).
2. General examination of a pregnant woman.
3. Fetal position in the uterus and clinical fetal assessment (growth, signs of life).
4. Examination of the pelvis. Assessment of pelvis by inspection, anatomical landmarks on the body
surface, the rhombus of Michaelis.
5. Pelvimetry. Internal and external pelvic measurements. Pelvimeter.
6. Internal examination and assessment of the pelvis.
7. Internal (bimanual) examination of a pregnant woman.
8. Self-monitoring of fetal movements, documentation of findings.
9. Nonstress test (NST) and oxytocin challenge test (OCT), examples of normal results.
10. Early amniocentesis – theoretical framework, method of performing the procedure.
Ishodi učenja
1. Medical records. Pregnancy logbook. Partogram. Labor logbook. Birth certificate.
2. Admission and preparation of the woman in labor. Admission cardiotocography, cardiotocographic
monitoring during labor. Typical sites for external transducers placement on the pregnant woman’s
abdomen.
3. Assessment of labor progress. Clinical assessment of labor. Labor documentation.
4. Vaginal examination of a woman in labor. Stages of cervical dilation. Description of a finding in active
labor. The position of the woman in the first stage of labor. Alternative childbirth delivery methods.
5. Expulsion of the fetus (optional): head-down delivery, head movements in expulsion (breech, vacuum
extraction, cesarean section).
6. Episiotomy. Method of performing the procedure. Surgical care of the perineal incision. Suturing kit.
Postpartum perineal care.
7. Placental stage of labor. Spontaneous delivery of the placenta. Signs of placental abruption. Examination of the placenta.
8. pH-metry. Equpment for performing the procedure. Fetal scalp blood sampling technique.
9. Newborn. APGAR score. Clamping and ligation of the umbilical cord. Examination and primary care of the newborn.
10. Early puerperium. Monitoring of the mother in labor in the delivery room. Vital signs. Fundal height.
Postpartum hemorrhage.
11. Puerperium. Medical documentation in the puerperium. General status of puerpera, monitoring of
puerpera. Physiological functions. Breastfeeding. The most common breastfeeding problems.
Ishodi učenja
1. Reproductive history. Patient’s statement on her health condition.
2. Semen analysis. Demonstration of several different categories of semen analysis.
3. Ovulation test. Demonstration of several hormonal assay tests for assessment of cycle quality
(ovulatory/anovulatory). Ultrasound detection of ovulation. Demonstration of a basal body temperature
chart. Demonstration of cervical mucus – fern phenomenon.
4. Hysterosonosalpingography/Hysterosalpingography. Demonstration of the procedure, video. Instrument kit. X-ray images of a normal finding (uterine anomaly, fallopian tube disease).
5. Cycle monitoring – ultrasound, hormonal. Documentation of findings.
6. Ultrasound in reproductive medicine. Egg retrieval. Embryo transfer. Videos.
7. Conservative treatment of infertility. Ovulation induction. Timing of sexual intercourse. Stimulation of
ovulation. Case reports.
8. Medically assisted reproduction procedures. Homologous intrauterine insemination – video. In vitro
fertilization and embryo transfer – video. Controlled ovarian hyperstimulation – video. Optional: intrauterine insemination, egg retrieval, embryo transfer. Frozen embryo transfer.
9. Fertility conservation. Cryopreservation of gametes and embryos.
10. Surgical treatment of infertility. Microoperations. Diagnostic laparoscopy. Diagnostic hysteroscopy.
Transvaginal hydrolaparoscopy. Videos.
Ishodi učenja
1. Semen analysis. Semen collection, preparation of semen for analysis, slide preparation. CASA analysis.
Sperm counting in a chamber under a microscope. Test results and their interpretation. WHO criteria.
2. Preparation of semen for MAR procedures. Special procedures in cases of severe male infertility.
3. Methods of egg fertilization. In vitro fertilization (IVF). Intracytoplasmic sperm injection (ICSI).
4. Cryopreservation of gametes and embryos. Storage conditions. Storage space. Demonstration of the
procedure with eggs. Demonstration of the procedure with sperm.
5. Laboratory forms for monitoring embryo development. Photographs of embryos at different stages of
development.
6. Standard surgical procedures, books, records, protocols.
Ishodi učenja
Skills in obstetrics and perinatology
1. Demonstration and practice of performing a gynecologic examination on a model. Dressing gloves.
Holding a speculum. Taking a cytological smear from three typical sites. Taking a microbiologic smear.
Bimanual examination and palpation of internal organs.
2. Demonstration and practice of performing an external examination of a pregnant woman. Model of
a pregnant woman. Dressing gloves. Fetal lie, position, presentation, and posture (habitus). Shape of the
maternal abdomen. Leopold-Pavlik’s (I-IV) and Zangemeister’s maneuvers. Cephalic engagement.
Cephalopelvic disproportion.
3. Demonstration and practice of performing pelvic examination. External examination of the pelvis.
Pelvimeter. Female pelvis, pelvic bony ring, landmarks on skeleton and abdomen of a model.
Measurements of the normal pelvis – diameters (DS, SC, DT, CE). Internal examination and estimation of
the pelvis. Internal measurements of the pelvis (CD, CV). Planes of the pelvis – inlet, midpelvis, outlet.
4. Demonstration and practice of performing internal (bimanual) examination of a pregnant woman.
Description of a normal finding through pregnancy trimesters. Cervix, cervical ostium, cervical canal,
presenting fetal part / vertex presentation.
5. Demonstration and practice of performing internal (bimanual) examination of a woman in labor.
Determining of the descent of the presenting part in the birth canal. Demonstration and practice of the
mechanism of normal delivery with fetal movements. Demonstration of typical fetal head structures and
practice of recognizing typical sites.
6. Demonstration of fetal position/presentation in the uterus. Position, place, pose, and posture
Ishodi učenja
Learning outcomes: Pathophysiology and Etyiology of pelvic pain, diagnostic procedures and treatment of pelvic pain, psychological problems of patients with pelvic pain.
Ishodi učenja
Learning outcomes: Pathophysiological mechanism of PMS syndrome, diagnostic criteria for diagnosis, types of treatment.
Ishodi učenja
Learning outcomes: What is low-risk and what is high-risk pregnancy, management of low risk pregnancy.
Ishodi učenja
Learning outcomes: Interpretation and analysis of the most common symptoms and signs present during childbirth. Planning and applying methods to relieve pain during childbirth, including standard pharmacological and nonpharmacological methods and other alternative methods.
Ishodi učenja
Learning outcomes: Identification of obesity as a global, epidemiological problem. Categories of nutrition and recommended weight gain during pregnancy. The impact of obesity on the menstrual cycle, reduced fertility, frequency of miscarriages, macrosomia, prematurity, and congenital anomalies in pregnancy. Connection between obesity, preeclampsia, and gestational diabetes during pregnancy and prediction of pregnancy outcomes.
Ishodi učenja
Learning outcomes: Historical development of the approach to breech delivery. Results of the perinatal outcome of breech delivery compared with the head-down delivery in our Clinic. Informed consent for a trial vaginal delivery and the right to a second opinion in accordance with the Act on Protection of Patients’ Rights, as well as the patient’s right to choose the method of completing delivery from the professional, ethical and forensic aspects.
Ishodi učenja
Learning outcomes: The most important and commonly used operative methods for completing delivery. Advantages and disadvantages and the possible complications of certain obstetric operations. Application of certain operative methods depending on the indication and the specific clinical situation.
Ishodi učenja
Learning outcomes: The right to procreate or reproduce, the moral status of the embryo, the involment of a third party in the reproductive process by genetic material donation, the practice of surrogacy, genetic manipulations experiments on pre-embryos.
Ishodi učenja
Learning outcomes: Indications for fertility preservation, cryopreservation of embryos and oocytes, ovarian tissue cryopreservation, medical management of ovarian protection
Ishodi učenja
Learning outcomes:Nomenclature, prevalence, biologic determination of gender identity, transgender heath and wellness, gender reassigning surgery
Ishodi učenja
Learning outcomes: Anatomical abnormalities of the uterus, abnormalities of ovaries ang vagina
Ishodi učenja
Learning outcomes: Appearance, definition, clinical presentation, and therapeutic options for pelvic floor muscle disorders, descended and prolapsed uterus. The basics of micturition function. The mechanism of maintaining urinary continence. Incontinence – types, diagnosis, treatment. Urinary fistulas
Ishodi učenja
Learning outcomes: Gene variants and risks of reproductive abnormalities, diagnosing genetic disorders, preimplatation genetic testing
Ishodi učenja
Learning outcomes: Definition and prevalence of iron deficiency in pregnancy, Causes and diagnosis, Cinical effects of iron deficiencyon the mother and fetus, treatment of iron deficiency in pregnancy, optimisation of haemoglobin in the antenatal period, general proniples of blood transfusion.
Ishodi učenja
Learning outcomes: Overview and anatomy of the pelvis, pelvic bones, and peritoneum. Pelvic and urogenital diaphragm. Blood vessels, nerves and lymphatic vessels of the pelvis. Female reproductive organs. Planes and spaces of the pelvis. Developmental stages in embryology
Ishodi učenja
Learning outcomes: Neuroendocrinology, hypothalamus, pituitary gland, reproductive hormones, physiology of the menstrual cycle, cyclic changes of the endometrium, and follicle development.
Ishodi učenja
Learning outcomes: Mechanism of the menstrual cycle. Stages of normal puberty. The most common disorders and diseases in childhood and puberty. Symptoms, diagnostic methods and treatment in pediatric and adolescent gynecology
Ishodi učenja
Learning outcomes: Basics of the menstrual cycle, physiology of fertilization and implantation of a fertilized egg. Early pregnancy diagnosis. Formation, development, and function of the placenta. Composition and changes of amniotic fluid, determination of fetal maturity and compromise, ultrasound evaluation of amniotic fluid.
Ishodi učenja
Learning outcomes: Physiological changes of genital and extragenital organs and organ systems during pregnancy, including changes in normal laboratory values in normal pregnancy. Physiology of pregnancy and nutrient metabolism, endocrinology of pregnancy.
Ishodi učenja
Learning outcomes: Basic principles of antenatal care, examinations, and all diagnostic and other procedures used to supervise normal pregnancy. Standard laboratory tests run in normal pregnancy and how to interpret them. Basic organization of health care for women and pregnant women (laboring women and midwives) in the Republic of Croatia.
Ishodi učenja
Learning outcomes: Definition and diagnosis of disorders, specifics of prenatal screening and monitoring, clinical significance and prevention. Human karyotype, numerical chromosomal abnormalities, structural chromosomal abnormalities, monofactorial disorders according to Mendel’s laws of inheritance, polygenic and multifactorial disorders. Definition, methods, and goals of prenatal diagnosis of fetal chromosomopathies and malformations. Biochemical screening of Down syndrome, biochemical screening of neural tube defects.
Ishodi učenja
Learning outcomes: Types of miscarriage, their causes, identification of risk factors, clinical presentation, diagnostic and therapeutic procedures, possible complications, and consequences. Classification and incidence of gestational trophoblastic disease. Mechanism of complete and partial molar pregnancy, diagnosis, treatment. Patient follow-up after molar pregnancy. Diagnosis, classification, and treatment of gestational trophoblastic neoplasia. Pregnancy after gestational trophoblastic disease. Clinical features of ectopic pregnancy, etiologic factors, symptoms, diagnosis, and treatment.
Ishodi učenja
Learning outcomes: Causes, symptomatology, treatment. Screening, public health significance of STD.
Ishodi učenja
Learning outcomes: Clinical presentation of the lower and upper female reproductive system, routes of transmission, and symptoms of the diseases. Diagnostic modalities and options in the therapeutic approach. Chronic pelvic inflammatory disease.
Ishodi učenja
Learning outcomes: Symptomatology of acute gynecologic conditions that require immediate intervention and surgical care. Emergency surgical procedures in gynecology.
Ishodi učenja
Learning outcomes: Cervical cancer screening – significance, organization, and implementation. Proper collection and handling of cytology specimens. Definition and classification of the Pap test. Application of Pap test in screening, diagnosis, and monitoring of cervical lesions. Cytology in the diagnosis of endometrial changes. Cytology in the diagnosis, staging, and monitoring of gynecologic malignancies.
Ishodi učenja
Learning outcomes: Principles of normal labor, factors affecting labor (birth canal, uterine contractions, and fetus), and the mechanism of physiologic labor. Different stages of labor. Interpretation of all fetal movements during physiologic labor in the cephalic presentation. Clinical assessment of labor, the effect of uterine contractions on the course of delivery.
Ishodi učenja
Learning outcomes: Third labor stage, signs of placental abruption, examination of the placenta, fourth labor stage, complications of the third and fourth labor stages – bleeding, uterine atony, uterine inversion, peripartum hysterectomy, maternal mortality.
Ishodi učenja
Learning outcomes: Physiologic processes in the postpartum period, midwife’s postpartum monitoring, and the most significant complications and diseases in that period. Pathologic processes in the postpartum period. Postpartum hemorrhage, puerperal infections, mastitis, thrombosis and thromboembolism, urinary tract infections, postpartum psychiatric disorders – causes, diagnosis, and treatment.
Ishodi učenja
Learning outcomes: Epidemiology and etiology of endometriosis, its pathogenesis, pathohistology, and symptoms. Critical approach to diagnosis and classification of the disease. The importance of endometriosis in human reproduction. Treatment options for endometriosis.
Ishodi učenja
Learning outcomes: Normal menstruation, abnormal menstruation, dysfunctional uterine bleeding, and juvenile metrorrhagia. Pathophysiology of dysfunctional uterine bleeding. Diagnosis and treatment. Fractional curettage, endometrial ablation, IUS, and hysterectomy2
Ishodi učenja
Learning outcomes: Definition, objectives and principles of family planning (FP). Individual FP counseling, group work. Benefits of FP for mother and child. Public health significance of FP. Family planning methods. Natural FP methods. Barrier methods. Chemical contraception. Intrauterine contraception. Hormonal contraception. Emergency contraception. Permanent contraception methods. Laws and policies.
Ishodi učenja
Learning outcomes: Definition, endocrinologic and clinical features of premenopause and postmenopause, effects of postmenopause on a woman’s body, urogenital atrophy. The mechanism of menopausal hot flashes. Osteoporosis. Cardiovascular diseases. Hormone replacement therapy, indications and contraindications.
Ishodi učenja
Learning outcomes: Definition, classification, epidemiology, etiology, pathophysiology, clinical presentation, and treatment of hypertensive disorders in pregnancy
Ishodi učenja
Learning outcomes: Basic pathophysiology of fetal growth restriction. Distinguish between different types of fetal growth restrictions. Diagnostic procedures for detection of fetal growth restriction and procedures performed in pregnant women with detected fetal growth restriction.
Ishodi učenja
Learning outcomes: Definition, risk factors, treatment, and complications of premature labor. Definition, clinical significance, and procedures for post-term pregnancy.
Ishodi učenja
Learning outcomes: Causes and treatment of bleeding in late pregnancy (placenta previa, placental abruption, rupture of the marginal sinus) and labor (uterine rupture). Blood clotting disorders during pregnancy and puerperium, basic mechanisms and therapeutic guidelines.
Ishodi učenja
Learning outcomes: Definition, goals, methods, and risks of these obstetric procedures.
Ishodi učenja
Learning outcomes: Human papilloma virus. Classification of cervical intraepithelial neoplasia. Guidelines in the diagnosis and treatment of premalignant cervical lesions. Risk factors for malignancy. Etiopathogenesis and natural history of the disease, symptoms, diagnosis, treatment. Survival rate, prognosis and patient monitoring, quality of life. Treatment modalities, surgical treatment, radiotherapy, and chemoradiation. Survival rate, prognosis and patient monitoring, quality of life. Cervical cancer in pregnancy.
Ishodi učenja
Learning outcomes: Types, symptoms, diagnosis, and treatment of benign ovarian tumors. Epithelial benign ovarian tumors, functional ovarian cysts, follicular cysts, corpus luteum cysts. Risk factors for malignancies, etiopathogenesis and natural history of the disease, symptoms, diagnosis, and treatment. Survival rate, prognosis and patient monitoring, quality of life.
Ishodi učenja
Learning outcomes: Benign uterine tumors. Pathogenesis of fibroids, histologic structure, types of fibroids, diagnosis and treatment. Endometrial hyperplasia, disease mechanism, classification, clinical presentation, diagnosis. Endometrial polyps. Risk factors for malignancy, etiopathogenesis, and natural history of the disease, symptoms, diagnosis, treatment. Survival rate, prognosis and patient monitoring, quality of life.
Ishodi učenja
Learning outcomes: The concept of Rh-isoimmunization and the etiology and pathophysiology of hydrops fetalis. Monitoring of isoimmunized pregnant woman and fetus. Treatment.
Ishodi učenja
Learning outcomes: Definition, screening, diagnostic criteria, complications, and treatment of this gestational diabetes
Ishodi učenja
Learning outcomes: Abnormal labor due to abnormal fetal position and presentation, rotation and flexion of the fetal head.
Ishodi učenja
Learning outcomes: Causes of dystocia. Identification of irregular contractions, narrowed pelvis, cephalopelvic disproportion. Fetal shoulder dystocia.
Ishodi učenja
Learning outcomes: Epidemiology, classification and specificities of multiple pregnancies and birth of twins. Basic concept and definition of intrahepatic cholestasis, etiology, differential diagnosis, treatment and prognosis
Ishodi učenja
Learning outcomes: The most common infections in pregnancy and their effect on the course and outcome of pregnancy. Definition, diagnosis, treatment, and prevention of TORCH and IAI.
Ishodi učenja
Learning outcomes: Hyperandrogenism, PCOS – theories on the causes of polycystic ovaries, genetic factors, fetal programming. Symptoms and signs of PCOS. Diagnostic criteria. Treatment of PCOS, treatment risks. Long-term health risks of PCOS.
Ishodi učenja
Learning outcomes: Definition of ovarian reserve. Methods for ovarian reserve testing. Premature ovarian aging. Definition of reproductive aging. Disorders associated with reproductive aging. Cushing’s syndrome, congenital adrenal hyperplasia, androgen-secreting ovarian and adrenal tumors. Stromal hyperplasia and stromal hyperthecosis. Virilization during pregnancy and virilizing adrenal tumors. Disorders of prolactin secretion.
Ishodi učenja
Learning outcomes: Basic surgical principles and surgical procedures in gynecology. Basics of preoperative preparation of patients for gynecologic surgical procedures and postoperative care. Hysterectomy indications and techniques and other surgical techniques in gynecology.
Ishodi učenja
Learning outcomes: Symptoms, diagnosis, and treatment of the most common surgical complications. Uterine perforation. Abdominal organ injury. Abdominal bleeding. Wound infection. Sepsis.
Ishodi učenja
Learning outcomes: Definition and classification of amenorrhea. Four levels of disorders that cause amenorrhea. Diagnostic algorythms of individual levels: I – uterus and vagina, II – ovary, III – pituitary gland, IV – hypothalamus. Hormone tests for the diagnosis of certain disorders. Principles of treatment.
Ishodi učenja
Learning outcomes: Definitions of reproductive period, monthly and annual fecundity. Stages and processes of human reproduction. Relationship between age and fertility. Factors affecting fertility. Decreased fertility in women and men.
Ishodi učenja
Learning outcomes: Definition of infertility. Diagnostic procedure and scedule of tests. Semen analysis. Detection of ovulation. Evaluation of fallopian tube function. Ovarian reserve testing. Procedures and methods for diagnosis of infertility. Other affected organs that cause infertility.
Ishodi učenja
Learning outcomes: List of seminars (with titles and learning outcomes): Principles of ovulation induction. Monofollicular growth and controlled ovarian hyperstimulation. Microsurgical principles of treatment of affected fallopian tubes. Corrective uterus surgery. Other surgical procedures affecting fertility. Medical insemination procedures. Freezing, storing and preserving biological samples. Gamete donation.
Ishodi učenja
Learning outcomes: Options for intentional termination of pregnancy. Advantages and disadvantages of certain methods of termination of pregnancy. Laws and policies.
Ishodi učenja
Learning outcomes: The issue of taking medicines during pregnancy. The most commonly used medicines in pregnancy. Medications used in induction and stimulation of labor. Progesterone in pregnancy, gynecologic disorders and reproductive medicine. Induction and stimulation of ovulation.
Ishodi učenja
Final meeting of the theoretical part of the course. Making arrangements for writing the midterm exam.
Ishodi učenja
1. Gynecologic examination. Gynecologic examination table, gloves, speculum, lighting.
2. Position of the patient for gynecologic examination – gynecologic positioning.
3. Examination with a speculum. Insertion of the speculum into the vagina. Inspection of the vagina and
cervix. Description of a normal finding.
4. Taking a smear for cytologic analysis (cervicovaginal cytology – Pap test).
5. Taking a cervical smear for bacteriologic analysis.
6. Bimanual examination (palpation of internal genital organs). Description of a normal finding.
7. Gynecologic ultrasound diagnostics. Typical scanning planes. Examination of the uterus. Examination of ovaries. Echogenicity, differences in echogenicity of gynecological organs. .
Ishodi učenja
1. Preparation of a pregnant woman for examination. Blood pressure measurement. Detection of albumin in urine. Weighing. Weight gain.
2. Appearance/Shape of the abdomen (size, shape). Measurement of abdominal circumference. Symphysisfundus height measurement.
3. Fetal assessment. Auscultation of the fetal heartbeats. Pinard’s aural fetoscope.
4. Cardiotocography. Imaging technique and equipment. Normal cardiotocogram – description of a finding.
5. Internal (bimanual) examination of a pregnant woman
6. Clinical assessment of labor. Cardiotocographic assessment of labor.
7. Diagnosis of emergencies (optional, depending on daily cases). Latent phase of labor. Bleeding in the
early stages of pregnancy. Bleeding in late pregnancy.
8. Ultrasound examination in the first trimester of pregnancy.
9. Ultrasound examination in the third trimester of pregnancy. Fetal biometry (BPD, AC, FL).
10. Physical basics of Doppler ultrasound, application in perinatology. Description of a sonogram. Typical
blood vessels for assessment of fetal circulation. Ultrasound indices.
Ishodi učenja
1. Infertility diagnostic algorithm. Criteria, basic tests. Specifics of history-taking in women and men.
2. Follicular monitoring (folliculometry). Documentation of ultrasound findings.
3. Hormonal assay tests in the assessment of ovarian function.
4. Preparation of the couple for the medically assisted reproduction (MAR) treatment.
Ishodi učenja
1. Material needed to take a cytologic smear, spatula, brush, microscopic slide, gloves, fixative vials.
Cytologic finding form. Images with basic elements of cervicovaginal cytology.
2. Organization of gynecologic cytology laboratory.
3. Cytologic screening. Equipment, smear-taking method and handling of slides for Pap test. Pap test
procedure.
4. Demonstration of normal and abnormal cells in cytologic cervical samples (Pap test). Pattern and
cytologic classification for cervical cytology. Interpretation of basic categories of abnormal cytologic cervical findings.
5. HPV detection laboratory. Use and basic interpretation of HPV test results.
6. Sampling and use of direct endometrial cytology.
7. Processing and use of liquid cytologic samples in gynecology.
Ishodi učenja
1. PAP test – elements of a cytologic finding.
2. Examination with a speculum. Inspection of the vagina and cervix – macroscopically visible changes
(normal and pathologic, depending on the cause).
3. Colposcopy – goal, principle, preparation of the field, performance. Schiller test.
4. Cervical biopsy and endocervical excochleation.
Ishodi učenja
1. Patient admission for minor procedures, preparation of medical documentation (daily case reports).
2. Preparation of the staff for surgery. Surgical hand scrubbing. Sterile dressing and putting on gloves.
3. Preparation of the patient for surgery. Surgical positioning, vaginal approach. Preparation of the operating field (vagina and perineum).
4. Surgical instruments for minor procedures. Kit. Diathermy incision loop, electrocautery with a ball tip.
5. Hysteroscopy – diagnostics and treatment
Ishodi učenja
1. Preparation of the staff for surgery. Surgical hand scrubbing. Sterile dressing and putting on gloves.
2. Preparation of the patient for surgery. Preparation of the operating field (abdomen, vagina, and
perineum).
3. Surgical instruments for abdominal, vaginal, and laparoscopic procedures.
4. Equipment for laparoscopic surgery.
5. Assistance in surgical procedures (optional)
Ishodi učenja
1. Gynecologic history. Organization and constituents of the Department.
2. Morning rounds. Postoperative monitoring of gynecologic patients. Preoperative monitoring and
preparation of patients for the operating room.
3. Patient admission to the Department. Preoperative findings and diagnostics. Screening and
categorization of patients scheduled for surgery (general gynecology, gynecologic urology and gynecologic oncology).
4. Gynecologic ultrasound diagnostics. Typical scanning planes. Examination of the uterus. Examination of the ovaries. Echogenicity, differences in echogenicity of gynecologic organs. Pathologic pelvic formations (optional).
5. Termination of unwanted pregnancy (medical and surgical).
Ishodi učenja
1. Perinatologic history, specifics of history-taking. Daily case reports (optional).
2. General examination of a pregnant woman.
3. Fetal position in the uterus and clinical fetal assessment (growth, signs of life).
4. Examination of the pelvis. Assessment of pelvis by inspection, anatomical landmarks on the body
surface, the rhombus of Michaelis.
5. Pelvimetry. Internal and external pelvic measurements. Pelvimeter.
6. Internal examination and assessment of the pelvis.
7. Internal (bimanual) examination of a pregnant woman.
8. Self-monitoring of fetal movements, documentation of findings.
9. Nonstress test (NST) and oxytocin challenge test (OCT), examples of normal results.
10. Early amniocentesis – theoretical framework, method of performing the procedure.
Ishodi učenja
1. Medical records. Pregnancy logbook. Partogram. Labor logbook. Birth certificate.
2. Admission and preparation of the woman in labor. Admission cardiotocography, cardiotocographic
monitoring during labor. Typical sites for external transducers placement on the pregnant woman’s
abdomen.
3. Assessment of labor progress. Clinical assessment of labor. Labor documentation.
4. Vaginal examination of a woman in labor. Stages of cervical dilation. Description of a finding in active
labor. The position of the woman in the first stage of labor. Alternative childbirth delivery methods.
5. Expulsion of the fetus (optional): head-down delivery, head movements in expulsion (breech, vacuum
extraction, cesarean section).
6. Episiotomy. Method of performing the procedure. Surgical care of the perineal incision. Suturing kit.
Postpartum perineal care.
7. Placental stage of labor. Spontaneous delivery of the placenta. Signs of placental abruption. Examination of the placenta.
8. pH-metry. Equpment for performing the procedure. Fetal scalp blood sampling technique.
9. Newborn. APGAR score. Clamping and ligation of the umbilical cord. Examination and primary care of the newborn.
10. Early puerperium. Monitoring of the mother in labor in the delivery room. Vital signs. Fundal height.
Postpartum hemorrhage.
11. Puerperium. Medical documentation in the puerperium. General status of puerpera, monitoring of
puerpera. Physiological functions. Breastfeeding. The most common breastfeeding problems.
Ishodi učenja
1. Reproductive history. Patient’s statement on her health condition.
2. Semen analysis. Demonstration of several different categories of semen analysis.
3. Ovulation test. Demonstration of several hormonal assay tests for assessment of cycle quality
(ovulatory/anovulatory). Ultrasound detection of ovulation. Demonstration of a basal body temperature
chart. Demonstration of cervical mucus – fern phenomenon.
4. Hysterosonosalpingography/Hysterosalpingography. Demonstration of the procedure, video. Instrument kit. X-ray images of a normal finding (uterine anomaly, fallopian tube disease).
5. Cycle monitoring – ultrasound, hormonal. Documentation of findings.
6. Ultrasound in reproductive medicine. Egg retrieval. Embryo transfer. Videos.
7. Conservative treatment of infertility. Ovulation induction. Timing of sexual intercourse. Stimulation of
ovulation. Case reports.
8. Medically assisted reproduction procedures. Homologous intrauterine insemination – video. In vitro
fertilization and embryo transfer – video. Controlled ovarian hyperstimulation – video. Optional: intrauterine insemination, egg retrieval, embryo transfer. Frozen embryo transfer.
9. Fertility conservation. Cryopreservation of gametes and embryos.
10. Surgical treatment of infertility. Microoperations. Diagnostic laparoscopy. Diagnostic hysteroscopy.
Transvaginal hydrolaparoscopy. Videos.
Ishodi učenja
1. Semen analysis. Semen collection, preparation of semen for analysis, slide preparation. CASA analysis.
Sperm counting in a chamber under a microscope. Test results and their interpretation. WHO criteria.
2. Preparation of semen for MAR procedures. Special procedures in cases of severe male infertility.
3. Methods of egg fertilization. In vitro fertilization (IVF). Intracytoplasmic sperm injection (ICSI).
4. Cryopreservation of gametes and embryos. Storage conditions. Storage space. Demonstration of the
procedure with eggs. Demonstration of the procedure with sperm.
5. Laboratory forms for monitoring embryo development. Photographs of embryos at different stages of
development.
6. Standard surgical procedures, books, records, protocols.
Ishodi učenja
1st week – skills in obstetrics and perinatology
1. Demonstration and practice of performing a gynecologic examination on a model. Dressing gloves.
Holding a speculum. Taking a cytological smear from three typical sites. Taking a microbiologic smear.
Bimanual examination and palpation of internal organs.
2. Demonstration and practice of performing an external examination of a pregnant woman. Model of
a pregnant woman. Dressing gloves. Fetal lie, position, presentation, and posture (habitus). Shape of the
maternal abdomen. Leopold-Pavlik’s (I-IV) and Zangemeister’s maneuvers. Cephalic engagement.
Cephalopelvic disproportion.
3. Demonstration and practice of performing pelvic examination. External examination of the pelvis.
Pelvimeter. Female pelvis, pelvic bony ring, landmarks on skeleton and abdomen of a model.
Measurements of the normal pelvis – diameters (DS, SC, DT, CE). Internal examination and estimation of
the pelvis. Internal measurements of the pelvis (CD, CV). Planes of the pelvis – inlet, midpelvis, outlet.
4. Demonstration and practice of performing internal (bimanual) examination of a pregnant woman.
Description of a normal finding through pregnancy trimesters. Cervix, cervical ostium, cervical canal,
presenting fetal part / vertex presentation.
5. Demonstration and practice of performing internal (bimanual) examination of a woman in labor.
Determining of the descent of the presenting part in the birth canal. Demonstration and practice of the
mechanism of normal delivery with fetal movements. Demonstration of typical fetal head structures and
practice of recognizing typical sites.
6. Demonstration of fetal position/presentation in the uterus. Position, place, pose, and posture
Ishodi učenja
2nd week – skills in presentation of patient case, gynecologic case reports
1. Major surgical procedures (5 cases according to the planned operational program). Under the teaching
assistant’s supervision, students analyze the patient’s gynecologic medical history and independently
present one case.
2. Minor surgical procedures (5 cases according to the planned operational program). Under the teaching assistant’s supervision, students analyze the patient’s gynecologic record/documentation and independently present one case.
3. Surgical instruments for abdominal surgical procedures. Names of instruments. Correct handling of
instruments. Purpose of instruments.
4. Surgical instruments for minor procedures. Names of instruments. Correct handling of instruments.
Purpose of instruments.
Ishodi učenja
3rd week Surgical procedures in obstetrics, gynecology and reproductive medicine
1. Demonstration: Manual extraction of the placenta. Instrumental exploration of the uterus after delivery / instrumental evacuation of the placenta. Instrument kit.
2. Demonstration: Vacuum extraction of the fetus. Vacuum kit.
3. Demonstration of gynecologic surgical procedures. Curettage. Instrument kit.
4. Surgical procedures for completion/termination of pregnancy. Vacuum aspiration + curettage.
Intentional termination of pregnancy. Surgical completion of delayed abortion. Medical abortion methods.
5. Surgical procedures in the diagnosis of infertility. Laparoscopy and chromopertubation.
Hysteroscopy. Transvaginal hydrolaparoscopy. Videos. Hysteroscopy model.
6. Contraception. Demonstration: condom, diaphragm. Insertion of intrauterine contraception. Instrument kit. Types of intrauterine contraception. Demonstration of hormonal contraceptive blister pack (combined, regimens, mini-pill)
Ishodi učenja
Learning outcomes: Complexity and sensibility of the approach to a pregnant woman. Identification of difficulties and obstacles in communicating with the patient and her family members. Specificities of obstetric history-taking. Components of the physical examination and detailed description of the examination of a pregnant woman. The significance of informed consent in the perinatologist’s and obstetrician’s daily work.
Ishodi učenja
Learning outcomes: The technique of gynecologic history-taking and its important details and specificities. Types of gynecologic physical examination. The significance of informed consent in gynecology, especially for surgical treatment.
Ishodi učenja
Learning outcomes: Definition of low-risk pregnancy and the concept of screening tests. Professional recommendations for preconception care, performing crucial diagnostic tests, and analyzing results during pregnancy until (term) childbirth.
Ishodi učenja
Learning outcomes: Interpretation and analysis of the most common symptoms and signs present during childbirth. Planning and applying methods to relieve pain during childbirth, including standard pharmacological and nonpharmacological methods and other alternative methods.
Ishodi učenja
Learning outcomes: Identification of obesity as a global, epidemiological problem. Categories of nutrition and recommended weight gain during pregnancy. The impact of obesity on the menstrual cycle, reduced fertility, frequency of miscarriages, macrosomia, prematurity, and congenital anomalies in pregnancy. Connection between obesity, preeclampsia, and gestational diabetes during pregnancy and prediction of pregnancy outcomes.
Ishodi učenja
Learning outcomes: Historical development of the approach to breech delivery. Results of the perinatal outcome of breech delivery compared with the head-down delivery in our Clinic. Informed consent for a trial vaginal delivery and the right to a second opinion in accordance with the Act on Protection of Patients’ Rights, as well as the patient’s right to choose the method of completing delivery from the professional, ethical and forensic aspects.
Ishodi učenja
Learning outcomes: Facts about COVID-19 as new disease. Outome of pregnacy, labor and puerperium. Complication related with infection in healthy pregnant women or in woman with risk.
Ishodi učenja
Learning outcomes: The most important and commonly used operative methods for completing delivery. Advantages and disadvantages and the possible complications of certain obstetric operations. Application of certain operative methods depending on the indication and the specific clinical situation.
Ishodi učenja
Learning outcomes: Term newborn: initial care, asphyxia, lung diseases (transient tachypnea, meconium aspiration, hyaline membrane disease, bronchopulmonary dysplasia, pneumonia), apnea, hypoglycemia, newborn of a diabetic mother, neonatal jaundice, conatal bacterial infections. Premature newborn (lung pathology, central nervous system pathology, diet, fluid and electrolyte balance, hematologic disorders, infections). Organization of neonatal care and treatment. Breast milk, breastfeeding.
Ishodi učenja
Learning outcomes: Classification of premalignant cervical lesions. Importance of regular gynecologic examinations and detection of premalignant lesions. The role of colposcopy and the method of performing it. Destructive and excision methods of treating premalignant lesions as well as indications for the use of each method. Importance of regular check-ups in patients with previous premalignant lesions. Methods of prevention of premalignant lesions. The role of the media in the prevention of premalignant cervical disorders.
Ishodi učenja
1. spontaneous abortion, 2. ectopic pregnancy, perimenopausal bleeding, postmenopausal bleeding. Learning outcomes: Basic elements of the differential diagnosis of gynecologic bleeding that have the same/similar clinical presentation.
Ishodi učenja
Learning outcomes: The principles of choosing contraceptive methods depending on the patient’s age and needs, and the main limitations of certain contraceptive methods. Counseling and behavioral methods that help the couple to accept and successfully continue using the chosen contraception method. Symptoms and signs associated List of practicals (with titles and learning outcomes): with contraception, with special emphasis on patients who require the assessment of a gynecology specialist or subspecialist for the safety of contraceptive use and the patients’ future health.
Ishodi učenja
Learning outcomes: Appearance, definition, clinical presentation, and therapeutic options for pelvic floor muscle disorders, descended and prolapsed uterus. The basics of micturition function. The mechanism of maintaining urinary continence. Incontinence – types, diagnosis, treatment. Urinary fistulas
Ishodi učenja
The classic approach – abdominal surgical procedures, vaginal surgical procedures, laparoscopy and hysteroscopy, minor surgical diagnostic and therapeutic procedures. Learning outcomes: Basic approaches to the operating field and its preparation, as well as the basic instruments necessary to perform surgical procedures. Method and selection of surgical procedure in case of gynecologic surgical emergencies. Overview of available minimally invasive surgical techniques in gynecology. Indication area, equipment and specifics of work. Benefits, limitations, and complications of applying these techniques.
Ishodi učenja
Learning outcomes: Health problems of the postmenopausal female population and the achievements of preventive medicine. The role of hormone replacement therapy (HRT) in raising the quality of life of the elderly female population. Diseases and disorders of the body systems that can be alleviated or prevented by HRT, i.e. the indications for the introduction of HRT in postmenopausal women. Timing related to the indications for HRT, and contraindications for the therapy. Preparation of patients for HRT use and monitoring of such patients. Positive effects of HRT on target body systems (cardiovascular, skeletal, urogenital, skin, metabolism). Cessation of HRT use.