All India Institute of Medical Sciences, Rishikesh (Uttarakhand)

College of Nursing

UNIT PLAN
Subject : Obstetrical & Gynecological Nursing Including Midwifery

Program and Placement : B.Sc. (Hons.) Nursing III Year

Course Duration : 1 Year

Allotted Hours : Particulars Prescribed (Hrs) Planned (Hrs)

a) Theory 90
b) Practical 360 375

Unit Consultants : 1. Mrs. Prasuna Jelly

2. Dr. Rakhi Gaur
3. Mrs. Navjeet Kaur
4. Mrs. Renu Sandhu
5. Ms. Sneha Sehrawat

General Objectives : At the end of each unit the students will be able to have thorough theoretical and practical
knowledge and comprehension regarding all the topics and apply the same knowledge in educational,
clinical, community & research settings.
 Prescribed Learning A.V.
Unit Contents Hours Method of Method of
Hour
Objectives Teaching Aids Evaluation

I. 2  Recognize the Introduction to midwifery and obstetrical nursing:

trends &  Introduction to concepts of midwifery and obstetrical 10 mints
issues in nursing.
midwifery &  Trends in midwifery and obstetrical nursing. 1 hr
obstetrical o Historical perspectives and current trends.
nursing o Legal and ethical aspects.
o Preconception care and preparing for Lecture cum
PPT &
 Questioning
parenthood. Discussion Chalk
o Role of nurse in midwifery and obstetrical care. Board
 National policy and legislation in relation to maternal
health and welfare.
30 mints
 Maternal morbidity, mortality and fertility rates.
Peri-natal morbidity and mortality rates. 15 mints
 Concept of family centered maternity care.
5 mints
II. 5  Describe the Review of anatomy and physiology of female
anatomy & reproductive system and fetal development
physiology of  Female organs of reproduction –external genitalia, 1 hr
female internal genital organs and their anatomical relations,
reproductive musculature –blood supply, nerves, lymphatic, pelvic
system cellular tissue, pelvic peritoneum.
 Physiology of menstrual cycle
15 mints
 Human sexuality 10 mints
 Fundamental of reproduction-gametogenesis, 30 mints  Lecture cum PPT,  Questioning
ovulation, fertilization , implantation (embedding of Discussion OHP,  Unit Test
the ovum )  Demonstration &  Assessment
 Development of the embryo 15 mints  Practice Chalk of skills
 Development of placenta at term, structure, functions 20 mints session Board with
and placental circulation, fetal sac  Clinical checklist
 Amniotic cavity, amnion and amniotic fluid 10 mints practice
 Umbilical cord 10 mints
 Anatomical variations of the placenta and the cord 10 mints
10 mints
  Fetus- fetal physiology, time scale of fetal
development, 20 mints
 Fetal circulation 20 mints
 Fetal skull, bones, sutures and measurements
 Female pelvis-general description of the bones, joints, 40 mints
ligaments, planes of the pelvis, diameters of the true
pelvis, important landmarks, variations in pelvis shape
 Review of genetics: genetics, principles of heredity,
genetic disorders and counseling, prevention and 20 mints
prediction of congenital malformation, embryology
related to congenital malformation
10 mints
 Role of nurse in rendering sex education
III. 5  Describe the Assessment and management of pregnancy in
diagnosis & antenatal period
management  Normal Pregnancy
of women  Physiological changes during pregnancy
20 mints
during o Reproductive system.
40 mints
antenatal o Cardio vascular system.
period. Lecture cum  Questioning
o Respiratory system. PPT &
Discussion
o Urinary system. Chalk
o Gastro intestinal system Board
o Metabolic changes.
o Skeletal changes.
o Skin changes.
o Endocrine system.
o Psychological changes
o Discomfort of pregnancy
 Signs and symptoms of pregnancy- differential 20 mints
diagnosis.
 Diagnosis of pregnancy- Sign and symptoms at first, 30 mints
second and third trimester, Confirmatory test-
immunological tests, presenting part, denominator
 Obstetrical examination confirmatory test, invasive 20 mints
and non-invasive procedures.
 Minor ailments during pregnancy and its 30 mints
management.
 Antenatal care 30 mints
o Objectives.
o Assessment.
- History taking
 - Physical examination
- Antenatal examination
- Sign of previous child birth
o Relationship of fetus to uterus and pelvis: lie,
attitude, presentation, presenting part,
position.
o Per vaginal examination.
 Screening and assessment of high risk and risk 20 mints
approach.
 Antenatal preparation 30 mints
o Diet.
o Exercise.
o Substance use
o Education for child birth
o Preparation for safe -confinement
o Prevention from radiation
o Husband and families
o Counselling and teaching.
 Psycho-social and cultural aspects of pregnancy –
30 mints
assessment and support.
o Adjustment to pregnancy.
o Teenage pregnancy.
o Unwed mother.
o Single parent.
o Sexual violence.
 Adoption. 30 mints
IV. 10  Describe the Assessment and management of intra-natal period
physiology &  Physiology of labour. 1 hr
stages of  Mechanism of labour. 30 mints
labour.  Management of first stage of labour 1 hr
 Describe the o Signs and symptoms of labour.
management o Duration.
of women o Preparation of labour room and women.
during intra- o Assessment and observation of women in
natal period. labor.
o Partogram-Maternal and fetal monitoring
 Lecture cum  Questioning
 Assessment of pain and anxiety during labour – pain 30 mints Discussion PPT,  Unit Test
management and comfort in labour.
 Demonstration OHP,  Assessment
 Induction of labour. 30 mints  Practice & of skills
 Active management of labor. 30 mints session
  Management of second stage of labour 2 hr  Clinical Chalk with
o Signs and symptoms normal and abnormal. practice Board checklist
o Duration.  Group Work
o Conduction of delivery-principles and
techniques.
o Episiotomy(only if required)
o Receiving the newborn.
- Neonatal resuscitation; initial steps and
subsequent resuscitation.
- Care of umbilical cord.
- Bonding
- Initiate feeding.
- Screening and transportation of neonate.
 Neonatal resuscitation and immediate care of the
newborn after delivery. 1 hr
 Management of third stage of labour
1 hr
o Signs and symptoms.
o Duration
o Method of placental expulsion.
o Management – principles and techniques.
o Active management of labour.
 Examination of placenta and perineum. 30 mints
 Management of fourth stage of labour. 30 mints
 Maintenance of reports and records. 30 mints
 Concept of water birth 30 mints
V. 5  Describe the Assessment and management of women during
physiology of postnatal period
puerperium.  Normal puerperium. Physiological changes and its
 Describe the management
1 hr
management  Involution of uterus and other pelvic structure, lochia
of women  Lactation and physiology of lactation with its 30 mints
30 mints
during post- Lecture cum  Questioning
management. PPT &
natal period. Discussion  Assessment
 Episiotomy (if present) different types and its care 30 mints
Chalk
Board of skills
 Postnatal care: episiotomy care, postnatal exercise, 30 mints with
immunization, promoting physical and emotional checklist
wellbeing.
 Mother infant bonding 30 mints
 Family dynamics after child birth. 30 mints
 Family welfare services- methods, counseling, follow 30 mints
up.
  Maintenance of records and reports. 30 mints

VI. 5  Describe the Assessment and management of normal neonates

assessment &  Normal neonates
management o Physiological adaptation. 1 hr
of normal o Assessment and management
neonate.  Physiological adaptation of new born.
 Characteristics of newborn. 20 mints  Lecture cum PPT,  Questioning
 Immediate appraisal of newborn.
20 mints Discussion OHP,  Unit Test
20 mints  Demonstration &  Assessment
 Apgar score care of newborn.
10 mints  Practice Chalk of skills
 Initial and daily assessment. 10 mints Board
session with
 Identification of congenital abnormalities and referral. 20 mints  Clinical checklist
 Essential newborn care, Thermal regulation and 30 mints practice
prevention of infection.
 Breast feeding. 20 mints
 Immunization. 10 mints
 Minor disorders of newborns and its management. 1 hr
 Levels of neonatal care and maintenance of records 20 mints
and reports.
VII. 10  Describe the Assessment and management of high-risk pregnancy
identification  Screening and assessment 30 mints
& o History taking
management o Physical examination
of women with o Ultrasonic
high risk o Cardiotomography  Lecture cum PPT,  Questioning
pregnancy. o NST, CST Discussion OHP,  Unit Test
o Invasive procedure  Demonstration &  Assessment
o Non-invasive procedure  Practice Chalk of skills
o Latest modalities of diagnosis: CVS, session Board with
Amniography, Radiology in obstetrics, etc)  Clinical checklist
 High-risk approach practice
30 mints
 Levels of care: primary, secondary & tertiary
20 mints
 Disorders of pregnancy 1 hr
o Hyperemesis Gravidarum
o Bleeding in early pregnancy
o Abortion
o Ectopic pregnancy
o Vesicular mole
 Antepartum hemorrhage 30 mints
  Uterine abnormality and displacement 30 mints
 Diseases complicating pregnancy 3 hrs
o Medical and surgical conditions: hematological
disorders in pregnancy , tuberculosis, heart
disease, diabetes mellitus, thyroid dysfunction
o jaundice, asthma, proteinuria, haematuria in
pregnancy, general surgery during pregnancy.
o Infections -viral hepatitis, syphilis, leprosy,
bacteria, parasitic and protozoal infestation in
pregnancy, pyelonephritis in pregnancy, SLE
Epilepsy, viral infections, HIV and AIDS, RTI, UTI,
TORCH, STD.
o Gynecological disorders in pregnancy – abnormal
vaginal discharge, congenital malformations,
carcinoma cervix, fibroid, ovarian tumour,
retroverted gravid uterus, genital prolapsed.
o Mental disorders
 Postpartum blues
 Postpartum depression
 Postpartum psychosis
 Toxemia of pregnancy 30 mints
o Pre-eclampsia
o Eclampsia
o Hydramnios
 Rh-incompatibility 20 mints
 Multiple pregnancy and IUGR 30 mints
 Nursing management of the mother’s with high-risk 1 hr
pregnancy
 Adolescent pregnancy, elderly primigravida and grand 1 hr
multipara.
 Maintenance of records and reports. 20 mints
VIII. 10  Describe Assessment and management of abnormal labour
management  Disorders in labour 2.5 hrs
of abnormal o CPD and Contracted pelvis
labour & o Mal-presentations and mal-positions
obstetrical o Disorders in uterine contractions
emergencies. o Precipitated labour, premature labour and  Lecture cum PPT,  Questioning
prolonged labour Discussion OHP,  Unit Test
o Complications of 3rd stage of labour and injury to  Demonstration &  Assessment
birth canal  Practice Chalk of skills
Board
 Obstetrical emergencies and their management session
 o Cord prolapse & presentation 2.5 hrs  Clinical with
o Vasa praevia practice checklist
o Amniotic fluid embolism
o Rupture of the uterus
o Shoulder dystocia
o Obstetrical shock
 Obstetrical operations and techniques
o Caesarean section 3 hrs
o Forceps
o Vacuum
o Destructive operations
o Manual removal of placenta
 Nursing management of the woman undergoing 2 hrs
obstetrical operation and procedures
IX 4  Describe Abnormalities during post-natal period
management  Assessment and management of women with 3 hrs
of postnatal postnatal complications
complications. o Puerperial sepsis  Lecture cum PPT,  Questioning
o Breast complications (abscess, engorgement, Discussion OHP,  Unit Test
cracked nipple, etc) &
o UTI Chalk
o Thrombo-embolic disorders Board
o Sub-involution of uterus
o Eclampsia
1 hr
 Post-partum hemorrhage
X 10 Identify the high Assessment and management of high-risk newborn
risk neonates &  Protocol for admission of neonates in NICU 30 mints
their nursing  Assessment and nursing management of high risk 3 hrs
management newborn:
o small for date, large for date, infant of diabetic  Lecture cum PPT,  Questioning
mother, prematurity, postmature babies, IUGR, Discussion OHP,  Unit Test
Asphyxia neonatrum, Respiratory distress  Demonstration &  Assessment
syndrome, Hyaline mambrance disease, birth  Practice Chalk of skills
session Board with
injuries, congenital anomalies, congenital
 Clinical checklist
syphilis, newborn with HIV positive Hemolytic
practice
deseases of newborn, Infections, TORCH neonatal
seizures, matabolic disorders still birth - causes
and management.
 Nursing management of
 o LBW 3 hrs
o Pre-mature baby
o Neonatal infections
o Respiratory problems
o Haemolytic disorders
o Birth injury
o Malformations
 Maintenance of records and report
 Monitoring and feeding of high-risk neonates 30 mints
 Organization and management of the NICU 1 hr
 Infection control in NICU 1 hr
1 hr
XI 4  Describe Pharmaco-therapeutics in Obstetrics
indication,  Indication, Doses, Action, Contra-indication and side- 30 mints
dosage, action, effects of drugs
side effects &  Effect of drugs on pregnancy, labour and puerperium 30 mints  Lecture cum PPT,  Questioning
nurse’s  Nursing responsibilities in the administration of drugs Discussion OHP,  Unit Test
1.5 hrs
responsibilitie in obstetrics
&
s in the o Oxytocin
Chalk
administration o Anti-hypertensive
Board
of drugs used o Diuretics
for mothers. o Tocolytic agents
o Anti-convulsants
o Anticoagulants
 Analgesia and anesthetics use in obstetrics 30 mints
 Effects of maternal medication on fetus and neonates 30 mints
 Alternative therapies in Obstetrics 30 mints
XII 10  Appreciate the Family welfare Programme
importance of  Population dynamics in India 10 mints
family welfare  Concepts, Aims, Importance and History of Family 1 hr
programme Welfare Programme, National Population dynamics
 Describe the Policy and National Education Policy
methods of  National Family Welfare Programme 1 hr
contraception o MCH
& role of nurse o Safe Motherhood  Lecture cum PPT,  Questioning
in family o ICDS Discussion OHP,  Unit Test
welfare &
o RCH-I
programme. Chalk
o RCH-II
Board
  Organization and administration of Family Welfare 1 hr
Programme at
o Village level
o Block level
o District level
o State level
o National level
 Method of contraception, spacing, temporary, 1.5 hrs
permanent and Emergency contraception
 Infertility and its management
 Motivation and counseling for Family Welfare 1 hr
 Maintenance of vital statistics and latest research in 1 hr
contraception 30 mints
 Role of national, International, voluntary and NGOs in
Family Welfare Programme
1 hr
 Role of nurse in Family Welfare Programme
 Training/ Supervision / Collaboration with other 1 hr
functionaries in community like ANMs LHVs, 2 hrs
Anganwadi workers, TBAs (Traditional birth
attendant dai)
XIII 10  Describe the Nursing Management of Patient With Disorders of
etiology, female reproductive system (Gynecological
pathophysiolo disorders)
gy, clinical
 Review of anatomy and physiology of the female
manifestation, 1.5 hrs
reproductive system
diagnostic
 Nursing Assessment: History and physical
measures & 1 mint
assessment.
management
 Etiology, pathophysiology, clinical manifestations,
of patients 7.5 hrs
diagnosis, treatment modalities and medical and  Lecture cum PPT,  Questioning
with disorders
surgical nursing management of disorders of female OHP,  Unit Test
of Female Discussion
reproductive System &
Reproductive
o Menstrual disorders Chalk
system
o Ovarian & fallopian tube disorders Board
 Describe
o Endometriosis
concepts of
o Polyps, fibroids
reproductive
o Cervical & uterine tumors
health and
o Uterine displacement
family welfare
o Vaginal disorders
programme
o Vulval disorders ;
o Menopause & hormonal replacement therapy
o Abortion – natural, medical & surgical abortion –
MTP act
o Toxic shock syndrome
o Congenital abnormalities of female reproductive
system
o Drugs used in treatment of gynecological
disorder