Module 10-11: Labour & Delivery - Module 12: The Puerperium

This blogpost provides the outline of three (3) Modules in obstetrics “Module 10 & 11: Management of Labour & Delivery” AND “Module 12: Postpartum Problems (The Puerperium)”. I decided to cover these in a single post as all these modules are closely interlinked

• It is important to develop understanding of a particular problem as it may start in antenatal period and has to be dealt till the postpartum period (and may even effect the management of next pregnancy)
• Kindly have a look at the details of modules on RCOG website which will clarify what are you expected to demonstrate under these modules
• Module 10 & 11 are covered under a Single Main Heading as it is difficult to clearly distinguish it in a given scenario
• Some of the topics to be covered in these modules are already outlined in posts covering Module 8: Antenatal Care Click Here: Post#1 Post#2
• Specially in the postpartum module, you may notice that there is repetition of some topics which were already outlined under antenatal care module. The main purpose to repeat these is to give a clear idea how all these modules are connected. Some of the problems are more relevant in postpartum period e.g. mental health issue, Sepsis or VTE to name a few
• Following tables may help you to collect and organize your study material in one place
• If you use gadgets (iPad/Laptop/Smartphone) its easier to arrange but if you prefer hard copies, you can get the printouts and arrange it according to your convenience 
• You can make a Big folder and add Subfolders based on following tables. This is to ensure that you do not miss any topic
• For each topic you can make a ‘NOTE’ file which should be a summary of the points taken from all resources
• Your NOTES are the most useful document. It should be made in way which is concise and easy to retain the information
• Keep practicing SBAs and EMQs from different sources as labour and delivery scenarios are tricky. You need to focus on EACH and EVERY word to get to the right answer
• In the following outline, if you find any topic is missing kindly modify your list and let me know

I hope you find this compilation helpful and it saves your precious time. Suggestions to improve future posts are welcome.

Thanks

Module 10 & 11: Management of Labour and Delivery

Details— 10: Management of labour 11: Management of delivery

Intrapartum Care
NICE	Intrapartum Care for Healthy Women & Babies Intrapartum Care for women with existing medical conditions  Summary Part 1  Part 2
TOG	Management of delivery with malposition of fetal head in 2nd stage of labour 2015
SIP	#2 Umbilical Cord Blood Banking #14 Clamping of Umbilical Cord and Placental Transfusion
Induction/Augmentation of Labour
NICE	Induction of Labour
TOG	Overview of trends for cervical ripening in IOL 2017 Use and Abuse of Oxytocin 2015
SIP	#34 Induction of Labour at Term in Older Mothers
Assessment of Fetal Wellbeing It is required to learn interpretation of CTG and apply understanding on the given scenarios tested in the exam The topic is can be covered from StratOG and NICE guideline on Intrapartum Care You may also find following resources useful
eFM	e-Learning for Healthcare (eLFH) Electronic Fetal Monitoring (eFM): It is a very comprehensive web-based resource developed by RCOG and Royal College of Midwives It also provides some case studies which can be helpful It requires registration. You can join it by Clicking Here
TOG	ST Analysis for Intrapartum fetal monitoring 2015
Operative Vaginal Delivery
GTG	#26 Assisted Vaginal Birth Summary: Click Here
CA	#11 Operative Vaginal Delivery
TOG	Clinical assessment for instrumental birth
Labour Ward Management
GP	#7 Maternity Dashboard #8 Responsibility of consultant On-Call #10 Labour Ward Solutions #12 Improving Patient Handover
Operative Obstetrics This topic is outlined in details covering almost all aspects of ANY surgical procedure in a previous blog post about Modules 5, 6 & 7 (Surgery in Ob/Gyn) Following is the list of relevant topics taken directly from that post To access the full post please Click Here
Anaesthesia/ Analgesia
SIP	#59 Antenatal and Postnatal Analgesia
TOG	Analgesia for labour 2015
Blogpost	Analgesia in Obstetrics
LA	Recommended Local Anaesthetic Doses (Adults)
Caesarean Section
GTG	#45 Birth after previous Caesarean Birth
NICE	Caesarean Section
CA	#7 Caesarean Section #12 C/S for Placenta Previa
GP	#11 Classification of Urgency of C/S
TOG	Gynaecological morbidity associated with CS niche 2020 Acute colonic pseudo-obstruction after CS 2019 Perimortem C/S- why, when and how 2018 Complications of C/S 2016 C/S at full dilatation 2014 Counselling women about risks of C/S delivery on future pregnancies 2014
Perineal Tear
GTG	#29 Management of Third-and-Fourth-degree Perineal Tears
CA	#9 Repair of Third-and-Fourth- degree Perineal Tears following childbirth
TOG	Obstetrics pelvic floor and anal sphincter injuries 2012
Relevant Obstetrical Emergencies Obstetrics Emergencies are covered in ANC post #2 Only relevant topics are listed below To access the complete list Obstetrics Emergencies please Click Here
GTG	#42 Shoulder Dystocia #50 Umbilical Cord Prolapse #56 Maternal Collapse in Pregnancy and Puerperium
Maternal Mortality
MBBRACE	The term stands for Mothers Babies: Reducing Risk through Audits and Confidential Enquiries across UK You need to collect and go though at least last 2 reports in order to make the comparison and these numbers should be on fingertips To access November 2018 report please Click Here
TOG	Autopsy in the event of maternal death —a UK Perspective 2019

Module 12: Postpartum Problems (The Puerperium) 

Details— 12: The Puerperium

The Postpartum Period
NICE	Postnatal Care upto 8 weeks after birth
Postpartum Haemorrhage
GTG	#52 Postpartum Haemorrhage, Prevention and Management
GP	#6 The role of emergency and elective interventional radiology in PPH
TOG	Pelvic and vaginal packing for intractable venous obstetrics hemorrhage 2014 The surgical approach to postpartum haemorrhage 2009 Acute Inversion of Uterus 2009
PostPartum Sepsis
GTG	#64a Sepsis in Pregnancy, Bacterial #64b Sepsis following Pregnancy, Bacterial
TOG	Maternal Sepsis Update 2020 Click Here: Summary Genital Tract Sepsis: early diagnosis, managment and prevention 2012 Group A streptococcal puerperal sepsis: management and prevention 2012
Thromboembolism
GTG	#37a Reducing Risk of thrombosis and embolism during pregnancy and puerperium #37b The Acute Management of thrombosis and embolism during pregnancy and puerperium
NICE	NG#89 VTE in over 16s: reducing risk of hospital-acquired DVT or PE TOG Postpartum ovarian vein thrombosis 2016
Perinatal Mental Health
NICE	#192 Antenatal and Postnatal Mental Health
TOG	Perinatal mental health: how to ask and how to help 2017 Postpartum psychosis 2013
GP	#14 Management of women with mental health issues during pregnancy and postnatal period
SIGN	#127 Management of perinatal mood disorders
Newborn Care
YouTube	You need to cover the topic of newborn assessment & resuscitation Following YouTube links may be helpful: Neonatal Examination Neonatal Resuscitation
PostPartum Contraception
FSRH	Contraception After Pregnancy Executive Summary Contraception After Pregnancy
TOG	Postpartum Contraception 2018
BPP	#1 Postpartum Family Planning

NOTE: Kindly keep following the blog and facebook page for future updates

You may also like:

Module 2-3: Teaching-Apppraisl-Clinical Governance-Research 
Module 5,6,7: Core Surgical Skills, Post-op Care & Surgical Procedures

Module 8: Antenatal Care — Part 1

Module 8: Antenatal Care — Part 2
Module 9: Maternal Medicine

Module 13: General Gynaecology
Module 14: Subfertility
Module 15: Sexual and Reproductive Health

Module 16: Early Pregnancy Care

Module 17: Gynaecological Oncology
Module 18: Urogynaecology & Pelvic Floor Problems

Starting Point for MRCOG Part 2
3Ws and General Advice for MRCOG Part 2

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