Labour and its Complications, Operative Obstetrics, Newborn Baby Puerperium and its Abnormalities, Safe Motherhood

At the end of this course, students should be able to: 1. define post-term and induction of labour; 2. describe incidence and recurrence of post-term; 3. enumerate the physiological changes and complications associated with post term; 4. describe interventions to reduce post-term, role of accurate pregnancy dating, sweeping of foetal membranes; 5. discuss the management of post-term labour induction versus expectant management, failed induction, role of foetal surveillance; 6. list the causes of obstructed labour and its clinical features; 7. describe the management including mode of delivery; and 8. list the complications of obstructed labour. 114

Physiology of labour. Management of labour including the use of the partogram. Induction of labour. Prolonged labour. Feto-pelvic disproportion and obstructed labour. Face, brow presentations and other malpositions. Obstetric injuries. Uterine rupture. Obstetric analgesia and anaesthesia. Instrumental delivery, forceps. Instrumental delivery, vacuum. instrumental delivery, destructive operations. Symphysiotomy, caesarean delivery. Management of the new-born baby. Management of the puerperium, episiotomy, postpartum haemorrhage, retained placenta, abnormal placental attachments, placenta accreta, increta, percreta, placenta praevia and acute uterine inversion. Sudden postpartum collapse. Puerperal pyrexia. Upper genital tract infections. Post-partum contraception. Safe motherhood initiative. Maternal mortality in Nigeria. Age and reproductive outcome. Parity and reproductive outcome.