FOURTH YEAR BSC NURSING

OBSTETRICAL AND GYNECOLOGICAL NURSING

Title of course : Obstetrical Nursing

Placement : Fourth Year

Hours of instruction : Theory - 90 Hours

[External-10 Hours]

Practical-480 Hours

Course Description:

This course is designed for students to appreciate the concepts and principles of obstetrical nursing and helps them to acquire knowledge and develop
attitude and beginning skills in rendering nursing care to normal and high risk pregnant women during antenatal, natal and postnatal periods in hospital and
community settings. It also helps to develop skills in managing normal and highrisk neonate and participate in family welfare programmes.

Objectives

At the end of the course the students

1. Appreciate the historical perspectives, trends and issues in obstetric Nursing

2. Identify the anatomical, physiological and psychosocial changes take place during pregnancy.
3. Render comprehensive care to mother during antenatal, natal and post partum periods.

4. Demonstrate beginning skillsin conducting normal deliveries.

5. Identify and manage abnormalities and complications of pregnancy, labour and puerperium.

6. Demonstrate competence in caring fore high risk newborn.

7. Describe the pharmacological agents, their effects during, pregnancy, childbirth, puerperium, lactation and role of the nurse

8. Describe the recent advancement in contraceptive technology, birth control measures and role of the nurse.

9. Give health education to antenatal, intranatal, postnatal mothers and their family members.

10. Explain the legal and ethical issues pertaining to obstetric nursing
Unit Time in hours Learning Objective Content Teaching and learning Assessment method
activity essays
 I. 3 Appreciate the trends Introduction to Lecture Discussion Essay type Short
and issues in concepts of Obstetrical Explain using slides, answers
Obstetrical nursing Nursing Charts

Historical perspectives
and current trends Hall
marks of Midwifery
Identify the legal and
ethical aspects in Contemporary issues in
obstetric nursing obstetrics

Legal and ethical

aspects

Role of Obstetrical
Nurse

II. 7 Describe the anatomy Review of anatomy and Lecture discussion Short answers,
and physiology of physiology of female Review with Charts and Objective type
female reproductive reproductive system models Assessment
system of skills with check list
Assessment of skills
Discuss pre conception Female pelvis- general with check list
care and preparation description of the Demonstrate
for planned bones, joints, with models, objects
parenthood ligaments, planes of
the pelvis, diameters of
the true pelvis, Practice sessions
important landmarks, Explain using charts,
variation in shape of slides& models
pelvis Female organs of
Explain conception and reproduction- external Demonstrate with
fetal development genitalia, internal models, object Practice
genital organs and session
their anatomical
relations, musculature-
blood, supply, nerves,
lymphatics, pelvis
floor, pelvic cellular
tissue, pelvic
peritoneum

Physiology of
menstrual cycle-
Human sexuality
Preconception care
and preparing for
parenthood

Conception and
foetal development
Review of
fertilization,
implantation,
embedding of the
ovum, development
of
With the embryo and
placenta, placenta at
term, functions
abnormalities, the
foetal sac, amniotic
fluid, the umbilical
cord Foetal
circulation, foetal
skull, bones, Sutures
and measurements.
 3 Explain Maternal Maternal, prenatal and Lecture Discussion Short answers,
III. prenatal and genetic genetic influences on Explain using charts, Objective type
influences on development of slides
development of defects and diseases
defects and diseases Conditions affecting
the mother, genetic
and infections
Consanguinity Prenatal
nutrition and food
allergies. Maternal Age
Maternal drug therapy
Prenatal diagnosis and
counseling Effect of
radiation, drugs and
chemicals Infertility
Spontaneous abortion
Neural Tube
Defects and the role of
folic acid in lowering
the risks Down
syndrome (Trisomy 21)
Genetic counseling
Nurses role in
minimizing threats to
the developing
embryos and foetus .
IV. 8 Describe the diagnosis Assessment and Lecture Discussion case Essays Short answers
and management of management of discussion Explain Objective type
women during pregnancy antennal using slides, charts Assessment of skills
antenatal period Normal pregnancy with check list
Physiological changes Presentation Health Assessment of patient
during pregnancy. talk Practice session management problems
Reproductive system Counseling session
Cardio vascular system
Respiratory system
Urinary system Gastro
intestinal system
Metabolic changes
Skeletal changes Skin
changes Endocrine
system[changes of
endocrine and role of
endocrine system in
relation to
reproduction]
Psychological changes
Diagnosis of pregnancy
History physical
assessment
Confirmatory tests
Differential diagnosis Lecture discussion
Explain using charts,
Foetal assessment- Bio slides Case discussion
physical – foetal in clinical area Short answers
movement count, objective type
sonographycardio
tocography, NST, CST,
nipple stimulation test,
vibroacoustic
stimulation test[VAST],
Manning score

Biochemical- Human
estriol, Maternal
serum, alpha
fetoprotein, acetyl
choline esterase(AchE),
Triple test,
Aminocentesis,
Cordocentesis.
Chorionic villus
sampling[CVS].

Radiology in obstetrics
Antenatal care
Objectives Assessment
History and physical
examination Antenatal Assessment of skills
Examination Signs of with checklist
previous child birth Demonstration
Relationship of foetus Practice session
to uterus and pelvis:
Lie, Attitude
presentation, Position Supervised clinical
Pervaginal examination practice
Screening and
assessment for high
risk Risk approach
Antenatal preparation
Antenatal counseling
Antenatal exercises
Diet Minor disorders
and management
Complementary
therapies in obstetric
practice Child birth
Education classes -
Husband and -
Families

Preparation for safe

confinement Psycho
social and cultural
aspects of pregnancy
Adjustment to
pregnancy Unwed
mother
 Single parent Teenage
pregnancy Sexual
violence Adoption .

V. 12 Describe the Assessment and Lecture labour Essay type short

physiology and stages management of Discussion answers Objective type
of labour intranatal period- Demonstration using Assessment of skills
Essential factors of partograph case with check list
Describe the labour Physiology of discussion/ Assessment of woman
management of labour, mechanism of presentation. & management of
women during labour Management of Simulated practice problems
intranatal period labour First stage- supervised clinical
Physiology of normal practice
labour Signs and
symptoms of onset of
labour normal and
abnormal Duration Lecture discussion
Preparation of - Demonstration using
Labour room - Women Obstetric
Assessment and maniquinsimulated Assessment of skills
observation of women practice Practice with checklist
in labour. Partogram- session
maternal and foetal
monitoring Active
management of labour
Pain, relief and Demonstrate using
comfort in labour – episiotomy simulator
Pharmacological
and non pharmacologic
management Second
stage Signs and
symptoms: normal and
abnormal Duration
Mechanism of labour
Conduct of delivery:
Principles and
techniques Episotomy
(only if required)
Receiving the new born
- Neonatal
resuscitation; initial
steps and subsequent
resuscitation, Apgar
scoring - Care of
umbilical cord -
Immediate assessment
including screening for
congenital anomalies -
Identification - Bonding
- Initiate feeding -
Screening and
transportation of the
neonate Third stage
Signs- and
symptoms- normal and
abnormal Duration
Methods of placental
separation, expulsion
of placenta and
membranes
Management
Principles and
techniques
Examination of
perineum Maintaining
records and reports
Fourth Stage Vigilant
observation and care
of the mother and
newborn .
VI. 4 Describe the Assessment and Lecture discussion Essay type short
physiology of management of Demonstration health answers objective type
puerperium Describe woman during post talk Practice session Assessment of skills
the management of natal period. Normal supervised clinical with check list
women during post puerperium practice Assessment of patient
natal period Physiology, management problems
Psychological phases of
puerperium Post natal
assessment and
management -
Promoting physical and
emotional wellbeing
- Management of
lactation - Family
dynamics after child
birth - Family welfare
services, methods,
counseling - Follow up
- Records and reports .

VII. 4 Describe the Assessment and Lectures discussion Essay type Short
assessment and management of Demonstration answers objective type
management normal normal neonates The Practice session Assessment of skills
neonate normal neonate Supervised Clinical with check list
Physiological practice Assessment of patient
adaptation, Initial & management
 daily assessment, problems.
including neonate
reflexes & clinical
implication Essential
newborn care Thermal
control, Breast feeding
Prevention of
infections,
immunization Minor
disorders of newborn
and its management
Levels of Neonatal care
(level I, II & III) At
primary, secondary
and tertiary levels
Maintenance of
reports and record

VIII. 15 Describe the High risk pregnancy- Lecture discussion Essay type, Short
identification and assessment & Demonstrate using answers, Objective
management of management video films, scan, type, Assessment of
women with high risk Screening and reports partograph skills with checklist
pregnancy assessment case discussion Assessment of woman
Ultrasound, presentation Health Management of
cardiotocography, NST, talk Practice session problems
CST non invasive & Supervised clinical
invasive, Admission practice
test Newer modalities
of diagnosis High risk
approach Levels of
care, primary
secondary and tertiary
level Disorders of
pregnancy Hyper
emesis gravidarum,
bleeding in early
pregnancy- abortion,
ectopic pregnancy
&Vesicular mole
Bleeding late
pregnancy Ante
partum haemorrhage-
placenta pravia
Abruptco placenta
Uterine abnormality
and displacemen
Diseases complicating
pregnancy- Medical
and surgical conditions,
infections UTI, STD,
HIV, TORCH
Gynecological diseases
complicating
pregnancy Pregnancy
 included hypertension
& Diabetes,
Hydramnios, Rh
incompatibility,
multiple gestation
Mental disorders
Adolescent pregnancy,
Elderly primi and grand
multipara
Abnormalities of
placenta & cord Intra
uterine growth
Restriction
Immunology in
pregnancy Nursing
Coagulation failure in
pregnancy
management of
mothers with high risk
pregnancy
Maintenance of
records and reports
IX. 15 Describe management Abnormal Labour- Lecture Discussion Essay type short
of abnormal labour Assessment and Demonstration case answers objective type
and obstetric Management Disorders discussion/ Assessment of skills
emergencies in labour CPD and presentation Practice with check list
contracted Session Supervised Assessment of patient
pelvis,Malposition s clinical practice Management of
and malpresentations problems
premature labour&
Premature Rupture of
Membrane disorders
of uterine actions-
precipitate labour,
prolonged labour or
dysfunctional labour,
abnormal uterine
action Obstructed
labour Post maturity,
Intra uterine fetal
death Complications of
third stage: Injuries to
birth canal Obstetrical
emergencies and their
management
Presentation and
prolapsed of cord, Vasa
praevia, amniotic fluid
embolism, rupture of
uterus, shoulder
dystocia, obstetrical
shock, inversion of
Uterus
Obstetrical procedures
and operations
Induction of labour,
forceps,
vaccumversion,
manual removal of
placenta, caesarean
section, destructive
operations. Nursing
management of
women undergoing
Obstetrical operations
and procedures
X. 4 Describe management abnormalities during Lecture discussion Case Essay type, short
of post natal Post natal Periods discussion/ answers, Objective
complications Assessment and presentation type Assessment of
management of Supervised Clinical skills with checklist
women with post natal practice Assessment of patient
complication Management of
Puerperal infections, problems
Breast engorgement &
infections, UTI,
Thrombo- embolic
disorders Difficulties of
lactation Suppression
of lactation Post-
partum hemorrhage,
and sub involution
Psychological
complications - Post
partum blues - Post
partum depression -
Post partum Psychosis
XI. 5 Describe assessment Assessment and Lecture discussion Essay type Short
and management of management of high demonstration on answers Objective type
the high risk neonates risk newborn Practice session case Assessment of skills
Admission of neonates discussion with checklist
in the neonatal presentation Assessment of patient
intensive care units. Supervised clinical management of
Protocols of practice problems
management Nursing
management of low
birth weight babies-
Infections, Respiratory
problems Hemolytic
disorders Birth injuries,
Malformations
Monitoring of high risk
neonates Kangaroo
mother care Feeding of
high risk neonates
Organization and
management of
neonatal intensive care
units Infection control
in neonatal intensive
care units
Maintenance of
reports and records
XII. 4 Describe indications, Pharmaco- Lecture Discussion Short answers,
dosage, action, side therapeutics in Drug book Drug Objective type
effects and nurses Obstetrics Indication, presentation
responsibilities in the dosage, action, contra
administration of drugs indication and side
used for mothers effects of drugs Effect
of drugs on pregnancy,
labour&puerperiu m
Nursing responsibilities
in the administration of
drug in Obstetrics
oxytocios, anti
hypertensives,
diuretics,
corticosteroids,
tocolytic agents, anti
convulsants,
anticoagulants
Analgesics and
Anaesthetics in
Obstetrics Effects of
maternal medication
on foetus and neonate
Role of obstetric nurse
XIII. 4 Appreciate the Family, Welfare Lecture discussion Essay type short
importance of family programme Demonstration answers objective type
welfare programme Population trends and Practice session Assessment of skills
problems in India Supervised practice with check list project
Concepts, aims, Group project and field visits reports
importance and history Counseling session
of family welfare Field visits
programme National
population: dynamics,
policy and education
National family welfare
programme: National
maternal and child
health services CSSM,
RCH, ICDS,BFHI,NRH M,
integrated
management of child
Describe the methods hood illnesses[IMSI],
of contraception and Expanded programe of
role of nurse in family immunization,
welfare programme JananiSurakshaY ojana

National policy and

legislation in relation
to maternal health and
welfare Organization
and administration; at
national, state, district,
block and village levels

Methods of
contraception
Counseling for family
welfare Latest research
in contraception

Role of national,
international and
voluntary organizations
Role of a nurse in
family welfare
programe Training/
Supervision/
Collaboration with
other functionaries in
community like ANMs,
HVs, Anganwadi
workers, TBAs
(Traditional birth
attendant Dai), ASH
2 Explain the Maintenance of vital
epidemiology of statistics Maternal,
Obstetrics morbidity, mortality
and fertility rates
Perinatal, morbidity
and mortality rates
Nearmiss mortality

Causes and preventive

measures Safe
motherhood initiative
Obstetric health care-
Essential obstetrics
care, Early detection
of complication,
Emergency obstetrics
care[EMOC] Making
pregnancy safe
strategy
REFERENCES (latest editions)

Balakrishnan, Sheela, Textbook of Obstetrics, Hydrabad,

Paras Publishers

Bennett V. Ruth and Brown.K.Linda, Myles Text Book for Midwives, ChurchilLivingstone, London.

Bobak and Jenson, Maternity and Gynecologic care, Mosby year Book

DaftaryShirish.N, Manual of Obstetrics, Elsevier

Dawn C.S, Manual of Obstetrics and Neonatology, Dawn books, Calcutta

Dutta.D.C, Textbook of Obstetrics New central book agency, Calcutta

James K David et al, High risk Pregnancy Management options, W B Saunders Elsevier

Krishnamenon P.K, and Devi, Postgraduate Obstetrics and Gynecology., Orient Longman Ltd, Madras.
Lowdermilk& Perry, Maternity & Women’s health care, Mosby Publishers.

Mudaliar A.L, and Menon, Clinical Obstetrics, Orient Longman Ltd, Madras.

Padubidri,V&AnandEla, Text book of obstetrics, Newdelhi, BI Publications

Pilliteri Adele, Maternity and Child Health Nursing, Lippincott, Newyork

Reeder J.Sharon et.al, Maternity Nursing, Lippincott, Newyork

SabaratnamArulkumaran et.al, Essentials of Obstetrics, Delhi , Jaypee publishers

Trula Myers Corrieet. al, Foundations of Maternal- Newborn Nursing, W.B Saunder’s Company.

Varney Helen and Kriebs, Jan M, Varney’s Midwifery, Massachusetts. Jones and Barlett publishers.
VALUATION [Obstetrics & Gynecological Nursing]

Theory [Internal] - 50 Marks

Average of 3 sessional exams- 40

Written assignment - 10

============ 50 ============

Practical [Internal] - 50 Marks

Ongoing clinical evaluation - 40 %

Clinical Assignments - 30%

Internal practical - 30%

============== 100% ============== Clinical Assignments

Care study - 3

Procedure Demonstration

Antenatal Assessment - 20
Post Natal assessment - 20

Conduct of Normal labour - 15

Observation report of family welfare clinic

Drug file

OT Report

Clinical Presentation - 2

Health Education - 2

Maternity Case record -

Project
OBSTETRICAL NURSING- PRACTICAL

PLACEMENT: FOURTH YEAR

Areas Duration in weeks Objective skills Assignment Assignment method

4 Assessment of Antenatal history Conduct Antenatal Verification of findings

Antenatal Ward, OPD, pregnant women taking Physical Examinations -30 of Antenatal
Clinic examination Recording Health talk-2 Case examinations
of weight & B.P Hb& book Recordings-20 Completion of case
Urine testing for sugar Case study Normal-1 book recordings
and examination Abnormal-1 Case Evaluation of health
abdomen and breast presentation-1 talk Evaluation of case
immunization study Clinical
Assessment of risk performance
status Teaching evaluation
antenatal mothers
maintenance of
Antenatal records
Labour room OT 3 Assess woman in Assessment Woman in Conduct normal Assessment of clinical
labour prepare the labour Prepare the deliveries- 20 Per performance
woman for labour women for labour vaginal examinations Assessment of each
conduct normal Monitoring and caring -5 Perform and suture skill with check lists
deliveries perform of woman in labour the episiotomies-5 Completion of Case
episiotomy and suture Maintenance of Resuscitate new borns- book recordings
it Assist with normal partogram Conduct 5 Instrument used in
delivery Resuscitate normal delivery Obstetric practice-
newborns Assist with Newborn assessment Assist with Caesarean Vivavoci
caesarean sections and immediate care sections-5 Witness/
Resuscitation of Assist abnormal
newborns Assist with deliveries-5
abnormal vaginal
delivery Assessment of
risk status of newborn
Episiotomy and
suturing Maintenance
of labour and birth
Assist with other records Arrange for
surgical procedure and assist with
Caesarean section and
care for woman & baby
during Caesarean
Arrange for and assist Assist with other
with other surgical surgical procedures-
procedures case book recordings