MINISTRY OF HIGHER AND SECONDARY SPECIAL EDUCATION OF THE REPUBLIC
OF UZBEKISTAN
TASHKENT MEDICAL ACADEMY
DEPARTMENT OF OBSTETRICS AND GYNECOLOGY 4TH AND 5TH YEARS OF
STUDY
Taken on account of the educationalmethodical part №______________
"CONFIRM"
Prorector for educational work
«_____» ________________2015 y.
Prof. Teshaev O.R._____________
«_____» _____________2015 y
WORKING PROGRAM
ON THE SUBJECT "OBSTETRICS"
Area of knowledge:
500000 -
Health care and education
Area of education:
110000 -
Pedagogy
510000 -
Health care
Direction of education:
5111000 - Professional education
(5510100 – Treatment work)
5510100 - Treatment work
Tashkent - 2015 y.
The working program is composed on the basis of educational work plan and a model program.
Compilers:
Ayupova F.M. – head of department of obstetrics and gynecology 4th and 5th years study, MD,
professor
Bekbaulieva G.N. - associate professor of department obstetrics and gynecology 4th and 5th
years study, MD
Ayupova D.A. - assistant of the department of obstetrics and gynecology 4th and 5th years study,
PhD
Mirzaeva D.B. - assistant of the department of obstetrics and gynecology 4th and 5th years study
Reviewers:
Najmutdinova D.K.- head of department of obstetrics and gynecology GP, MD, professor
Kurbanov D.D. - head of department of Obstetrics and Gynecology TashMPI, MD, professor
The work program was discussed at the meeting of the department №
of May and recommended for approval at faculty meeting
Headof the department
The work program was discussed at a faculty meeting №
and recommended for use
Chairman of the faculty meeting
Ayupova F.M.
on the
Salomova F.I.
Coordinated:
Head of the educational methodical part
on the
Azizova F.H.
th of June
th
1. Introduction
According to the State Standart of Higher Education of Obstetrics in the field Pedagogy and
Health care include physiological and pathological obstetrics. Teaching students accordingly
qualifying characteristics of a general practitioner to basics of obstetrics on bases of knowledge
finded them on previous courses, to principles of effective perinatal care at the physiological and
complicated pregnancy, based on the evidence, to conduct of normal and abnormal labor and
postpartum periods, newborn care, preventive and primary care, diagnosis, pressing statesand
the most common in obstetric practice.
1.1.
Purposes and objectives of the subject:
Subject refers to the section of motherhood and childhood and taught in VII and VIII
semesters.
The aim of the subject - teaching students accordingly qualifying characteristics of a
general practitioner to basics of obstetrics on bases of knowledge finded them on previous
courses, to principles of effective perinatal care at the physiological and complicated pregnancy,
based on the evidence, to conduct of normal and abnormal labor and postpartum periods,
newborn care, preventive and primary care, diagnosis, pressing statesand the most common in
obstetric practice.
Learning objectives for the cycle "Obstetrics":
- form students' knowledge on the specifics of the operation of the various systems and
organism pregnant and their regulation;
- develop knowledge on the diagnosis of early pregnancy, examined of pregnant, diagnosis
and rational management of women with physiological pregnancy and childbirth in dispensaries
p conditions;
- teach students the diagnosis, course and management of physiological birth by period,
possible complications and also tactics to address them, and maintaining the flow of the normal
postpartum period;
- generate knowledge about some obstetric complications: pre-eclampsia, bleeding,
miscarriage, narrow pelvis, immunkonflikt pregnancy, postpartum of purulent septic
complications their diagnosis, about contingent risk, prevention, clinical tech research Institute,
providing first aid and urgent pathology tactics of the general practitioner on the profile and
practices and of the hospitalization;
- familiarize students with the types and principles of conducting medical documentation;
- familiarize students with the structure and functions of the fetoplacental syst e we, the
methods of diagnosis of her condition, with modern concepts of perinatal pathology and
principles of its prophilactics;
- familiarize students with modern medical-diagnostic equipment, surgical delivery methods
used in obstetric.
1.2. Requirements for knowledge, skills and experience
Students enrolled in the program, "Obstetrics" 4th year student with the latest achievements of
modern clinical medicine and is biological science should know:
- physiological characteristics of the course of pregnancy, childbirth, the postpartum
period;
- etiopathogenesis, clinical pathological childbirth - anomalies tribal forces, bleeding in the
III and early postpartum period;
- etiopathogenesis, clinical manifestations and diagnosis of the most common obstetric
pathology - ectopic pregnancy, miscarriage, gipretension pregnant, placenta previa,
breech, transverse positions, narrow pelvis, rhesus-conflict edges e nancy;
- etiopathogenesis, clinical manifestations, diagnosis of postpartum septic s and diseases;
The student should be able to:
- conduct a focused history and perform a clinical examination pregnant and
gynecological patients;
- diagnose pregnancy;
- determine the gestational age;
- diagnose birth, stages of labor;
- formulate and justify a preliminary diagnosis;
- diagnose preeclampsia and to assess the degree of its severity;
- diagnose emergency obstetric pathology (placenta previa, blood on the flow in
childbirth);
- diagnose narrow pelvis, malposition;
- be able to correctly interpret the data of laboratory and instrumental examinations of
pregnant women;
- be able to conduct physiological labor;
- be able to provide first aid to the newborn, who was born in asphyxia;
The student must have Skills:
- methods of external obstetric studies of pregnant women and mothers;
- measurement of the size of the pelvis;
- listening to the fetal heart rate;
- the timing of the pregnancy, the period of maternity holiday times;
- defining the term of the upcoming birth;
- receiving a normal delivery,
- definition of the expected fetal weight;
- determination of the frequency, intensity and duration of contractions;
- transection and processing of umbilical cord;
- primary toilet newborn;
- assessment of the newborn Apgar and Silverman;
- assessment of full-term, premature and mature newborn;
- first attachment to the breast;
- defining features of the placenta;
- mastering the techniques of separation of the placenta;
- determining the integrity of the placenta;
- definition of allowable blood loss;
- definition of involution of the uterus in the postpartum period;
- definition of signs of pre-eclampsia;
- principles of breastfeeding;
- prevention of mastitis.
1.3. Linking with about related disciplines.
4th year students for successful study Obstetrics must have a good level of knowledge in
the following subjects: normal and topographical anatomy, physiology, pathophysiology,
histology, pathology, microbiology, epidemiology, therapy and surgery, anesthesiology and
intensive therapy, skin and venereal diseases, clinical pharmacology, endocrinology, childhood
illnesses.
1.4. The use of new educational technologies while teaching the subject
State associated with the learning process determines the quality of education: the lessons
of the high pedagogical level, holding problem lectures, drawing lessons as a stakeholder survey,
the use of modern educational technology and multimedia, deducing interesting problem
situations to deal with, demanding, individual work with students, to enable free thinking and
scientific scrutiny.
When designing a course "Obstetrics", the following conceptual approaches:
 Education with the approach to the individual. This education is aimed at the training
of all participants in the process of education.
 A systematic approach. Shall include all designated in system: logical process,
connectedness of all parts, connected to each other, integrity.
 Approach to building a high-quality directional action. In action, activation, and
increase in the intensity of action of the recipient of education.
 Dialogic approach. Means of improving relations role of the educational process. At the
same time amplifies the activation of the individual and a reading from the scientific side.
 Structure of education. The importance of paying attention to democracy, equality, joint
assessment outcomes achieved.
 Problem-solving education. Giving essence of education as a problem to activate the
recipient's education action.
 Using the latest technology in giving information - the use of new computer and
information technologies in the educational process.
 Tools and equipment of teaching. Lecture (introduction, vizualize theme), problembased learning, case - step, pinbord, paradoks and practical work.
 Types of organization of teaching: dialogue polylogue joint communication, and of
foundation for self-study in the form of the frontal, group and team.
 Means of teaching: traditional methods (textbook, lecture text), as well as computer and
information technology.
 Methods of communication: direct operational feedback to the listener ..
 Feedback means. observation blitz - survey, diagnosis knowledge in the analysis of the
results of current, intermediate and sum results.
 Means of government. planning sessions in the form of routing, joint steps lecturer in
the student to achieve the goal, and control as classroom and extracurricular independent
works.
 Evaluation and Monitoring: Routine monitoring of the outcomes of learning.
Evaluation students' knowledge at the end of the course by laboratory diagnostics and
commissioning tests.
When learning a subject "Obstetrics" used computer technology, handouts by topic.
Assessing students' knowledge of arbitrariness through oral questioning and commissioning
tests.
Distribution of workshops and hours on the subject of obstetrics
5 5101 00 – Treatment work, 5111000 – Professional Education (5510100 Treatment work)
VII semester
№
Title of the topic workshops
1
The organization and structure of the obstetric and
gynecological hospital. Principles of safe
motherhood. Modern views on the profiles to tick
infection. Clinical anatomy of the female genital
organs. The birth canal, the fetus as to delivery.
Fundamentals of perinatal care. Methods of
2
Total
hours
8
Lectur
e
2
Practical
lesson
6
Independ
learning
-
15
2
6
7
3
4
5
6
7
8
9
10
11
№
12
13
14
15
examination of pregnant women. Diagnosis of early
and late pregnancy. Assessment of the status of the
fetus. The role of family clinics in the prevention of
obstetric complications. Preparing to leave the
partnership. School maternity.
Childbirth. Periods of delivery. Partnership
delivery. Maintain the partograph. Active
management of the third stage of labor. Assessment
of the newborn Apgar. Biomechanism birth in the
front as the occipital previa. Primar treatment of the
newborn.
Physiological postpartum. Rooming m and losses
and the child. Care of breasts.
Breech presentation. Biomechanism birth. Lovseta
reception, reception of Maurice Smellie-Veit.
Premature birth. The use of tocolytic agents.
Antenatal corticosteroids approxetion. Induction of
labor at term pregnancy. Neor false state and
problems of the fetus.
Nausea and vomiting of pregnancy. Etiology,
classification, clinical features, treatment.
Hypertensive condition during pregnancy.
Preeclampsia, a diagnostician and ka treatment
tactics.
The role of the Rh factor in obstetrics. Hemolytic
disease of the fetus and newborn. Jaundice of the
newborn, diagnosis and treatment.
During pregnancy, childbirth and the postpartum
period in renal disease. Asymptomatic bacteriuria.
During pregnancy, childbirth and the postpartum
period in anemia.
Intermediate control.
Total
14
2
6
6
12
6
6
13
6
7
14
2
6
6
13
1
6
6
14
1
6
7
8
2
6
-
6
7
13
5
2
3
-
129
14
63
52
Lectur
e
2
2
Practical
lesson
6
6
Independ
learning
7
2
6
7
2
6
7
VIII semestr
Title of the topic workshops
Total
hours
Vaginal bleeding in late pregnancy: placenta previa
8
Vaginal bleeding after delivery: placental
15
abnormalities, hypotension, and atony of the uterus,
cervical laceration and perineum, the delay part of
the follow. Diagnosis, tactics, preventive measures.
Unsatisfactory progress of labor. Passive and active
15
phase of labor. Classification. Etiology, clinical
features and diagnosis of various kinds of
anomalies of labor. Obstetric and prevention tactics.
Oxytocin on the recommendations of the WHO.
Narrow pelvis, etiology, and classification,
15
diagnosis. The disproportion of fetal head and
maternal pelvis. Shoulder dystocia. Complications
for mother and fetus, and their prevention.
16
17
18
19
20
21
22
Malposition, causes, diagnosis, tact.
Vaginal bleeding during labor: uterine rupture.
Classification, etiology and pathogenesis, clinical
features, diagnosis, treatment principles, and
prophylactic methods.
Surgery operation methods of delivery: cesarean
section, forceps, vacuum extraction of the fetus.
Transmission of HIV from mother to fetus.
Integration of prevention of HIV transmission from
mother to child in an effective perinatal care.
Infection in the postpartum period. Modern ideas.
Classification, the path of infection.
High temperature after delivery. Obstetric
peritonitis, causes, diagnosis, treatment
Emergency conditions and problems of the
newborn. Intensive therapy of newborns.
Intrauterine infection of the fetus.
Total
Total
13
8
6
6
7
-
6
6
-
13
6
7
2
14
1
6
7
7
1
6
-
11
2
2
7
125
254
14
28
62
125
49
101
2. MATTER OF EDUCATIONAL MATERIAL.
2.1. Lectures
Vll -semestr:
1 PERIODS OF OBSTETRICS AS SCIENCE / fertilization.
STAGES OF DEVELOPMENT OF PLATSENTA- mother-fetus.
EFFECTS harmful factors on the fetus (2 hours)
Obstetrics- as the science of the woman. Communication with other disciplines and unlike other
professions.
Contribution of scientists in Central Asia and Uzbek scientists in the development of Obstetrics.
Stages of development of the fetus. Critical periods of development.
Distinguish 1 preimplantation period of 6-7 days .; 2 - during implantation and organogenesis of
the main 1 week to 12 weeks. 3 - fetogenez period.
Embryo to 8 weeks is called an embryo, after 8 weeks, the fetus. Perinatology examines the state
of the fetus in the antenatal period before the onset of labor. Then, in the intrapartum period,
during labor and after birth that in the neonatal period. Development, structure and function of
the placenta.
Effect of harmful factors on the fetus.
Fetal development period in humans lasts up to 40 weeks of pregnancy.
Factors affecting the development of the fetus, are divided into exogenous and endogenous:
physical chemical, biological.
Nutritional factor. Chronic anoxia. Extragenital pathology. Infectious disease, viral infection,
transferred pregnant.
Examples of children born with anentsefalopaty, microcephaly from the drug ,after syphilis
transferred SARS during pregnancy, especially in the early timing of it; with Down syndrome,
with consanguineous marriage.
References: M (main) -1,3,5, O (optional) -1,2,7.
2. Physiological birth. The reasons for the onset and regulation of labor. Clinical features
and mechanism of periods p rows. (2 hours)
At a lecture given in detail: what is birth, the causes of the birth, the harbingers of birth,
characteristic to the periods of labor, the concept of battles and attempts, that is the contraction
ring, belt contact, the disclosure of neck of uterus and multiparous paramount role of membranes
in the neck of the disclosure uterus, fetal assessment (CTG, UTT, doplerometry), management of
labor and delivery at the front biomechanism as occipital previa.
References: M (main) -1,3,5, O (optional) -1,2,7.
3. Toxicosis of pregnancy. Etiology, classification.
Early on the Toxic Threat. Hypertensive condition during pregnancy. Classification,
clinical features, complications, treatment. (2 hours)
The term refers to pregnancy toxicosis all pathological conditions that occur only during
pregnancy, lead to complications of pregnancy and maternal and fetal side and often terminated
after pregnancy. Modern theories of toxicity are considered to be the failure of adaptation of the
organism - the inability of the female body to respond adequately to the growing pregnancy.
Early toxicosis of pregnant dyspeptic disorders are manifested in the form of vomiting,
salivation; rare form - dermatoses of pregnancy, asthma during pregnancy, pregnant steatosis
(fatty liver up to pregnant women).
Depending on the frequency of vomiting, the extent of deterioration and laboratory parameters
distinguish mild, moderate and severe vomiting.
Pathogenesis, clinical manifestations, diagnosis and treatment guidelines, the tactics of the
physician in each form.
The lecture deals with a serious complication of pregnancy - hypertensive syndrome. The
submission paid attention to the frequency of this disease in pregnant women, risk factors for
hypertensive syndrome, the reasons leading to the occurrence of this complication. A
classification of hypertensive states (pregnancy-induced hypertension, chronic hypertension,
mild preeclampsia and severe), and the most severe forms - eclampsia, steatosis pregnant,
HELLP -sindrom. Particular attention is paid to the influence of hypertensive states in pregnancy
and the fetus. Given principles of diagnosis of these conditions. The lecture presents the basic
principles of treatment based on WHO recommendations, given the principles of the magnesium
therapy.
References: M (main) -1,3,5, O (optional) -1,2,7.
4. Fetoplacental system and its functional station. Fetoplacental insufficiency, IUGR.
Etiology. Diagnosis, prevention. (2 hours)
Perinatology - the science of the fetus and its development, and the influence of external and
internal environment, diseases of the newborn resulting from violations of its prenatal
development. Due to the close functional interrelationship and interdependence of uteroplacental blood flow and fetal became widespread, the term "fetoplacental system", although
correct to speak of the mother-placenta-fetus. Perinatal period - the time from the 28th week of
fetal development on the 7th day of life of the newborn.
Divided into ante; intra; postnatal periods. In the antenatal period to reflect the state of
development of the fetus pregnancy and abnormal pregnancy. In the intrapartum period, the fetus
is influenced by deviations from the normal course of childbirth, as well as their combination
with previous pathology of pregnancy.
During its internal development fruit provides the vital needs of the placenta. Due to the
complicated mechanism of nap provides the fetus with oxygen saturation of the blood and
excretion of CO 2 .
Nevertheless, even in normal pregnancy, the fetus in her late experiencing a significant shortage
of oxygen. Timely delivery and the occurrence of emerging infant pulmonary respiration save
him from intrauterine death. Cause fetal hypoxia is fetoplacental insufficiency, which develops
in the pathology of pregnancy; pathology of birth; extragenital diseases of the mother; diseases
of the fetus.
Fetoplacental insufficiency is divided into chronic (hr. anemia, heart disease, lung and others.)
subacute (placenta previa, preeclampsia, Rh and ABO-conflict); acute (PONRP, hemorrhagic
shock, rupture of the vessel at plevist placental anomalies rod.sil, uterine rupture, impaired
circulation in the vessels of the umbilical cord, the knot of the umbilical cord, loss of loops,
compression loops, the absolute and the relative shortness of the umbilical cord, etc..). Therapy
failure FPS based on the application of methods and products that will improve uterine blood
flow and increasing the utero-placental blood flow.
References: M (main) -1,3,5, O (optional) -1,2,7.
5. Miscarriage and pregnancy perenashivanie. (2 hours)
The lecture presents information about the reasons for the premature termination of pregnancy,
delayed deliveries and transfering. Dismantled late termination of pregnancy complications and
transfering for mother and fetus. Presented tactics of pregnancy and childbirth in this pathology.
References: M (main) -1,3,5, O (optional) -1,2,7.
6. Rh factor in obstetrics. Immunokonflikt pregnancy: Rh antigen and the ABO system.
Hemolytic disease of the fetus. (2 hours)
The lecture presented the concept of alloimmunization, immunization by the Rh factor arising
during pregnancy in women with Rh-negative blood type. Given representation of Rh factor
blood types of antigen prevalence in the land of people with Rh-negative blood. The lecture is an
article on hemolytic disease of the fetus and newborn, the mechanism of immunization in
subsequent pregnancies. Lecture material contains information about clinical forms of hemolytic
disease of the fetus and newborn outcomes in each form. Particular attention is paid to the
diagnosis of Rh immunization during pregnancy by ultrasound, detection of Rh antibodies by the
reaction of Coombs, the study of amniotic fluid. Given the principles of treatment of hemolytic
disease of the newborn, including the method of exchange transfusion. Finally, describe the
methods of prevention of Rh immunization in pregnancy.
References: M (main) -1,3,5, O (optional) -1,2,7.
7. Pregnancy and childbirth in anemia and kidneys diseases. (2hours)
The lecture deals are quite common extragenital diseases during pregnancy - anemia and
pyelonephritis. In the material provides detailed information on iron deficiency anemia, the
causes leading to this state, the standards of diagnosis and treatment recommended by the WHO,
as well as possible complications. Other than that provided complete information about
pyelonephritis, including etiology, pathogenesis, clinical features and treatment. As well as the
introduction of pregnancy pyelonephritis, and prevention of extragenital diseases during
pregnancy.
References: M (main) -1,3,5, O (optional) -1,2, 7.
VIII -semestr:
8. Unsatisfactory progress of labor. (2 hours)
The lecture presents the modern theory of the mechanism of labor. In the regulation of labor
involved:
I. Brain: 1) cortex, 2) g ipotalamus 3) pituitary (oxytocin)
II. F is - placental system (estrogen, progesterone)
III. Uterus (acetylcholine, prostaglandin, kinin, serotonin, catecholamines, ATP, actomyosin,
etc.)
In the process of giving birth are important 3 mechanisms: contraction, retraction, distraction.
The phenomenon of "triple increase in the gradient ", consisting of muscle contraction begins
with a little area of intense and for a long time. Simultaneously there is a relaxation of the uterus.
Structure and mechanism of reduction of the myometrium. Normal and pathological CTG.
Classification violations of labor:
- pathological preliminary period
- with labost labor (primary, secondary)
- excessively coarse labors (fast delivery)
- diskoordinat labors (dystocia cervical uterine hypertonicity of the lower segment of the
uterus tetanus).
prolonged labor, reasons for the weakness of labor activities: primary and secondary, risk
groups, diagnosis based on the partograph, principles of treatment, prevention. Complications
for both mother and fetus. Methods of delivery.
References: M (main) -1,3,5, O (optional) -1,2,7.
9. Vaginal bleeding in late pregnancy: abruptio placentae, placenta previa. (2 hours)
The lecture deals with an important topic - bleeding in the second half of pregnancy. Are all
common causes of bleeding during the second half of pregnancy (partial detachment of normally
situated placenta and placenta previa). Describes the symptoms of these complications, methods
of diagnosis, principles of first aid and medical treatment. The principles of the prevention of
bleeding in pregnancy.
References: M (main) -1,3,5, O (optional) -1,2,7.
10. Vaginal bleeding after childbirth: in placental and early postnatal period.
Hemorrhagic shock. DIC. (2 hours)
The lecture presents the causes of bleeding in the sequence and early postnatal periods, methods
to stop bleeding. Methods of emergency needs to know every doctor, that is. To. For 10-20
minutes blood loss can occur in the Ob ume of 2 to 3 liters incompatible with life.
In the world die every year 127,000 women from bleeding. Among the causes of maternal deaths
are haemorrhage 25%. In a lecture given the underlying determinants of maternal mortality. It is
shown that the main causes of bleeding during labor are: violation of the placenta, uterine
rupture, uterine hypotonia, coagulation disorders. The following is a description of hemorrhagic
shock, blood loss severity depending on the amount of blood lost and the clinical picture. Details
given pathogenesis of shock, various kinds of its complications and their clinical picture. The
second part of the lecture is devoted to the clinic and diagnosis of disseminated intravascular
coagulation. The lecture also shows the basic principles of treatment of hemorrhagic shock and
disseminated intravascular coagulation, including modern medications and blood products. Are
types of operational assistance in hemorrhagic shock and DIC.
References: M (main) -1,3,5, O (optional) -1,2,7.
11. Narrow pelvis in modern obstetrics. (2 hours)
This lecture is given definition of anatomical narrow pelvis (ONP), its prevalence, etiology, and
classification on the degree of narrowing. And also for the impact of maternal and newborn
health, depending on the type of pathology.
In the second part of the definition of available clinical narrow pelvis (ONP), the prevalence
and management of pregnancy and childbirth with ONP and CNP.
At the end of the lecture presented clinical cases and issues to improve the knowledge and
skills of students.
References: M (main) -1,3,5, O (optional) -1,2,7.
12. Vaginal bleeding during childbirth: Obstetric injuries. Rupture of uterus (2 hours)
The lecture deals with the diagnosis and treatment of various types of obstetric injury (ruptured
uterus, cervical laceration, perineal fistulas). The classification of the type of uterine rupture
gistopaticheskogo and mechanical disruption at the time of interruption (during pregnancy,
childbirth), the localization of rupture. Presented clinical and basic diagnostic criteria and
treatment guidelines. The second part of the lecture is devoted to the rupture of soft birth canal,
their causes, complications, diagnosis and methods of surgical care.
References: M (main) -1,3,5, O (optional) -1,2,7.
13. Asphyxia. Generic injuries. Intensive therapy of newborn. (2 hours)
By the term "neonatal asphyxia" (AH) will be understood pathological condition caused by gas
exchange abnormalities as lack of O2 and an excess of CO2, as well as metabolic acidosis, due
to the accumulation of metabolic products of unoxidized.
Asphyxia - a pathological condition in which the birth of the child there is no spontaneous
breathing or is shallow and irregular, that does not provide adequate gas exchange in the body.
Causes of hypoxia newborn: airway obstruction with meconium aspiration of amniotic fluid,
mucus, blood; in severe damage to the central nervous system; functional immaturity of the lung
tissue or insufficient development of surfactant; hemodynamic changes in the pulmonary
circulation in certain malformations
To assess the state of the newborn born today is a common patient assessment scale proposed by
Apgar. Assess the condition of the newborn at 1 min and 5 min.
8-10 points - good condition; 7 points - border state; 6 points - mild asphyxia; 5-4 points - the
average degree of asphyxia; 4 points or less - severe degree of asphyxia; absence of symptoms stillbirth.
References: M (main) -1,3,5, o (optional) -1,2,7.
14. Purulent-septic diseases in postpartum period. Etiology, ways of distributions.
Classification. Groups of high risk, prevention on an outpatient basis. Obstetric
peritonitis. Sepsis. (2 hours)
Postnatal pyo-septic diseases - are observed in women during labor directly related to pregnancy
and childbirth, and caused by the bacterial infection. But this group does not include the
infectious diseases identified during the postpartum period, but not associated with pregnancy
and childbirth (flu, etc..). Relevance. Septic complications in the postpartum period as a cause
of maternal mortality. Classification Sazonov-Bartels. Clinical symptoms, diagnosis. Treatment
principles, tactics of the patients.
Obstetric peritonitis - one of the most dangerous complications of the postnatal period. In most
cases the source of infection is the uterus (the presence of a blood clot and the remnants of the
ovum as the entrance gate to the infection and the environment for the growth of
microorganisms). Types, clinical features, management tactics.
References: M (main) -1,3,5, O (optional) -1,2,7.
2.2. TOPICS OF PRACTICAL LESSONS
Vll -semestr:
1 The organization and structure of the obstetric and gynecological hospital. Principles of
safe motherhood. Modern views on the profiles to tick nosocomial infection. Clinical
anatomy of the female genital organs. The birth canal, the fetus as to delivery. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
2 Fundamentals of perinatal care. Methods of examination of pregnant women. Dia g nosis
of early and late pregnancy. Assessment of the status of the fetus. The role of family clinics
in the prevention of obstetric complications. Preparing to leave the partnership. School
maternity. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
3 Delivery. Periods of delivery. Partnership delivery. Maintain the partograph. Active
management of the third stage of labor. Assessment of the newborn Apgar. Biomechanism
birth in the front as the occipital previa. Initial processing of the newborn. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
4 Physiological postpartum. Physiological neonatal period. 10 principles of breastfeeding.
Rooming-in of mother and child. Care of breasts (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
5. Breech presentation. Biomechanism birth. Lovseta reception, reception Maurice
Smellie-Veit. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
6. Prematurity. The use of tocolytic agents. Antenatal use corticosteroids. Transfer
pregnancy. Induction of labor at term pregnancy. Intensive conditions and problems of the
fetus. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
7 Nausea and vomiting during pregnancy. Etiology, classification, clinical features,
treatment. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; o: 1,3,4,6,7,8,9,10,11,12,13,14
8 Hypertensive conditions during pregnancy. Preeclampsia, a diagnostician and treatment
tactics. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
9 The role of the Rh factor in obstetrics. Hemolytic disease of the fetus and newborn.
Jaundice of the newborn, diagnosis and treatment. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
10. During pregnancy, childbirth and the postpartum period in renal disease.
Asymptomatic bacteriuria. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
11 The course of pregnancy, childbirth and the postpartum period in cases of anemia.
Intermediate control. (3 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
VIII -semestr:
1. Vaginal bleeding in late pregnancy: placenta previa . (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
2 Vaginal bleeding after delivery: placental abnormalities, hypotension, and atony of the
uterus, cervical laceration and perineum, the delay part of the follow. Diagnosis, tactics,
preventive measures. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
3 Unsatisfactory progress of labor. Passive and active phase of labor. Classification.
Etiology, clinical features and diagnosis of various kinds of anomalies of labor. Obstetric
and prevention tactics. Oxytocin on the recommendations of the WHO. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
4 narrow pelvis, etiology, and classification, diagnosis. The disproportion of fetal head and
maternal pelvis. Shoulder dystocia. Complications for mother and fetus, and their
prevention. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
5. Malposition, causes, diagnosis, tact. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
6. Vaginal bleeding during labor: uterine rupture. Classification, etiology and
pathogenesis, clinical features, diagnosis, treatment principles, and prophilactic. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
7. Surgical delivery: cesarean section, forceps, vacuum extraction of the fetus. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
8. Transmission of HIV from mother to fetus. Integration of prevention of HIV
transmission from mother to child in an effective perinatal care. (6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
9. Infection in the postpartum period. Modern ideas. Classification, the path of infection.
(6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
10. High temperature after delivery. Obstetric peritonitis, causes, diagnosis, treatment
(6 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
11. Emergency conditions and problems of the newborn. Intensive therapy of newborn.
Intrauterine infection of the fetus. (2 hours)
Educational technology: discussion, brainstorming, web.
References: M: 1,2,3; O: 1,3,4,6,7,8,9,10,11,12,13,14
2.3. Laboratory work is not provided in the standard program
2.4. Course work is not provided in the sample program
2.5. Types of independent work
Independent work of students on the subject is an integral part of education, and for this there are
methodological and informational resources.
Forms of independent work:
1. Assimilation of some of the topics on their own with the help of educational material
2. Cook on a given topic essay, presentation
3. Preparing for a practical training
4. Note-taking in order
5. Prepare a report on the scientific articles or monographs
6. Prepare a thesis or paper for the conference
7. Solve the case
8. Develop organizer and fill it
9. Solve a crossword puzzle or invent new
10. Solution case studies
Self-study is conducted as a classroom and outside it.
Independent work of students is estimated and included in the current score.
Independent work of students
5 5101 00 – Treatment work, 5111000 - Professional Education (5510100 - Treatment
work)
Vll -semestr:
№
Topic name
Assignments
hour
s
1. Physiological changes in the body of the pregnant woman. Prepare individual work.
Methods for assessing the fetal heart rate: ultrasound, fetal
biophysical profile, doplerometrii, CTG, hormonal, Prepare a presentation or
immunological, genetic health research methods, X-ray, essay
endoscopic (amnioscopy, amniocentesis).
7
2. The theory of the birth. Evaluation of maturity of the cervix. Prepare individual work.
Stage of fetal development. Critical periods of ontogenesis.
structure and function of the placenta.
Prepare a presentation or
essay
6
3. During the early neonatal period. Transient condition of the Prepare individual work.
newborn. Physiological weight loss. Generic tumor.
Transient fever. Physiological jaundice. Sexual crises.
Prepare a presentation or
Principles of breastfeeding, prevention of mastitis.
essay
6
4. Antenatal and intrapartum preparation of pregnant women
for delivery in breech presentation. Complications for
mother and fetus.
Prepare individual work.
5. Signs of prematurity. Nursing preterm infants.
Fetoplacental insufficiency, fetal growth retardation
syndrome
Prepare individual work.
7
Prepare a presentation or
essay
6
Prepare a presentation or
essay
6. Rare forms of toxicosis of pregnancy (ptyalism, acute yellow Prepare individual work.
6
atrophy of the liver, dermatitis, ostemalyatsiya, tetany,
asthma)
Prepare a presentation or
essay individual work.
7. Eclampsia. Clinic. Diagnostics. First aid. Treatment.
Prepare
7
Methods of delivery.
Complications of hypertensive states. Rehabilitation
Prepare a presentation or
parturients undergoing hypertensive disorders and their
essay
complications..
8. During pregnancy, childbirth and the postpartum period,
Prepare individual work.
7
with cardiovascular diseases.
During pregnancy, delivery and postpartum diabetes.
Prepare a presentation or
During pregnancy, childbirth and the postpartum period in essay
liver disease.
During pregnancy, childbirth and the postpartum period in
bronchial asthma.
Total
52
VIII -semestr:
№
Topic name
1. Hemorrhoids and cal shock. Disseminated intravascular
coagulation.
Assignments
Prepare individual work.
hour
s
7
Prepare a presentation or
essay
2. Excessively violent labors. Cervical dystocia. Diskoordinary Prepare individual work.
labors.
Prepare a presentation or
essay
7
3. Clinical narrow basin: causes and symptoms of cal wedge
Prepare individual work.
and functionally narrow pelvis. Complications. Tactics labor
management.
Prepare a presentation or
Biomechanism labor with rare forms ah narrow pelvis.
essay
7
4. Malpresentation: causes, diagnosis, biomechanism delivery,
tact, and ka.
7
Prepare individual work.
Prepare a presentation or
essay
5. Professor and prevention of obstetric complications of HIV
in the workplace. Antiviral therapy
The choice of mode of delivery (elective cesarean section).
Methods used safed feeding.
Prepare individual work.
6. Modern conceptions of the infectious agent. Diagnostics.
Principles of treatment. Prevention. High-risk groups,
prevention in the outpatient setting.
Prepare individual work.
7. The concept of TORCH infection. Ways of intrauterine
infection. Diagnosis, treatment, obstetric tactics in viral
infections.
Prepare individual work.
7
Prepare a presentation or
essay
7
Prepare a presentation or
essay
7
Prepare a presentation or
essay
Total
2.6. The list of practical skills
1. Determine whether there is separation of the placenta
2. Transection and processing of umbilical cord in newborns
3. The timing of delivery
4. Auscultation of the fetal
5. Determination of allowable blood loss
6. Measurement of the female pelvis
7. Technique of external methods of isolation of placenta
8. Technique of external devices midwifery research Leopold-Levitsky
9. Definition of integrity of the placenta
10. Determination of estimated fetal weight
11. Determining the status of the newborn Apgar
12. Show 5 sizes of the head, on models of a newborn baby. (Small, medium and large
oblique, straight, vertical size)
13. Show the longitudinal position, breech presentation, 2 position, front view.
14. Show the longitudinal position, occipital previa, II position, front view
15. The purpose and the steps undertaken diagonal measurement conjugates in pregnancy
16. Pressing the abdominal aorta
17. Bimanual compression of the uterus
18. Show the transverse position, I position the anterior view of the fetus.
19. Tell the technique of episiotomy and perineal recovery step by step
20. Tell the technique of suturing the cervix
21. Tell and show the technique of manual separation and recovery of the placenta
22. Take hold of the pelvis and tazomer, determine the normal size of the pelvis, and then
differentiate to form the restriction of the pelvis
2.7. Information and methodological support
In the process of learning on the subject of obstetrics uses modern teaching methods, teacher
training, and information and communication technologies:
1. All lectures using modern computer technology in the form of presentations
2. Practical exercises are conducted with the use of new educational technologies in the
form of brainstorming, web, role-playing, a cat in a bag.
2.8. Rating control and evaluation criteria of knowledge and skills in the discipline
49
The main criterion of the quality of the student is its rating, the term of the current evaluation,
the evaluation of the intermediate monitoring and evaluation of the final control, forms, and
scoring system for each type of control. Students are informed about it is given in the first
session.
To assess the progress of students, respectively, the state standard on the subject of obstetrics
conducted after following types of controls:
- Current control (CC)
- Independent work of students (IWS)
- Intermediate control (IC)
- Final control (FC)
Student assessed during the academic year ie twice in 7 willows in 8 semesters and academic
performance is evaluated on a 100-point system.
100 points in the whole discipline distributed as follows:
Type of control
The maximum score
Passing score
№
Coeficcient
Current control with a
view of the IWS
2. Intermediate control
3. Final control
TOTAL
1.
50
0,5
27,5
20
30
100
0,2
0,3
1
11,0
16,5
55,0
Points are allocated per semester, depending on the duration of the study subject.
Criteria for assessing the practical exercises is the current estimate, the terms of the control of the
student readiness to engage and assess the quality of the job.
Criteria for evaluation of CC: Current control (CC) - carried out at each lab (grades are in
accordance with the approved position of the rating control). In each session, all students must be
assessed.
Current control (CC) is composed of a theoretical part and practical part and IWS (50:40:10)
The
theoreti
cal part
The
practica
l part
IWS
Levelsofest
imates
96100
52- 50
9195
4648
86-90
81-85
7680
3840
7175
3638
66-70
61-65
55-60
31-54
0-30
43-45
41-42
33-35
31-33
28-30
15-27
0-18
35-40
3638
34-36
32-34
3132
2830
26-28
24-26
22-24
12-22
0-12
9-10
9
9
8-9
7-8
7
7
6
5-6
4-5
0
When evaluating students' knowledge of the following criteria:
Rating
Characteristicsofcurrentcontrol
96-100
Exellent
91-95
86-100%
86-90
81-85,9
Good
71-85,9%
76-80
71-75,9
66-70,9
Satisfactory
55-70,9%
61-65,9
55-60,9
Unsatisfact
ory
Lessthan
55%
Lessthan55
%
The answer is original, high quality , exceeding the requirements of
the program . Demonstrated high scholarship student.
High quality of response that exceeds the requirement of the
program, its competent performance and design .
The answer is correct. Speech on the protection of deep content with
additional literature. Student actively campaigned in morning
conferences, competently prepared a clinical audit.
Answer is right in line with the program. Marked by a good
knowledge of the student.
Response meets the program requirements. The student is actively
demonstrated its provisions, is familiar with the advancements in the
field of internal medicine .
The answer for the quality of the average, admitted some mistakes .
Work on the average level, there are inaccuracies in the response in
the protection of the individual and the error in performing the work
When parsing the case of patients and supervised student admitted
some mistakes
In response to serious errors , revealed poor knowledge of the theory
of the problem . When parsing the case of patients and supervised
student admitted quite significant errors
Response to low levels with significant disabilities. When you
answer revealed a weak student competence in the field of
knowledge.
A low-quality with great disadvantages, does not reflect the theory of
the problem.Theoretical knowledge of the student unsatisfactory .
Criteria for assessing the IC: according to the position of the wire d GSI orally twice (1 time
in each semester) in physiological and pathological obstetrics. For an interim control may only
those students who do not have debts on classes. If a student receives less than 55% of the IC, it
is not allowed at the final control (IC).
Interim control by a commission appointed by the Head of the Department. In the case of misuse
of the IC and the IC is interrupted held again.
Perform
Qualificati The level of student's knowledge
ance in
on
%
96-100% Excellent Completely answers all questions in the ticket, answers confidently.
“5”
Situational problems solves with the creative approach, answers correctly
and обоснованно. Brings total and makes decisions, creatively thinks,
independently analyzes. In time and correctly carries out and analyzes
problems of independent work.
91-95% Excellent Completely answers all questions in the ticket, answers confidently.
“5”
Situational problems solves with the creative approach, answers correctly
and обоснованно. Brings total decisions, independently analyzes. In time
and correctly carries out and analyzes problems of independent work.
86- 90% Excellent Completely answers all questions in the ticket, answers confidently.
“5”
Situational problems solves with the creative approach, answers correctly
and обоснованно. In time and correctly carries out and analyzes
problems of independent work.
81-85%
Well “4” Completely answers all questions in the ticket. Situational problems
76-80%
71-75%
66-70%
61-65%
55-60%
54% and
down
solves with the creative approach, answers correctly. In time and correctly
carries out and analyzes problems of independent work.
Well “4” Completely answers all questions in the ticket, but finds it difficult to
prove. Situational problems solves correctly but hardly. In time carries out
of a problem of independent work
Well “4” Answers 75-80 % questions in the ticket. Situational problems solves, but
proves hardly. In time but it is incomplete carries out of a problem of
independent work
Satisfactor Answers 65-70 % questions in the ticket. At the decision of situational
y“3”
problems there are errors. Poor quality performance of problems of
independent work
Satisfactor Answers 60 % questions in the ticket. At the decision of situational
y“3”
problems there are errors and необосноанность. Poor quality
performance of problems of independent work
Satisfactor There are gross blunders at performance of situational problems. Incorrect
y “3”
performance of problems of independent work
Unsatisfac Does not know a subject, cannot will solve situational problems
tory“2”
FC evaluation criteria: the final inspection is carried out in two stages: by OSCE at the
department and a test center. A student who collected a total of more than 55% total score (CC +
IWS + IC) is allowed on the final control.
100-86 points - excellent
85,9-71 points - well
70,9-55 points - satisfactory
54.9 and below - unsatisfactory.
If a student receives OSCE below 55 points, he will not be allowed to take the test exam.
Retake OSC E conducted to resolve the dean's office at the end of the semester. If a student does
not agree with the estimate obtained, within 24 hours after the announcement of points he has the
right to appeal. To do this, he should write to the head of the department and the department with
the dean or associate dean, a commission to review the student's work.
Results of OSCE regularly discussed at faculty meetings.
Criteria for evaluation of the IWS: A summary of the IWS is set in 100 point system.
One column in the academic journal in each semester after the last practice session is given to
assess students' independent work. The rating is exhibited in academic journal groups for all
students as the submission and evaluation of this type of work in accordance with the following
criteria
Levels of Rating
Characteristics of IWS
estimates
96-100
The paper is original, high quality, exceeding the requirements of the
program. Demonstrated high scholarship student in the protection
and performance of work.
Excellent
91-95
High quality of work in excess of the requirement of the program,
its reliable performance and design.
86-100%
86-90
The work is done correctly. Speech on the protection of deep
content with additional literature. Student actively campaigned on a
morning conference, competently prepared clinical audit.
81-85,9
Good quality work in accordance with the program. In the protection
of good scholarship is awarded student.
76-80
Work meets the program requirements. Student actively
Good
demonstrated its position, mark the achievements in this field of
internal medicine. Student self wisely spent curation patients.
71-85,9%
71-75,9
Work on the quality of the average level, there may be some
mistakes in the defense of the work may be negligent in its design.
When parsing the thematic and supervised patients admitted student
minor bugs.
66-70,9
Work on the average level, there are inaccuracies in the response in
Satis.
the protection of the individual and the error in the performance of
work. When parsing the thematic and supervised patients admitted
student individual errors
55-70,9%
61-65,9
In this study, serious mistakes, there is a sloppy performance of the
work. When defending revealed poor knowledge of the theory.
When parsing the thematic and supervised student admitted patients
quite significant errors
55-60,9
Work with low-level major drawbacks. In the protection of identified
weak students' competence in this field of knowledge. When parsing
the thematic and supervised student admitted patients significant
errors
Unsatis.
Less than Substandard work with large defects, does not reflect the theory
55%
question inaccurately completed. Theoretical knowledge of the
55% and
student in protecting poor.
down
The work does not count. When parsing the thematic and supervised
student admitted patients not permissible error
IWS performed student extracurricular selectable themes, in accordance with the
curriculum of discipline. A list of topics is presented in the standard IWS and work programs.
№
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Criteria for assessing the practical skills
Factor
Passing
Practical skill
score
(%)
Determine whether there is separation of the
0,03
1,96
placenta
Transection and processing of umbilical cord in
0,03
1,96
newborns
The timing of delivery
0,03
1,96
Auscultation of the fetal
0,03
1,96
Determination of allowable blood loss
0,05
2,0
Measurement of the female pelvis
0,05
2,0
Technique of external methods of isolation of
0,03
1,96
placenta
Technique of external devices midwifery
0,05
1,8
research Leopold-Levitsky
Definition of integrity of the placenta
0,03
1,96
Determination of estimated fetal weight
0,03
1,96
Determining the status of the newborn Apgar
0,03
1,96
Show 5 sizes of the head, on models of a
0,05
2,0
newborn baby. (Small, medium and large
oblique, straight, vertical size)
Show the longitudinal position, breech
0,03
1,96
Maximum
score (%)
3,5
3,5
3,5
3,5
3,75
3,75
3,5
3,75
3,5
3,5
3,5
3,75
3,5
presentation, 2 position, front view.
14. Show the longitudinal position, occipital previa,
II position, front view
15.
Diagonal measurement of the conjugates
in pregnancy
16. Pressing the abdominal aorta
17. Bimanual compression of the uterus
18. Tell and show the technique of use of vacuum
extraction
19. Show the transverse position, I stand, front
view of the fetus.
20. Tell the technique of episiotomy and perineal
recovery step by step
21. Tell the technique of suturing the cervix
22. Tell and show the technique of manual
separation and recovery of the placenta
23. Tell the necessary equipment with forceps and
phantom show the steps undertaken
24. Take hold of the pelvis and tazomerom,
determine the normal size of the pelvis, and
then differentiate to form the restriction of the
pelvis
25. Problem: The early postnatal period. Hypotonic
bleeding. Hemorrhagic shock I degree.
26. Problem: Marginal placenta previa
27. Problem: PONRP
28. Problem: Postpartum endometritis
0,03
1,96
3,5
0,03
1,96
3,5
0,03
0,03
0,05
1,96
1,96
2,0
3,5
3,5
3,75
0,03
1,96
3,5
0,05
2,0
3,75
0,03
0,03
1,96
1,96
3,5
3,5
0,05
2,0
3,75
0,03
1,96
3,5
0,05
2,0
3,75
0,03
0,03
0,03
1,96
1,96
1,96
3,5
3,5
3,5
Ranking the student on the subject
Ranking the student on the subject as follows:
V  O'
100
V- hours on the subject during a semestra (hours);
O' - The degree of achievement in the subject (s score).
If a student receives CC, IC and OSCE 55% or higher, he may be on the test control.
Rf =
Dates controls
IC and FC conducted according to the calendar tematic plan and approved the training part of
the rating control. FC is conducted in 8 semesters after the completion of the cycle, and lectures.
Literature
Main:
1. Акушерство, ред. Савельева Г.М., 2000, Москва
2. Айламазян Э.К. «Акушерство» - С.Пб., 2003.
3. Бодяжина В.И., Жмакин К.Н., Кирющенков А.П. «Акушерство» – М., 1995.
4. Клиническое руководство по ведению больных с кровотечениями в родах и
послеродовом периоде (на рус. и узб. яз.)
5. Клиническое руководство по ведению больных с гипертензией во время беременности
(на рус. и узб. яз.)
Optional
1. Акушерство. Клинические лекции (ред. проф. Макаров О.В.) – CD-DISC
2. Клиническое руководство по ведению больных с сепсисом/септическим шоком во время
беременности и в послеродовом периоде (на рус. и узб. яз.)
3. Гестационная гипертензия. Крит. и методы диагностики. Принципы терапии,
Подзолкова Н.М., 2003, Москва
4. Метод. рек. по акуш. для преп. на 4 курсе леч. фак., Газазян М.Г., 2002, Курск
5. Рациональная фармакотерапия в акушерстве и гинекологии, т. 9, ред. Кулаков В.И.,
2005, Москва
6. Эмбриональные стволовые клетки: фундаментальная биология и медицина, Репин В.С,
2002, Москва
7. Diagnostic Gynecologic and Obstetric Pathology, 2 ed. ed. Christopher P. Crum, Marisa R.
Nucci, Kenneth R. Lee, 2011, Philadelphia
The Internet sites
http://www.guideline.gov (USA). US National Guideline Clearinghouse (NGC)
http://www.rhlibrary.org/. (World Health Organization).The WHO Reproductive Health
Library. http://www.nice.org.uk. (Great Britain). National Institute for Clinical Excellence
(NICE). http://mdm.ca/cpgsnew/cpgs/index.asp. (Canada). Canadian Medical Association
(CMA).