Antonio MOLLO | Obstetric Pathology

cod. 1012400014

OBSTETRIC PATHOLOGY

	1012400014
	DEPARTMENT OF MEDICINE, SURGERY AND DENTISTRY "SALERNITANA MEDICAL SCHOOL"
	EQF6
	MIDWIFERY
	2024/2025

PERCORSO STUDY PATHWAY IN COMMON IN OBSTETRICS

	OBBLIGATORIO
	YEAR OF COURSE 2
	YEAR OF DIDACTIC SYSTEM 2013
	AUTUMN SEMESTER

TEACHING UNITS

	SSD	CFU	HOURS	ACTIVITY	TYPE OF ACTIVITY
1	PATOLOGIA OSTETRICA - MOD. GINECOLOGIA
	MED/40	2	24	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
2	PATOLOGIA OSTETRICA - MOD. SCIENZE INFERMIERISTICHE OSTETRICO-GINECOLOGICHE
	MED/47	3	36	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
3	PATOLOGIA OSTETRICA - MOD. MEDICINA LEGALE
	MED/43	1	12	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
4	PATOLOGIA OSTETRICA - MOD. MALATTIE INFETTIVE
	MED/17	1	12	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS

PROFESSORS

	PASQUALE PAGLIANO4 T Curriculum
	ANTONIO MOLLO1 Curriculum
	PASQUALINA TRANCHINO2 Curriculum
	VALENTINA FRESA3 Curriculum

EXAMS

Exam	Date	Session
PATOLOGIA OSTETRICA	05/03/2025 - 09:00	SESSIONE ORDINARIA
PATOLOGIA OSTETRICA	05/03/2025 - 09:00	SESSIONE DI RECUPERO
PATOLOGIA OSTETRICA	27/03/2025 - 09:00	SESSIONE ORDINARIA
PATOLOGIA OSTETRICA	27/03/2025 - 09:00	SESSIONE DI RECUPERO
PATOLOGIA OSTETRICA	20/06/2025 - 09:00	SESSIONE ORDINARIA
PATOLOGIA OSTETRICA	07/07/2025 - 09:00	SESSIONE ORDINARIA

	Objectives
	The course aims to provide students with the advanced technical and methodological knowledge necessary to prevent and identify pregnancy and childbirth pathologies and to ensure an adequate care approach to women and newborns. Knowledge and understanding At the end of the course, students will know and understand: - the main physiological and pathological processes of pregnancy and childbirth with the aim of acquiring progressive autonomy of judgment in the management and implementation of diagnostic and therapeutic procedures aimed at women's health. - acquire and understand the values, theories and models of Midwifery for the assessment of the health status of the assisted person and the application of good obstetric practice in labour-childbirth and puerperium care and in obstetric, neonatological and gynaecological care - frame and understand the determinants of health, risk factors and prevention strategies applied to the promotion and support of the health of women, pregnant women, mothers giving birth, puerperal women and the unborn child; - the principles and rules of ethical-deontological and medico-legal order and includes their respect in the gynaecological-obstetric-neonatal field. Applying knowledge and understanding At the end of the course, students: -will be able to monitor maternal-fetal well-being in pathological situations in collaboration with the specialist. -will be able to use the body of theoretical knowledge of Midwifery care-cure-educator, behavioral and social biological sciences for the recognition of the health needs of women in the various stages of reproductive life and of the couple, in the social context of belonging, and of the newborn up to the first year of life; -will be able to orient their work during the professional exercise in accordance with the professional profile and the code of ethics in compliance with current regulations. Making judgements At the end of the course, students will be able to: -integrate knowledge on cultural diversity, legal aspects, ethical principles in providing and/or managing obstetric care in a variety of contexts and health and social services; - take responsibility and answer for their actions during professional practice in accordance with the profile and the Code of Ethics; - manage and implement diagnostic-therapeutic procedures aimed at the health of women, newborns and couples, in care teamwork and at different levels of intensity of care - recognize the differences in the work and responsibilities between midwives, support workers and other health professionals and practice obstetric care in compliance with the professional's code of ethics. Act responsibly during obstetric practice and ensure adherence to ethical and legal standards. -make decisions of professional responsibility in the various phases of the care process and be able to verify their effectiveness and proceed with decision-making re-planning -decide on care priorities on groups of patients for which he/she is responsible -critically evaluate the outcomes of care decisions taken based on patient outcomes and care standards -analyse organizational problems and propose collaborative solutions -make decisions through a scientific approach to solving patient problems through the evaluation of available scientific studies and in compliance with the quality of care provided using research tools; -demonstrate autonomy of judgment on the application of verification tools to measure the effectiveness of preventive interventions implemented. Communication skills At the end of the course, students will be able to: - effectively communicate with verbal, non-verbal and written methods the evaluations and health decisions within the interdisciplinary health team - manage communication skills for a comparison at national and international level; - verify the application of research results through written, oral and computer communication strategies and methods to improve organizational quality Learning ability At the end of the course, students will be able to: - develop independent study skills; - demonstrate the ability to cultivate doubts and tolerate uncertainties arising from study and practical activity; - develop the ability to ask questions about the exercise of one's activity, relevant in time, place and interlocutors; - demonstrate the ability to continuously seek opportunities for self-learning, collaborative learning and self-assessment within work teams;

The course aims to provide students with the advanced technical and methodological knowledge necessary to prevent and identify pregnancy and childbirth pathologies and to ensure an adequate care approach to women and newborns.

Knowledge and understanding
At the end of the course, students will know and understand:
- the main physiological and pathological processes of pregnancy and childbirth with the aim of acquiring progressive autonomy of judgment in the management and implementation of diagnostic and therapeutic procedures aimed at women's health.
- acquire and understand the values, theories and models of Midwifery for the assessment of the health status of the assisted person and the application of good obstetric practice in labour-childbirth and puerperium care and in obstetric, neonatological and gynaecological care
- frame and understand the determinants of health, risk factors and prevention strategies applied to the promotion and support of the health of women, pregnant women, mothers giving birth, puerperal women and the unborn child;
- the principles and rules of ethical-deontological and medico-legal order and includes their respect in the gynaecological-obstetric-neonatal field.

Applying knowledge and understanding
At the end of the course, students:
-will be able to monitor maternal-fetal well-being in pathological situations in collaboration with the specialist.
-will be able to use the body of theoretical knowledge of Midwifery care-cure-educator, behavioral and social biological sciences for the recognition of the health needs of women in the various stages of reproductive life and of the couple, in the social context of belonging, and of the newborn up to the first year of life;
-will be able to orient their work during the professional exercise in accordance with the professional profile and the code of ethics in compliance with current regulations.

Making judgements
At the end of the course, students will be able to:
-integrate knowledge on cultural diversity, legal aspects, ethical principles in providing and/or managing obstetric care in a variety of contexts and health and social services;
- take responsibility and answer for their actions during professional practice in accordance with the profile and the Code of Ethics;
- manage and implement diagnostic-therapeutic procedures aimed at the health of women, newborns and couples, in care teamwork and at different levels of intensity of care
- recognize the differences in the work and responsibilities between midwives, support workers and other health professionals and practice obstetric care in compliance with the professional's code of ethics. Act responsibly during obstetric practice and ensure adherence to ethical and legal standards.
-make decisions of professional responsibility in the various phases of the care process and be able to verify their effectiveness and proceed with decision-making re-planning
-decide on care priorities on groups of patients for which he/she is responsible
-critically evaluate the outcomes of care decisions taken based on patient outcomes and care standards
-analyse organizational problems and propose collaborative solutions
-make decisions through a scientific approach to solving patient problems through the evaluation of available scientific studies and in compliance with the quality of care provided using research tools;
-demonstrate autonomy of judgment on the application of verification tools to measure the effectiveness of preventive interventions implemented.

Communication skills
At the end of the course, students will be able to:
- effectively communicate with verbal, non-verbal and written methods the evaluations and health decisions within the interdisciplinary health team
- manage communication skills for a comparison at national and international level;
- verify the application of research results through written, oral and computer communication strategies and methods to improve organizational quality

Learning ability
At the end of the course, students will be able to:
- develop independent study skills;
- demonstrate the ability to cultivate doubts and tolerate uncertainties arising from study and practical activity;
- develop the ability to ask questions about the exercise of one's activity, relevant in time, place and interlocutors;
- demonstrate the ability to continuously seek opportunities for self-learning, collaborative learning and self-assessment within work teams;

	Prerequisites
	BASIC FINDINGS OF MICROBIOLOGY

	Contents
	The course is divided into four modules: Gynecology (2 credits - 24 hours), Obstetric-gynecological nursing sciences (3 credits - 36 hours), Forensic medicine (1 credit - 12 hours) and Infectious diseases (1 credit - 12 hours). Gynecology Module (MED 40, 2 cfu - 24 hours) Gestational diabetes: definition and epidemiology. Metabolism and endocrine changes in pregnancy, insulin resistance in pregnancy. Pathogenesis, risk factors, clinical features, diagnostic process of gestational diabetes. The main risks for the fetus and the diabetic mother (2 hours). Pathology of fetal adnexa: what are the adnexa and where do they originate from, their functions, the pathologies they can encounter and their causes, symptoms and treatments (2 hours). Placenta accreta: definition, risk factors, signs and symptoms, complications and diagnosis. The role of the midwife and patient management (1 hour). Fetal growth retardation: differences between IUGR and SGA and their definitions and etiology. Fetal, placental and maternal factors. Neonatal complications and fetal growth assessment (2 hours). Twin pregnancies: the difference between identical and dizygotic twins, complications of a twin pregnancy, therapeutic options and intrauterine death of a twin (2 hours) Pregnancy and childbirth in women with fibromatosis: definition and histogenesis of fibroma, risk factors, types of localization, symptoms, diagnosis, therapy and implications for fertility and pregnancy (2 hours). Preterm birth: definition, etiopathogenesis, causes, incidence, neonatal outcomes based on gestational week, use of antibiotics, tocolytic drugs and corticosteroids for lung maturity (2 hours). Gestational hypertension: definition and various types of hypertension, risk factors, etiopathogenesis, preventive strategies, therapy and monitoring of pregnancy at risk, maternal and fetal complications. HELLP syndrome and DIC: definition, epidemiology, diagnosis, mode of delivery, situation in the puerperium and risk factors for the subsequent pregnancy (2 hours). Multiple abortions: the difference between recurrent and repeated abortion, risk factors, incidence and causes (1 hour). First trimester metrorrhagia: causes, clinical aspects and their etiopathogenesis (2 hours). Maternal-fetal isoimmunization: Rh incompatibility, genetics of the Rh antigen, MEN, its diagnosis and therapy. Anti-D immunoprophylaxis and the indirect and direct Coombs test (2 hours). Cardiac disease in pregnancy: definition, epidemiology, assessment of cardiac risk in pregnancy and obstetric follow-up and pharmacological therapy. Timing and mode of delivery, obstetric management of labor, in the postpartum and puerperium (2 hours). Ovarian torsion: definition and types of torsion, risk factors, clinical and instrumental diagnosis, recovery of ovarian function, laparoscopic technique and thromboembolic risk (2 hours). Obstetric-gynecological Nursing Sciences Module (MED 47, 3 cfu - 36 hours) Pathologies of the first trimester of pregnancy: symptoms, diagnosis and treatment of hyperemesis gravidarum. Threatened abortion, ongoing, spontaneous, internal and recurrent abortion. Differential diagnosis between ectropion and cervical polyp. Trophoblastic pathologies: choriocarcinoma, hydatidiform mole, complete, partial and invasive, diagnosis and treatment. Ectopic pregnancy, risk factors, diagnosis and treatment (6 hours). Gestational hypertension: blood pressure and its measurement, hypertensive pathology and classification of hypertension, epidemiology, risk factors, maternal and fetal complications, clinical management with the MEOWS card, therapy, timing of delivery and blood pressure monitoring in the postpartum period (6 hours). Preeclampsia and eclampsia: classification, prevalence, risk factors, pathogenesis, criteria for early diagnosis, clinical management, pharmacological treatment and timing with the mode of delivery in a woman with preeclampsia. Eclampsia: symptoms, various stages, maternal and perinatal mortality and management of the eclamptic attack. Hellp and cid syndrome: pathogenesis, clinical picture, management, diagnosis, cause and complications (6 hours). Fetal growth disorders: severe and moderate, symmetric and asymmetric fgr and sga, diagnosis, clinical management and mode of delivery based on the weeks of gestation. Fetal macrosomia, etiology, prevention, diagnosis, maternal complications and choice of delivery (4 hours). Preterm birth: definition, risk factors, infectious and non-infectious causes, prevention, diagnosis, therapy and care for the preterm newborn (2 hours). Amniochorionic membrane rupture and infectious risk: difference between pprom and prom, risk factors, the role of collagen, intra-amniotic infections/inflammations and their evolution, diagnosis, maternal and neonatal complications, clinical management and therapy. Group B streptococcus, prevention strategies, risk factors and intrapartum prophylaxis (5 hours). Management of the diabetic pregnant woman: type 1 and 2 diabetes mellitus, gestational diabetes, maternal risk factors, risks for the mother and the child, screening and diagnosis, ogtt. Home glycemic self-monitoring, the difference between women on dietary and insulin treatment. Intrapartum management of the diabetic pregnant woman both in case of tc and in case of natural birth and management of the postpartum period of both the mother and the newborn (5 hours). Twin pregnancy: definition, diagnosis, management and surveillance of pregnancy and maternal and fetal complications; ttts and taps: pathogenesis, prognosis, diagnosis, therapy, clinical management and monitoring. The mode of delivery and assistance at delivery and postpartum (2 hours). Forensic Medicine Module (MED 43, 1cfu - 12 hours) The medical certificate and its requirements, the difference between a report and a report, the omission of a report, personal injuries and the determination of death (2 hours). Professional ethics, reports and medical records (1 hour). The importance of correct information and communication (1 hour). The criminal liability of healthcare professionals: criminal, civil and disciplinary liability, the criteria and limits not to be exceeded and the importance of informed consent (1 hour). Firearm injuries: types of weapons, internal, external and terminal ballistics and types of wounds (1 hour). Gelli Bianco Law: articles (1 hour). Forensic medical causality: cause, contributory cause, occasion, coincidence, crime, fault, intent, material and psychological causal link, imputability and responsibility (1 hour). Legal capacity and civil capacity and simulation of infirmity and injury (1 hour). CEDAP form: function, structure and compilation (1 hour). Law 40/2004: articles (1 hour). The midwives' code of ethics: articles (1 hour). Infectious Diseases Module (MED 17, 1cfu - 12 hours) Sexually transmitted diseases (2 hours). Hepatitis A, B, C: epidemiology, clinic, therapy, prophylaxis. Breastfeeding yes or no (2 hours). HIV infection: Epidemiology: Prophylaxis, Therapy, Maternal-fetal transmission. Breastfeeding yes or no (2 hours). Cytomegalovirus, HSV, Salmonellosis, Varicella zoster, Epstein-Barr virus, Toxoplasmosis, Rubella, Group B Streptococcus infection (4 hours). Sars-Cov-2 viral pneumonia: diagnosis and therapy. Breastfeeding yes or no (2 hours).

Contents

The course is divided into four modules: Gynecology (2 credits - 24 hours), Obstetric-gynecological nursing sciences (3 credits - 36 hours), Forensic medicine (1 credit - 12 hours) and Infectious diseases (1 credit - 12 hours).

Gynecology Module (MED 40, 2 cfu - 24 hours)
Gestational diabetes: definition and epidemiology. Metabolism and endocrine changes in pregnancy, insulin resistance in pregnancy. Pathogenesis, risk factors, clinical features, diagnostic process of gestational diabetes. The main risks for the fetus and the diabetic mother (2 hours).
Pathology of fetal adnexa: what are the adnexa and where do they originate from, their functions, the pathologies they can encounter and their causes, symptoms and treatments (2 hours).
Placenta accreta: definition, risk factors, signs and symptoms, complications and diagnosis. The role of the midwife and patient management (1 hour).
Fetal growth retardation: differences between IUGR and SGA and their definitions and etiology. Fetal, placental and maternal factors. Neonatal complications and fetal growth assessment (2 hours).
Twin pregnancies: the difference between identical and dizygotic twins, complications of a twin pregnancy, therapeutic options and intrauterine death of a twin (2 hours)
Pregnancy and childbirth in women with fibromatosis: definition and histogenesis of fibroma, risk factors, types of localization, symptoms, diagnosis, therapy and implications for fertility and pregnancy (2 hours).
Preterm birth: definition, etiopathogenesis, causes, incidence, neonatal outcomes based on gestational week, use of antibiotics, tocolytic drugs and corticosteroids for lung maturity (2 hours).
Gestational hypertension: definition and various types of hypertension, risk factors, etiopathogenesis, preventive strategies, therapy and monitoring of pregnancy at risk, maternal and fetal complications. HELLP syndrome and DIC: definition, epidemiology, diagnosis, mode of delivery, situation in the puerperium and risk factors for the subsequent pregnancy (2 hours).
Multiple abortions: the difference between recurrent and repeated abortion, risk factors, incidence and causes (1 hour).
First trimester metrorrhagia: causes, clinical aspects and their etiopathogenesis (2 hours).
Maternal-fetal isoimmunization: Rh incompatibility, genetics of the Rh antigen, MEN, its diagnosis and therapy. Anti-D immunoprophylaxis and the indirect and direct Coombs test (2 hours).
Cardiac disease in pregnancy: definition, epidemiology, assessment of cardiac risk in pregnancy and obstetric follow-up and pharmacological therapy. Timing and mode of delivery, obstetric management of labor, in the postpartum and puerperium (2 hours).
Ovarian torsion: definition and types of torsion, risk factors, clinical and instrumental diagnosis, recovery of ovarian function, laparoscopic technique and thromboembolic risk (2 hours).

Obstetric-gynecological Nursing Sciences Module (MED 47, 3 cfu - 36 hours)
Pathologies of the first trimester of pregnancy: symptoms, diagnosis and treatment of hyperemesis gravidarum. Threatened abortion, ongoing, spontaneous, internal and recurrent abortion. Differential diagnosis between ectropion and cervical polyp. Trophoblastic pathologies: choriocarcinoma, hydatidiform mole, complete, partial and invasive, diagnosis and treatment. Ectopic pregnancy, risk factors, diagnosis and treatment (6 hours).
Gestational hypertension: blood pressure and its measurement, hypertensive pathology and classification of hypertension, epidemiology, risk factors, maternal and fetal complications, clinical management with the MEOWS card, therapy, timing of delivery and blood pressure monitoring in the postpartum period (6 hours).
Preeclampsia and eclampsia: classification, prevalence, risk factors, pathogenesis, criteria for early diagnosis, clinical management, pharmacological treatment and timing with the mode of delivery in a woman with preeclampsia. Eclampsia: symptoms, various stages, maternal and perinatal mortality and management of the eclamptic attack. Hellp and cid syndrome: pathogenesis, clinical picture, management, diagnosis, cause and complications (6 hours).
Fetal growth disorders: severe and moderate, symmetric and asymmetric fgr and sga, diagnosis, clinical management and mode of delivery based on the weeks of gestation. Fetal macrosomia, etiology, prevention, diagnosis, maternal complications and choice of delivery (4 hours).
Preterm birth: definition, risk factors, infectious and non-infectious causes, prevention, diagnosis, therapy and care for the preterm newborn (2 hours).
Amniochorionic membrane rupture and infectious risk: difference between pprom and prom, risk factors, the role of collagen, intra-amniotic infections/inflammations and their evolution, diagnosis, maternal and neonatal complications, clinical management and therapy. Group B streptococcus, prevention strategies, risk factors and intrapartum prophylaxis (5 hours).
Management of the diabetic pregnant woman: type 1 and 2 diabetes mellitus, gestational diabetes, maternal risk factors, risks for the mother and the child, screening and diagnosis, ogtt. Home glycemic self-monitoring, the difference between women on dietary and insulin treatment. Intrapartum management of the diabetic pregnant woman both in case of tc and in case of natural birth and management of the postpartum period of both the mother and the newborn (5 hours).
Twin pregnancy: definition, diagnosis, management and surveillance of pregnancy and maternal and fetal complications; ttts and taps: pathogenesis, prognosis, diagnosis, therapy, clinical management and monitoring. The mode of delivery and assistance at delivery and postpartum (2 hours).

Forensic Medicine Module (MED 43, 1cfu - 12 hours)
The medical certificate and its requirements, the difference between a report and a report, the omission of a report, personal injuries and the determination of death (2 hours).
Professional ethics, reports and medical records (1 hour).
The importance of correct information and communication (1 hour).
The criminal liability of healthcare professionals: criminal, civil and disciplinary liability, the criteria and limits not to be exceeded and the importance of informed consent (1 hour).
Firearm injuries: types of weapons, internal, external and terminal ballistics and types of wounds (1 hour).
Gelli Bianco Law: articles (1 hour).
Forensic medical causality: cause, contributory cause, occasion, coincidence, crime, fault, intent, material and psychological causal link, imputability and responsibility (1 hour).
Legal capacity and civil capacity and simulation of infirmity and injury (1 hour).
CEDAP form: function, structure and compilation (1 hour).
Law 40/2004: articles (1 hour).
The midwives' code of ethics: articles (1 hour).

Infectious Diseases Module (MED 17, 1cfu - 12 hours)
Sexually transmitted diseases (2 hours).
Hepatitis A, B, C: epidemiology, clinic, therapy, prophylaxis. Breastfeeding yes or no (2 hours).
HIV infection: Epidemiology: Prophylaxis, Therapy, Maternal-fetal transmission. Breastfeeding yes or no (2 hours).
Cytomegalovirus, HSV, Salmonellosis, Varicella zoster, Epstein-Barr virus, Toxoplasmosis, Rubella, Group B Streptococcus infection (4 hours).
Sars-Cov-2 viral pneumonia: diagnosis and therapy. Breastfeeding yes or no (2 hours).

	Teaching Methods
	The course includes frontal lessons for a total of 84 hours. Attendance at classroom lessons is mandatory. To take the final exam, the student must have attended at least 75% of the hours scheduled for the course. Attendance will be verified using the EasyAcademy software.

	Verification of learning
	The achievement of the objectives of the course is verified by passing an oral exam with a score of thirtieths lasting approximately 15 minutes per module. The test allows to ascertain knowledge and understanding of the topics covered in the course, the ability to present, the ability to develop solutions in autonomous judgment of the student. The oral exam will verify theoretical knowledge, with reference to diseases of medical-surgical-gynaecological interest, and infectious disease during pregnancy, the management of diagnostic-therapeutic procedures, the rules of the relevant professional profile and the specific code of ethics. The final grade of the exam of the integrated course is the weighted average of the grades of the individual modules. Honors requires achieving the maximum grades in all modules of the course.

Verification of learning

The achievement of the objectives of the course is verified by passing an oral exam with a score of thirtieths lasting approximately 15 minutes per module. The test allows to ascertain knowledge and understanding of the topics covered in the course, the ability to present, the ability to develop solutions in autonomous judgment of the student. The oral exam will verify theoretical knowledge, with reference to diseases of medical-surgical-gynaecological interest, and infectious disease during pregnancy, the management of diagnostic-therapeutic procedures, the rules of the relevant professional profile and the specific code of ethics. The final grade of the exam of the integrated course is the weighted average of the grades of the individual modules. Honors requires achieving the maximum grades in all modules of the course.

	Texts
	De Ferrari-Palmieri Manuale di Medicina Legale Giuffrè Di Luca Feola Manuale di Medicina Legale Minerva Medica 2017 EdizioniCostantini Midwifery Piccin MALATTIE INFETTIVE” BORGIA - GAETA William Ostetricia Piccin editore 2018 Dispense del corso

	More Information
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Antonio MOLLO | Obstetric Pathology