Antonio MOLLO | PATHOLOGY OF CHILDBIRTH AND PUERPERIUM

cod. 1012400018

PATHOLOGY OF CHILDBIRTH AND PUERPERIUM

	1012400018
	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
	SPRING SEMESTER

TEACHING UNITS

	SSD	CFU	HOURS	ACTIVITY	TYPE OF ACTIVITY
1	PATOLOGIA DEL PARTO E DEL PUERPERIO - MOD. GINECOLOGIA E OSTETRICIA
	MED/40	2	24	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
2	PATOLOGIA DEL PARTO E DEL PUERPERIO - MOD. CHIRURGIA PEDIATRICA E INFANTILE
	MED/20	1	12	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
3	PATOLOGIA DEL PARTO E DEL PUERPERIO - MOD. SCIENZE INFERMIERISTICHE OSTETRICO-GINECOLOGICHE
	MED/47	3	36	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS
4	PATOLOGIA DEL PARTO E DEL PUERPERIO - MOD. FARMACOLOGIA
	BIO/14	1	12	LESSONS	COMPULSORY SUBJECTS, CHARACTERISTIC OF THE CLASS

PROFESSORS

	ANTONIO MOLLO1 T Curriculum
	ALFREDO GARZI2 Curriculum
	-43

	Objectives
	The course systematically analyses the main syndromes and pathologies of pregnancy, the alterations of labour and the related maternal-fetal monitoring, and the main pathologies of the puerperium. Knowledge and understanding At the end of the course, students will know and understand: - the principles, values, theories and models of Midwifery, obstetric semiotics for the assessment of the health status of the patient and the planning, management and evaluation of obstetric, neonatological and gynecological care. - the main physiological and pathological processes of pregnancy, childbirth, puerperium. - the drugs used in obstetrics, gynecology and neonatology, and the diagnostic and therapeutic protocols of neonatal pathology. Applying knowledge and understanding At the end of the course, students: -will have acquired mastery of the methods and contents of the midwifery profession through theoretical, practical and clinical internship training activities. -will have acquired knowledge, skills and abilities in the practice of innovative and traditional surgical procedures carried out in collaboration with specialist doctors and other healthcare personnel. -will be able to collaborate in the care of newborns who require sub-intensive care. -will be able to participate in the organization of health education and promotion interventions with particular attention to sexually transmitted diseases, also through the adoption of appropriate lifestyles Making judgements At the end of the course, students will be able to: -use critical thinking skills to provide safe, personalized obstetric care. -make professional responsibility decisions at different stages of the care process and be able to verify their effectiveness and proceed with decision-making re-planning. -decide on care priorities for groups of patients for whom they are responsible. -decide on appropriate care interventions considering legal, political, geographical, economic, ethical and social influences. -critically evaluate the outcomes of care decisions taken based on patient outcomes and standards of care. -assume decision-making responsibility and be accountable for their actions during professional practice in accordance with the profile, the code of ethics and ethical and legal standards; -make decisions through a scientific approach to solving patient problems by evaluating the scientific studies available and respecting the quality of care provided using research tools; -make decisions during obstetric care by personalizing their choices based on the similarities and differences of the people assisted with respect to values, ethnicity and socio-cultural practices; -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 assessments and health decisions within the interdisciplinary health team; - conduct interpersonal interviews with users of all ages and with their families within the care process and/or with other health professionals in an appropriate manner, conducting effective negotiating relationships and methodological rigor; - support and encourage users towards health choices, reinforcing coping skills, self-esteem and enhancing available resources; - manage communication skills for a comparison at national and international level - use the principles of teaching and learning for specific informative or educational interventions aimed at individual users, families, groups, other professionals such as support staff, midwifery students, nursing students, applying clear and orderly communication of one's mental synthesis; -verify the application of research results through written, oral and computer communication strategies and methods to improve organizational quality -manage conflicts arising from different positions by negotiating solutions and communicate effectively with the care team to agree on operating methods and implement the application and development of protocols and guidelines Learning ability At the end of the course, students will be able to: - continuously self-assess their educational needs in relation to the nature and complexity of the problems to be addressed and the design and operational strategies to be managed; - develop independent study skills; - cultivate doubts and tolerate uncertainties arising from study and practical activity; - develop the ability to ask questions about the exercise of their activity, relevant in time, place and interlocutors; - continuously seek opportunities for self-learning, collaborative learning and self-assessment within work teams; - demonstrate the ability to share knowledge.

The course systematically analyses the main syndromes and pathologies of pregnancy, the alterations of labour and the related maternal-fetal monitoring, and the main pathologies of the puerperium.

Knowledge and understanding
At the end of the course, students will know and understand:
- the principles, values, theories and models of Midwifery, obstetric semiotics for the assessment of the health status of the patient and the planning, management and evaluation of obstetric, neonatological and gynecological care.
- the main physiological and pathological processes of pregnancy, childbirth, puerperium.
- the drugs used in obstetrics, gynecology and neonatology, and the diagnostic and therapeutic protocols of neonatal pathology.

Applying knowledge and understanding
At the end of the course, students:
-will have acquired mastery of the methods and contents of the midwifery profession through theoretical, practical and clinical internship training activities.
-will have acquired knowledge, skills and abilities in the practice of innovative and traditional surgical procedures carried out in collaboration with specialist doctors and other healthcare personnel.
-will be able to collaborate in the care of newborns who require sub-intensive care.
-will be able to participate in the organization of health education and promotion interventions with particular attention to sexually transmitted diseases, also through the adoption of appropriate lifestyles

Making judgements
At the end of the course, students will be able to:
-use critical thinking skills to provide safe, personalized obstetric care.
-make professional responsibility decisions at different stages of the care process and be able to verify their effectiveness and proceed with decision-making re-planning.
-decide on care priorities for groups of patients for whom they are responsible.
-decide on appropriate care interventions considering legal, political, geographical, economic, ethical and social influences.
-critically evaluate the outcomes of care decisions taken based on patient outcomes and standards of care.
-assume decision-making responsibility and be accountable for their actions during professional practice in accordance with the profile, the code of ethics and ethical and legal standards;
-make decisions through a scientific approach to solving patient problems by evaluating the scientific studies available and respecting the quality of care provided using research tools;
-make decisions during obstetric care by personalizing their choices based on the similarities and differences of the people assisted with respect to values, ethnicity and socio-cultural practices;
-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 assessments and health decisions within the interdisciplinary health team;
- conduct interpersonal interviews with users of all ages and with their families within the care process and/or with other health professionals in an appropriate manner, conducting effective negotiating relationships and methodological rigor;
- support and encourage users towards health choices, reinforcing coping skills, self-esteem and enhancing available resources;
- manage communication skills for a comparison at national and international level
- use the principles of teaching and learning for specific informative or educational interventions aimed at individual users, families, groups, other professionals such as support staff, midwifery students, nursing students, applying clear and orderly communication of one's mental synthesis;
-verify the application of research results through written, oral and computer communication strategies and methods to improve organizational quality
-manage conflicts arising from different positions by negotiating solutions and communicate effectively with the care team to agree on operating methods and implement the application and development of protocols and guidelines

Learning ability
At the end of the course, students will be able to:
- continuously self-assess their educational needs in relation to the nature and complexity of the problems to be addressed and the design and operational strategies to be managed;
- develop independent study skills;
- cultivate doubts and tolerate uncertainties arising from study and practical activity;
- develop the ability to ask questions about the exercise of their activity, relevant in time, place and interlocutors;
- continuously seek opportunities for self-learning, collaborative learning and self-assessment within work teams;
- demonstrate the ability to share knowledge.

	Prerequisites
	An adequate theoretical and practical knowledge of the physiology of childbirth and puerperium, as well as basic notions of the physiology and care of the healthy newborn, are considered essential prerequisites. The exam of Physiological childbirth and puerperium: mechanism and care is preparatory to this teaching activity.

	Contents
	The course is divided into 4 modules: Gynecology and obstetrics (2 credits – 24 hours), Pediatric and child surgery (1 credit – 12 hours), Obstetric-gynecological nursing sciences (3 credits – 36 hours), Pharmacology (1 credit – 12 hours). Gynaecology and Obstetrics Module (MED 40, 2 cfu – 24 hours) Fetal surveillance: CTG and ACOG classification (2 hours). Dystocia of force, canal and mobile body (2 hours). Asynchlisms (1 hour). Diagnosis and guidelines for the management of postpartum haemorrhages (2 hours). Perineal damage from childbirth (2 hours). Breech presentation. Sacral rotation (3 hours). Venous thromboembolism in pregnancy and puerperium - Sepsis in obstetrics (2 hours). Pathologies of childbirth, postpartum and puerperium (2 hours). Operative childbirth: application of obstetric vacuum and episiotomy (2 hours). Pathologies of the umbilical cord: prolapse and procidentia (2 hours). Pathology of the secondment: failure of the secondment due to placental accretism Induction of labor (2 hours). Ultrasound in the delivery room (2 hours). Paediatric and Infant Surgery Module (MED 20, 1 cfu – 12 hours) Neonatal surgical emergencies: prenatal diagnosis and screening for congenital anomalies and abdominal wall defects (omphalocele and gastroschisis) (3 hours). Digestive and respiratory system malformations: diaphragmatic hernia, oesophageal atresia, intestinal atresia, anorectal malformations, bile duct obstruction, cystic adenomatoid lung disease, congenital lobular emphysema, bronchogenic pulmonary cyst, hydrothorax and pulmonary sequestration, necrotizing enterocolitis, meconium hilus (6 hours). Congenital urinary system malformations: hypospadias, reflux nephropathy, pyeloureteral junction stenosis, vesicourethral reflux (3 hours). Obstetric-gynaecological Nursing Sciences Module (MED 47, 3 cfu – 36 hours) Physiological labour vs. dystocic labor: timing of the first, second and third stages; fetal malpositions: OIP, asynclitism, deflexed positions; diagnosis and management and treatment of malpositions. WHO: new partogram 2020 (4 hours). Dynamic dystocias and mechanical dystocias: causes and treatment of dystocias, midwifery skills. Augmentation: amniorexis, oxytocin (4 hours). Thromboembolism in pregnancy and puerperium (4 hours) Postpartum hemorrhage: etiology, diagnosis and treatment, active treatment of the third stage (4 hours). Sepsis in puerperium: Indices and risk factors, diagnostic score and treatment (4 hours). Perineal lacerations at childbirth: classification, diagnosis and treatment. Prevention in labor and perineal care (4 hours). Breastfeeding disorders: moniliasis, breast engorgement, mastitis and fissures (4 hours). Postpartum depression: Diagnostic screening for obstetricians and multidisciplinary management (4 hours). Operative delivery with kiwi vacuum: indications and degree of risk and obstetric skills (4 hours). Pharmacology Module (BIO 14, 1 cfu – 12 hours) Correlations between some pharmacokinetic aspects and special pharmacology (2 hours). Antimicrobials and antibiotics (1 hour). Beta-lactams (penicillins, cephalosporins, carbapenems, monobactams) (1 hour). Problems of antibiotic resistance (1 hour). Macrolides: erythromycin, clarithromycin, azithromycin, spiramycin - Ketolides and lincosamides (2 hours). Tetracyclines, Fluoroquinolones, Aminoglucosides, Antimicrobial Stewardship (2 hours). Drug excretion and breastfeeding (1 hour). Nonsteroidal anti-inflammatory drugs (NSAIDs), FAS (1 hour). Anticoagulant and antiplatelet drugs (1 hour).

Contents

The course is divided into 4 modules: Gynecology and obstetrics (2 credits – 24 hours), Pediatric and child surgery (1 credit – 12 hours), Obstetric-gynecological nursing sciences (3 credits – 36 hours), Pharmacology (1 credit – 12 hours).

Gynaecology and Obstetrics Module (MED 40, 2 cfu – 24 hours)
Fetal surveillance: CTG and ACOG classification (2 hours).
Dystocia of force, canal and mobile body (2 hours).
Asynchlisms (1 hour).
Diagnosis and guidelines for the management of postpartum haemorrhages (2 hours).
Perineal damage from childbirth (2 hours).
Breech presentation. Sacral rotation (3 hours).
Venous thromboembolism in pregnancy and puerperium - Sepsis in obstetrics (2 hours).
Pathologies of childbirth, postpartum and puerperium (2 hours).
Operative childbirth: application of obstetric vacuum and episiotomy (2 hours).
Pathologies of the umbilical cord: prolapse and procidentia (2 hours).
Pathology of the secondment: failure of the secondment due to placental accretism
Induction of labor (2 hours).
Ultrasound in the delivery room (2 hours).

Paediatric and Infant Surgery Module (MED 20, 1 cfu – 12 hours)
Neonatal surgical emergencies: prenatal diagnosis and screening for congenital anomalies and abdominal wall defects (omphalocele and gastroschisis) (3 hours).
Digestive and respiratory system malformations: diaphragmatic hernia, oesophageal atresia, intestinal atresia, anorectal malformations, bile duct obstruction, cystic adenomatoid lung disease, congenital lobular emphysema, bronchogenic pulmonary cyst, hydrothorax and pulmonary sequestration, necrotizing enterocolitis, meconium hilus (6 hours).
Congenital urinary system malformations: hypospadias, reflux nephropathy, pyeloureteral junction stenosis, vesicourethral reflux (3 hours).

Obstetric-gynaecological Nursing Sciences Module (MED 47, 3 cfu – 36 hours)
Physiological labour vs. dystocic labor: timing of the first, second and third stages; fetal malpositions: OIP, asynclitism, deflexed positions; diagnosis and management and treatment of malpositions. WHO: new partogram 2020 (4 hours).
Dynamic dystocias and mechanical dystocias: causes and treatment of dystocias, midwifery skills. Augmentation: amniorexis, oxytocin (4 hours).
Thromboembolism in pregnancy and puerperium (4 hours)
Postpartum hemorrhage: etiology, diagnosis and treatment, active treatment of the third stage (4 hours).
Sepsis in puerperium: Indices and risk factors, diagnostic score and treatment (4 hours).
Perineal lacerations at childbirth: classification, diagnosis and treatment. Prevention in labor and perineal care (4 hours).
Breastfeeding disorders: moniliasis, breast engorgement, mastitis and fissures (4 hours).
Postpartum depression: Diagnostic screening for obstetricians and multidisciplinary management (4 hours).
Operative delivery with kiwi vacuum: indications and degree of risk and obstetric skills (4 hours).

Pharmacology Module (BIO 14, 1 cfu – 12 hours)
Correlations between some pharmacokinetic aspects and special pharmacology (2 hours).
Antimicrobials and antibiotics (1 hour).
Beta-lactams (penicillins, cephalosporins, carbapenems, monobactams) (1 hour).
Problems of antibiotic resistance (1 hour).
Macrolides: erythromycin, clarithromycin, azithromycin, spiramycin - Ketolides and lincosamides (2 hours).
Tetracyclines, Fluoroquinolones, Aminoglucosides, Antimicrobial Stewardship (2 hours).
Drug excretion and breastfeeding (1 hour).
Nonsteroidal anti-inflammatory drugs (NSAIDs), FAS (1 hour).
Anticoagulant and antiplatelet drugs (1 hour).

	Teaching Methods
	The course includes lectures, seminars on specific topics, exercises in the operating room, delivery room, inpatient ward and outpatient clinic; simulations on mannequins; computer simulations for a total duration of 84 hours. To take the final exam, the student must have attended at least 75% of the hours required by the course. Attendance will be verified using the EasyAcademy software.

	Verification of learning
	The achievement of the objectives of the course is certified by passing an oral exam lasting approximately 15 minutes for each module with an evaluation in thirtieths. The oral exam will verify theoretical knowledge, with reference to the physio pathological and clinical problems concerning fertility and female reproductive health, pregnancy and its evolution and the birth event in its complexity; to the fundamental theoretical-practical knowledge for preoperative care of surgical diseases of the foetus, the newborn; to the drugs used in obstetrics, gynaecology and neonatology, and the diagnostic and therapeutic protocols of neonatal pathology. 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 the modules of the course.

Verification of learning

The achievement of the objectives of the course is certified by passing an oral exam lasting approximately 15 minutes for each module with an evaluation in thirtieths. The oral exam will verify theoretical knowledge, with reference to the physio pathological and clinical problems concerning fertility and female reproductive health, pregnancy and its evolution and the birth event in its complexity; to the fundamental theoretical-practical knowledge for preoperative care of surgical diseases of the foetus, the newborn; to the drugs used in obstetrics, gynaecology and neonatology, and the diagnostic and therapeutic protocols of neonatal pathology. 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 the modules of the course.

	Texts
	PESCETTO G., DE CECCO L., PECORARI D., RAGNI N. “GINECOLOGIA E OSTETRICIA” SOC. ED. UNIVERSO, ROMA 2017 COLACURCI ET AL, GINECOLOGIA E OSTETRICIA - IDELSON GNOCCHI NAPOLI 2022 W. COSATNTINI, TRATTANDO DI SCIENZA ED ARTE DELLA PROFESSIONALITÀ OSTETRICA, PICCIN EDITORE PADOVA Williams Ostetricia Piccin 2018

	More Information
	Teaching is in Italian. The location of the lessons is at the University teaching centre of the AOU San Giovanni di Dio e Ruggi d'aragona Di Salerno.

BETA VERSION Data source ESSE3 [Ultima Sincronizzazione: 2025-01-27]

Antonio MOLLO | PATHOLOGY OF CHILDBIRTH AND PUERPERIUM