Paper V: Elective – Obstetric and Gynecological Conditions – Basics, Assessment and Evaluation

Objectives:
On completion of the subject, student will have had the opportunity to develop the following generic skills-

• An advance understanding of the changing knowledge base in this clinical area
• An ability to evaluate and synthesis of research and professional literature in this area.
• An understanding of the significance and value of their knowledge to the wider community.
• An appreciation of team approach to learning.
• Plan, deliver and evaluate appropriate exercise programs for specific women’s groups of the community.
• Understand the impact of exercise on the altered physiology, patho physiology and psychology of pregnancy, menopause, aging, & osteopenia/ osteoporosis.
• Identify the legal and safety issue associated with leading exercise classes for women with specific physical need.
• Understand the motivational and marking aspect of leading community and hospital based exercise classes.

Section-I: Obstetrics and Gynecological Conditions – Basics

Anatomy and Physiology

• Developmental anatomy: Embryology & fetal development.
• General female anatomy & Physiology:
  • Reproductive system
  • Female breast.
  • Female abdomen.
  • Female bony pelvic
• Biomechanics of the female pelvic:
  • Reproductive tract.
  • Abdominal muscle.
• Endocrine physiology related different phase of women’s life.
• Puberty and menarche
• Physiology of Menstrual cycle
• Review of pelvic anatomy

Section-II: Obstetrics and Gynecological Conditions – Assessment and Evaluation

Obstetrics:

• Physiotherapy assessment in obstetrics:
  • Antenatal assessment.
  • Assessment during labour.
  • Postnatal assessment.
• Assessment includes:
  • Common musculoskeletal problem.
  • Diastasis recti.
  • Pelvic floor muscle function.
  • Bowel & bladder dysfunction.

Gynecology:

• Physiotherapy assessment in gynecology:
  • Physiotherapy Assessment of different gynecological condition.
  • Pre & Post operative assessment of gynecological surgery.
  • Physiotherapy assessment of Bladder and Bowel Dysfunction.
• Assessment includes:
  • Pelvic floor muscle assessment.
  • Assessment of pain.
  • Diagnostic tools used in gynecological assessment.
  • Examination of breast.

Paper VI: Elective – Physiotherapeutic Interventions in Clinical Obstetrics and Gynecological

Conditions
Section-I: Clinical Obstetrics and Gynecological Conditions

Obstetrics:

• Pregnancy detection methods and diagnostic test.
• Physiological changes during pregnancy.
• Common complications & discomforts during pregnancy: High risk pregnancy.
• Common syndrome during pregnancy.
• Psychological and emotional aspects of pregnancy
• Stages of Labour & its mechanism.
• Complication during labour.
• Assisted delivery :
• Episiotomy
• Forceps delivery.
• Caesarian section.
• Postnatal phase Puerperium & its physiological changes. Common problem & complications.
• Different methods of Contraception.

Gynecology:

• Menstrual disorder
• Puberty & common syndrome during this phase.
• Polycystic ovarian syndrome
• Gynecological infections.
• Displacement, Prolapse and pelvic floor dysfunction: surgical repair for it.
• Cysts & new growth.
• Cancer of the reproductive system, Breast cancer: Surgical procedures for it.
• Infertility.
• Menopause: Physiological changes and its consequences.
• Gynecological surgeries including exisitional and repair surgeries.

Section-II: Physiotherapy Interventions in Obstetrics and Gynecological condition

Obstetrics:

• Antenatal exercise in pregnancy.
• Concept, principles and organization of antenatal exercises.
• PT management of common syndrome of pregnancy.
• Role of PT in antenatal complication.
• Ergonomics during childbearing phase.
• Role of physiotherapy in high risk pregnancy.
• Role of physiotherapy during Labor and its management.
• PT management of immediate and late postnatal complications.
• Concepts, principles and organization of postnatal classes.

Gynecology:

• Exercise for an adolescent female.
• Principles and techniques of application of pelvic floor exercises.
• Use of electrotherapy modalities in training Pelvic floor muscles. a. Therapeutic electrical stimulation. & Biofeedback.
• Physiotherapy management in Pelvic floor dysfunction.
• Prevention and Physiotherapy intervention in Osteoporoses.
• Breast cancer rehabilitation.
• Physiotherapy management of Lymphedema after mastectomy.
• Physiotherapy intervention before and after gynecological surgeries.

Recommended Books:

• Physiotherapy in Obstetrics & Gynaecology – Polden & Mantle, Jaypee Brothers.
• Obstetrics & Gynaecologic Physical Therapy – Wilder Elaine, Churchill Livingstone.
• Therapeutic Management of Incontinence and Pelvic Pain by J. Laycock and J. Haslam (Jun 20, 2002)
• Physiotherapy of the cancer patient – McGaryex, Churchill Livingstone.
• Women’s Health in Physical Therapy by Jean M. Irion and Glenn L. Irion (May 27, 2009)
• Women’s Health: A Textbook for Physiotherapists by Ruth Sapsford, Joanne Bullock-Saxton and Sue Markwell Bphty (Dec 1, 1997)
• Obstetric and Gynecologic Care in Physical Therapy by Linda J. O’Connor and Rebecca J. Gourley (Jul 1990)
• Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice by Kari Bo, Bary Berghmans, Siv Morkved and Marijke Van Kampen (Jul 27, 2007)
• Obstetric and Gynaecologic Physical Therapy by E. Wilder (Oct 1988)
• Female Genital Prolapse and Urinary Incontinence (Vol 4) by Victor Gomel and Bruno van Herendael (Nov 19, 2007)
• Physiotherapy in Obstetrics and Gynaecology by Jill Mantle, Jeanette Haslam and Sue Barton (May 3, 2004)
• Obstetric and Gynecologic Care in Physical Therapy, 2E by Rebecca G. Stephenson and Linda J. O’Connor (Jan 1, 2000)
• Physiotherapy in Pregnancy: Antenatal, Postnatal and Baby Care by Balaji Hiranandani (Dec 1, 2007)