1. Study overview
2. Specific topic (e.g., preeclampsia, labor stages, PPH)
3. Clinical management question
4. Exam prep (MCQs/quick notes)

1) What obstetrics covers

• Care of mother and fetus from conception to postpartum
• Normal pregnancy, complications, labor/delivery, and immediate newborn transition

2) Antenatal care (routine)

• Confirm intrauterine pregnancy, estimate gestational age (LMP + early ultrasound)
• Baseline risk assessment: medical, surgical, obstetric, social history
• Screening/labs (varies by guideline/country):
  • CBC, blood group/Rh + antibody screen
  • Infectious screening (HIV, hepatitis B, syphilis, etc.)
  • Urine testing
  • Diabetes screening (24-28 weeks typically)
  • Aneuploidy screening options (first trimester combined, cfDNA, etc.)
• Supplements: folic acid, iron as needed, calcium depending diet/risk
• Vaccines in pregnancy per local protocol (e.g., Tdap, influenza)
• Visit goals: BP, weight trend, fundal height, fetal heart, fetal movement counseling, danger signs

3) Physiologic changes in pregnancy

• Cardiovascular: increased plasma volume, increased cardiac output, lower SVR
• Hematologic: physiologic anemia, hypercoagulable state
• Respiratory: increased minute ventilation, mild respiratory alkalosis
• Renal: increased GFR
• Endocrine/metabolic shifts supporting fetal growth

4) Common obstetric complications

Early pregnancy

• Miscarriage (threatened, inevitable, incomplete, missed)
• Ectopic pregnancy
• Hyperemesis gravidarum
• Gestational trophoblastic disease (less common, high importance)

Mid/late pregnancy

• Hypertensive disorders:
  • Gestational HTN
  • Preeclampsia/eclampsia
  • HELLP
• Gestational diabetes mellitus
• Fetal growth restriction (FGR)
• Preterm labor and PPROM
• Antepartum hemorrhage:
  • Placenta previa
  • Placental abruption
• Multiple gestation complications
• Cholestasis of pregnancy

5) Fetal assessment

• Ultrasound:
  • Dating scan
  • Anatomy scan
  • Growth and Doppler when indicated
• Fetal surveillance:
  • Kick counts
  • NST/CTG
  • Biophysical profile
• Red flags: reduced fetal movement, abnormal CTG, severe growth restriction, oligohydramnios/polyhydramnios

6) Labor and delivery

Stages of labor

1. First stage: latent + active cervical dilation
2. Second stage: full dilation to delivery of fetus
3. Third stage: delivery of placenta

Intrapartum monitoring

• Maternal vitals, contractions, cervical progress
• Fetal heart monitoring (intermittent auscultation or continuous CTG)
• Partograph can help identify abnormal labor progress

Mode of delivery

• Vaginal (spontaneous/assisted)
• Cesarean section indications:
  • Fetal distress not responsive to measures
  • Failed progress/obstructed labor
  • Malpresentation in selected settings
  • Placenta previa major, uterine rupture risk scenarios, etc.

7) Obstetric emergencies (must-know)

• Postpartum hemorrhage (PPH)
• Eclampsia
• Shoulder dystocia
• Uterine rupture
• Cord prolapse
• Amniotic fluid embolism
• Severe sepsis
• Key principle: rapid recognition, team response, ABCs, protocol-driven management

8) Postpartum care

• Monitor bleeding, uterine tone, BP, pain, fever, urinary issues
• Lactation support, mental health screening, contraception counseling
• Watch for postpartum preeclampsia, infection, thromboembolism, depression
• Routine follow-up and chronic risk counseling (e.g., future CVD risk after preeclampsia)

9) High-yield management snapshots

• Preeclampsia severe features: stabilize mother, seizure prophylaxis (magnesium sulfate), BP control, plan delivery by gestational age/severity
• PPH: uterine massage + uterotonics + tranexamic acid early + IV access/blood protocol + identify 4 Ts (Tone, Trauma, Tissue, Thrombin)
• Preterm labor: corticosteroids, tocolysis (selected), magnesium sulfate for fetal neuroprotection (gestation-dependent), GBS prophylaxis as indicated
• GDM: diet/exercise, glucose monitoring, medication when needed, postpartum glucose re-testing

10) Ethics and communication in obstetrics

• Maternal autonomy and informed consent are central
• Balance maternal and fetal risk transparently
• Respect cultural context, birth preferences, and trauma-informed care
• Clear escalation and shared decision-making improve outcomes

11) Exam/crash revision list (ultra high yield)

• Diagnostic criteria: preeclampsia, GDM, labor arrest
• CTG interpretation and next steps
• PPH algorithm (first 10 minutes)
• Ectopic pregnancy diagnosis/management
• Placenta previa vs abruption differences
• Induction indications/contraindications
• VBAC/TOLAC basics and contraindications
• Rh isoimmunization prevention
• Postpartum red flags and discharge counseling

1. a one-page obstetrics cheat sheet,
2. a protocol-style emergency handbook (PPH/eclampsia/shoulder dystocia), or
3. a 100-question OB exam prep set with answers.