OBSTETRICS - High Yield Topics

1. Antenatal Care & High-Risk Pregnancy (25-30% weightage)

• ANC schedule, investigations at each visit
• Screening tests: Dual marker (11-14 wks), Triple/Quadruple marker (15-20 wks), NIPT/cell-free DNA
• Amniocentesis (15-18 wks), CVS (10-13 wks), Cordocentesis (>24 wks)
• TORCH infections - timing and fetal effects
• Rh incompatibility: Anti-D prophylaxis (doses, indications, timing)
• Gestational diabetes: screening (OGTT), management, targets
• Hypertensive disorders: classification, management (MgSO4 dosing, antihypertensives - methylergometrine CONTRAINDICATED in HTN)
• Preterm labor: tocolytics, steroids for fetal lung maturity
• PROM vs PPROM management
• FGR: causes, Doppler changes (umbilical artery - absent/reversed EDF)
• Twin pregnancy: types, complications (TTTS)
• Anemia in pregnancy: iron/folate requirements, treatment targets

2. Normal & Abnormal Labor (Very High)

• Stages of labor - durations (active phase: cervical dilation 1 cm/hr)
• Cardinal movements of labor
• Partogram interpretation
• Fetal heart rate patterns: late decelerations, variable decelerations
• Prolonged labor, obstructed labor, ruptured uterus
• Shoulder dystocia: McRoberts maneuver, Zavanelli maneuver
• Cord prolapse management
• Vacuum vs forceps criteria and contraindications
• LSCS indications

3. Obstetric Hemorrhage (Very High)

• APH: Placenta previa (grades/types, painless bleeding) vs Abruptio placentae (painful, Couvelaire uterus)
• PPH: Causes (4Ts - Tone, Trauma, Tissue, Thrombin)
• PPH management: Oxytocin first, then ergometrine (not in HTN), Carboprost (not in asthma), Misoprostol
• Uterotonic ladder
• Morbidly adherent placenta: accreta, increta, percreta
• Uterine inversion management
• Amniotic fluid embolism

4. Early Pregnancy Complications

• Abortion types: threatened, inevitable, incomplete, missed, septic - differentiation + management
• Ectopic pregnancy: risk factors, diagnostic criteria (serum beta-hCG + TVS), management (methotrexate criteria for medical management vs surgical)
• Molar pregnancy (GTD): complete vs incomplete mole (pathology is very high yield), invasive mole, choriocarcinoma
• hCG levels in molar pregnancy; follow-up protocol; contraception during follow-up

5. Puerperium

• Normal involution timeline
• PPH (primary vs secondary)
• Puerperal sepsis (most common organism: Streptococcus)
• Lactation: prolactin vs oxytocin roles

GYNECOLOGY - High Yield Topics

1. Menstrual Disorders & AUB (25-30% weightage)

• PALM-COEIN classification of AUB
• Dysmenorrhea: primary (PGF2α) vs secondary
• PCOS: Rotterdam criteria (2 of 3: oligo-anovulation, clinical/biochemical hyperandrogenism, polycystic ovaries on USG)
• Endometriosis: chocolate cyst, CA-125, laparoscopy gold standard
• Fibroids (leiomyoma): types, symptoms, treatment (GnRH agonists, myomectomy, hysterectomy)
• DUB/ovulatory vs anovulatory bleeding
• Amenorrhea workup (Asherman's, Sheehan's, Turner's, MRKH)

2. Reproductive Endocrinology & Infertility (High)

• HPG axis, folliculogenesis, ovulation
• Infertility workup: semen analysis (WHO 2021 criteria), HSG, laparoscopy
• IUI vs IVF indications
• Ovulation induction: clomiphene citrate (1st line), letrozole, gonadotropins
• OHSS: risk factors, management
• Mullerian anomalies classification

3. Gynecologic Oncology (High)

• Cervical cancer: HPV 16/18, CIN grading, Pap smear (Bethesda system), colposcopy, LEEP, staging (FIGO 2018 - clinical + imaging), treatment by stage
• Endometrial cancer: risk factors (unopposed estrogen), type I vs II, staging, treatment
• Ovarian cancer: epithelial (most common), germ cell tumors (AFP, hCG, LDH markers), sex cord-stromal, Krukenberg tumor, CA-125
• Gestational trophoblastic neoplasia: staging, EMA-CO regimen, cure rates
• Vulval cancer: most common type (SCC), staging

4. Contraception (Medium-High)

• OCP: mechanism, contraindications (COCP absolute CIs: smoker >35, migraines with aura, previous DVT/PE, breast cancer)
• Progesterone-only pill: ideal for breastfeeding mothers
• IUCD: Cu-T 380A (10 yrs), LNG-IUS Mirena (5 yrs), mechanism, contraindications, complications
• Emergency contraception: levonorgestrel (72 hrs), COCP (Yuzpe), Cu-T (5 days)
• Barrier methods: failure rates
• Sterilization: IUCD failure < tubal failure; reversal rates

5. Urogynecology & Prolapse (Medium)

• POP-Q classification
• Stress vs urge incontinence: diagnosis (urodynamics) and treatment
• Genitourinary fistulas (VVF - most common cause in developing countries: obstetric trauma)

6. Puberty Disorders & Amenorrhea

• Precocious puberty: GnRH-dependent vs independent
• Turner syndrome (45XO): streak gonads, primary amenorrhea, short stature
• Kallmann syndrome: anosmia + hypogonadotropic hypogonadism
• Sheehan's syndrome: panhypopituitarism after PPH

Single Best Concepts (Frequently Asked)

Study Strategy Tips

1. Prioritize clinical scenario questions - NEET PG OBG is heavily scenario-based now
2. Revise from standard Indian textbooks - Shaw's Gynecology + DC Dutta's Obstetrics
3. Master flowcharts - APH, PPH, Ectopic pregnancy management
4. Know FIGO 2018 staging for cervical, endometrial, and ovarian cancers
5. Drugs in pregnancy - teratogens, safe drugs, contraindicated drugs