The Curriculum Outline of

Obstetrics & Gynecology

(for nepalese medical student)

Department of Obstetrics & Gynecology

Weifang medical college

January 6, 2006
 Introduction

Obstetrics and gynecology is a study of physiology and

pathology of female reproductive system and pregnancy. Mastering

theory and basical practice is the basis of family planning, women &

neonatal health and medical research.

The teacher play a important role in the course of teachering. Not

only they point out the emphatic contents and introduce new home &

abroad informations, but also should they give derections to further

research in some fields. Through connecting theory with pratice,

stimulating students’ mind, the students’ capability of analyzing and

resolving questions will be promoted.

The lecturer of theory: Liu yu-zhen

The lecturer of practice: Liu yu-zhen, liu ru-xin, chen zhao-ri,

lv xiu-ping, ren chun-e

Copywriter: Liu yu-zhen

 Teachering period of each part of subject
(1 class hour = 40 minutes)
chapter contents Total Theory Practice Self
period study
chapter 1 The anatomy of the female reproductive 8 4 4 2
system
Chapter2 Physiology of reproductive in women 8 4 4 2

Chapter3 Physiology of pregnancy 8 4 4 2

Chapter4 Pregnancy and prenatal care 8 4 4 2

Chapter5 Nomal labor 8 4 4 2

Chapter6 Abnormal labour 16 8 8 4

Chapter7 Hypertensive disorder complicating 10 6 4 2

pregnancy
Chapter8 Pregnancy complications 24 12 12 4

Chapter9 Complications of labour 10 6 4 2

Chapter10 Medical conditions complicating 12 6 6 2

pregnancy
Chapter11 Normal puerperium 4 0 4 2

Chapter12 Gynecological history and examination 8 4 4 2

Chapter13 Infections of vulva ,vagina and cervix 12 6 6 2

Chapter14 Pelvic inflammatory diease 8 4 4 2

Chapter15 Cervical tumor 12 6 6 2

Chapter16 Myoma and endometrial cancer 12 6 6 2

Chapter17 Ovarion tumor 10 6 4 2

Chapter18 Gestational trophoblastic disease 10 6 4 2

Chapter19 Gynecological endocrinism 9 5 4 2

Chapter20 Endometriosis and adenomyosis 7 3 4 2

Chapter21 Infertility 6 2 4 2

Chapter22 Family planning 6 2 4 2

Total 264 108 108 48

Chapter1 The Anatomy of the Female Reproductive System

1. Objective:

1) To master the anatomy of the female genital organs.

2) To master the composion of pelvis bone.

3) To know the relationship between genital organs and the neighbouring organs.

4) To understand the shape of pelvis, know the anatomical characteristic of

pelvis related to labour.

2. Content:

1) Emphatically explain the structure and shape of pelvis: The pelvis is made of

sacrum, coccyx and coxae. Three joints are contained, which is pubic symphysis,
sacro-iliac joint and sacro-coccygeal joint. Sacro-tuberous lig and sacro-spinous
lig are two ligs in pelvis.
2) Emphatically explain the genital organs: including vagina, uterus, oviducts and

ovaries. There are four ligs which are round lig, broad lig (ovarian lig and
infundibulopelvic lig), cardinal lig and uterosacral lig supporting the uterus. The
fallopian tube is divided into four parts: interstitial portion, isthmic portion,
ampulla and infundibulum.
 3) Emphatically explain four shapes of pelvis: gynecoid type, platypelloid type,

anthropoid type and android type. The anatomical characteristic of pelvis related
to labour.

4) Generally explain the neighbouring organs: urethra, urinary bladder, ureter

, rectum

and appendix .

3. Question:

1) The composion and types of pelvis.

2) The composion of internal genital organs.

4)

4. Practice

1) Anatomical model of female reproductive system including pelvis, external

genital organs, internal genital organs and neighbouring organs.

2) Viedo: demonstration of female reproductive system
 Chapter2 Physiology of Reproductive in Women

1. Objective:

1) To master the ovarian functions and its cyclic changes.

2) To know the physiological functions of sexual hormones and the cycles of

reproductive organs.
3) To know the control of menstrual cycle.

4) To understand the physiological characteristic in every stage of women.

2. Content:

1) There are four stages in women’ life according to physiological characteristic:

fetal period, neonatal period, childhood, adolescence, sexual maturity,

menopausal transition period and postmenopausal period. Explain the
physiological characteristics in each phase.
2) Elaborate the development, maturity and ovulation of follicles , the forming of

corpus luteum and the secreted sexual hormone including estrogen, progesterone
and androgen.

3) Emphatically explain cyclic changes in reproductive organs caused by sexual

hormone. Endometrium changes periodically in accordance with ovarian cycle, it

 is divided into four phases including proliferative phase, secretory/luteal phase
and menstrual phase.
4) Emphatically explain the control of menstrual cycle: hypothalam-pituitary-
ovarian axis.
3. Question:

1) The ovarian functions and its cyclic changes.

2) The methods of measuring the ovarian functions.

6)

4. Practice:

1) Samples: proliferitive endomitrum, secretory endomitrum, vaginal smear, basal

body temperature and so on.
2) Viedo:Dmonstration of the control of menstrual cycle.
 Chapter3 Physiology of Pregnancy

1. Objective:

1) To know the process of fertilization, development, transport and implantation of

fertilized ovum.
2) To know the formation and function of placenta.

3) To know the maternal changes during pregnancy

13) .

2. Content:

1) Emphatically explain the process of fertilization, development, transport and

implantation of fertilized ovum. Emphasize the four necessary factors as
follows:

I. The zonepellucida disappear.

II. The syncytiotrophoblastic cells appear.

III. Synchronic development of blastosphere and endometrium.

IV. Enough progesterone.

2) Emphatically explain the composition of placenta: amniotic membrane, chorion

frondosum and basal decidua.

3) Emphatically explain the

he function of placenta:

I. Gas exchange.

II. Transfer nutrient.

 III. Remove fetal catabolism.

IV. Defense function.

V. Synthesize function: HCG, HPL.

4) Emphatically explain the maternal changes during pregnancy

including changes

of reproductive tract, breasts, circulatory system, blood system, nurinary

system, respiratory system, digestive system, endocrine changes and so on.
6)

3. Question

1) The necessary conditions of fertilized ovum inbed.

inbed

2) The composition of placenta.

placenta

4)

4. Practice

1) Artifical model of pregnancy, one real placenta.

2) Viedo:

I. Demonstration of the process of fertilization, development, transport and

implantation of fertilized ovum.
II. Demonstration of maternal changes during pregnancy

XV. .

Chapter4 Pregnancy and Prenatal Care

 1. Objective:

1) To understand the diagnosis of early pregnancy, second trimester and late

pregnancy.
2) To master the definition and classification of fetal lie, fetal presentation and fetal
position.
3) To understand four maneuvers of Leopold.

2. Content:

1) The course of pregnancy is divided into three stages: early pregnancy(before the
end of 12 weeks), second trimester(from 13 to the end of 27 weeks) and late
pregnancy(from 28 to the end of 40 weeks). Explain the diagnosis of each
phase,especially early pregnancy.
2) Emphatically explain the definition and classification of fetal lie, fetal
presentation and fetal position.
3) Emphatically explain contents of the first prenatal care and repeated prenatal
visit including history, physical examimation, obstetric examimation, pelvimetry
, mornitoring for fetus and maturiy, fetal bio-physiological score and so on.

3. Question:

1) The definition and classification of fetal lie, fetal presentation and fetal position.

2) The diagnosis of early pregnancy.

8)

4. Practice:

1) Model of pregnancy, to understand four maneuvers of Leopold.

2) Model of pelvis, understand the methods of external and internal pelvimetry.

3) Viedo:Demonstration of the prenatal care.

 Chapter 5 Normal Labor

1. Objective:

1) To master four essential factors of labour.

2) To master the division of the course of normal labour.

3) To know the clinical signs and management of each stage.

4) To know the mechanism of normal labour in the vertex presentation.

2. Content:

1) The progress and final outome of labour are influenced by four factors①the
passage,②the powers,③the passenger, ④the psyche. Emphatically explain the
passage and the powers.The powers is the main factor. The passage includes
bony pelvis and pelvic soft tissues.
2) Elaborate the mechanism of normal labour in the vertex presentation.

3) Explain the definition and manifestation of threatened labour.

4) Elaborate the diagnosis and total stage of labour. Labour commonly is divided
into 3 stages:
I. The first stage begins with the onset of labour and ends when dilatation of
the cervix(10cm) is complete.
II. The second stage of labor extends from full dilatation of the cervix to the
birth of baby.
III. The third stage of labor is the period from the birth of the infant to delivery
of the placenta.
5) Explain the clinical course and management in each stage.

3. Question:

1) Four essential factors of labour.

2) The diagnosis of labour.

 3) The division of the total stage in labor

4. Practice

1) Model of the mechanism of normal labour in the vertex presentation.

2) Viedo:Demonstration of the course of labor.

Chapter 6 Abnormal labor(dystocia)

1. Objective:

1) To master the definition and classification of abnormal labor.

2) To know the clinical findings and diagnosis of abnormal powers, abnormal

passage and abnormal passenger.

3) To know the complications of abnormal labor and their preventive methods.

4) To understand the main problems and their management during abnormal labor.

2. Content:

1) Abnormalities of the powers:

①Emphasize the importance of abnormal powers during abnormal labor .

②Emphatically explain the categories, clinical findings and diagnosis of abnormal

powers.

③Emphatically explain the influence of abnormal powers to the maternal &

infants , as well as the precautions and therapeutic methods.

2) Abnormalities of the passage.
 ①Emphatically explain the clinical categories, diagnosis and influence to the

maternal & infants of abnormal bony birth canal. Pelvic contractions are

generally classified into inlet contraction, midpelvic-outlet contraction and

generally contraction.

②Elaborate the management of abnormal bony birth canal.The management of

abnormal bony birth canal should accord to categories and extent of pelvic
contractions, the fetus and the powers should be taken into consideration.

3) Abnormalities of the passenger: Emphatically explain the causes, diagnosis and

management of abnormal passenger.
3. Question:

1) The categories of breech presentation.

2) Concept of eight abnormal patterns of labor resulted from uterine inertia.

4. Practice

1) Model of the pelvis and fetus, manifesting each abnormal labor.

2) Viedo:Demonstration of abnormal labor.

Chapter 7 Hypertensive Disorder Complicating Pregnancy

1. Objective:

1) To master the basic pathophysiological changes of hypertensive disorder

complicating pregnancy.
2) To master the classified principles of hypertensive disorder complicating
pregnancy.
3) To master the guideline for treatment of hypertensive disorder complicating
 pregnancy.

4) To understand the risk factors and causes of hypertensive disorder complicating

pregnancy.
5) To understand the influence to mother and fetus of hypertensive disorder
complicating pregnancy.

6) To understand the screening test and precautions of hypertensive disorder

complicating pregnancy.
2. Content:

1) Generally explain the risk factors and causes of hypertensive disorder

complicating pregnancy.
2) Emphatically explain the basic pathophysiological changes: Generalized
vasoconstriction
3) .

3) Emphatically explain classified principles, clinical findings, diagnosis and

differential diagnosis of hypertensive disorder complicating pregnancy.
4) Generally explain the influence to mother and fetus of hypertensive disorder
complicating pregnancy.
5) Generally explain the screening test and precautions of hypertensive disorder
complicating pregnancy.

6) Emphatically explain the principle of managemant to hypertensive disorder

complicating pregnancy: Hospitalization, antispasm medication, sedatives,
antihypertensive drugs, expansive volume treatment, diuretics and proper
termination of pregnancy
7)
 3. Question:

1) The classified principles of hypertensive disorder complicating pregnancy.

2) The basic pathophysiological changes of hypertensive disorder complicating

pregnancy.
3) The management of preeclampsia.

4. Practice

1) Case discussion.

2) Viedo:Demonstration of the basic pathophysiological changes, classified

principles, the influence to mother and fetus, screening test , precautions and
managemant of hypertensive disorder complicating pregnancy.

Chapter 8 Pregnancy Complications

Section1. Spontaneous Abortion

1. Objective:

1) To master the clinical presentations and therapy of spontaneous abortion.

2) To understand the etiology and pathology of spontaneous abortion.

2. Content:

1) Emphatically explain the definitions of spontaneous abortion: abortion, early

abortion, late abortion.

 2) Emphatically explain the clinical presentations and diagnosis of spontaneous

abortion: threated abortion, inevital abortion, incomplete abortion, complete

abortion, missed abortion, septic abortion and habitual abortion.

3) Generally explain the etiology , pathological changes and therapeutic principles

of spontaneous abortion.
3. Question:

1) The clinical presentations of spontaneous abortion.

2) The principles of management for septic abortion.

4. Practice

1)Demonstration of pathological samples, case discussion.

2)Viedo:Clinical presentations, diagnosis and treatment of pontaneous abortion.

Section2. Ectopic Pregnancy

1. Objective:

1) To understand the definition and classification of ectopic pregnancy.

2) To know the clinical characteristics and axillary examinations of ectopic

pregnancy.
3) To

4) master the treatment of ectopic pregnancy.

 2. Content:

1) Generally explain the definition and classification of ectopic pregnancy.

2) Emphatically explain the the etiology , pathological changes and outcome of

ectopic pregnancy.
3)

4) Emphatically explain the clinical findings and axillary examinations of ectopic

pregnancy. The classic triad:amenorrhea, vaginal bleeding and abdominal pain.
5) Generally explain the differential diagnosis of ectopic pregnancy including
appendicitis, salpingitist, ruptured corpus luteum cyst, uterine abortion and
torsion of ovarion tumor.

6) Emphatically explain the guideline for treatment of ectopic pregnancy.

I. Expectant management.

II. Medical treatment.

III. Surgical treatment(by laparoscopy or laparotomy)

3. Question:

2) The main etiology of ectopic pregnancy.

3) The main symptoms of ectopic pregnancy.

4. Practice

1)Demonstration of pathological samples, case discussion.

2)Viedo:Clinical presentations, diagnosis and treatment of ectopic pregnancy.

Section 3. Placental Abruption

1. Objective:
 1) To understand the definition, etiology, pathogenesis and clinical findings of

placental abruption.
2) To know the main points of diagnosis and guideline for treatment.

3) To understand the influence to mother and fetus of placental abruption, as well

as the importance of early treatment.
2. Content:

1)

Generally explain the etiology of placental abruption.

2)Emphatically explain the pathalogy,

clinical findings and classifications of placental abruption.

3)

Generally explain the diagnosis, differential diagnosis, complications and

precautions of placental abruption
4) Emphatically explain the treatment of placental abruption.

3. Questions

1) The basic pathological changes of placental abruption.

2) The classification of placental abruption.

4. Practice:

1)Case discussion.
 2)Viedo:Demonstration of the etiology, classification, clinical findings, axillary
examinations and treatment of placental abruption.

Section 4. Placenta Previa

1. Objective:

1) To understand the definition, etiology, pathogenesis and clinical findings of

placenta previa.
2) To know the main points of diagnosis and guideline for treatment of placenta
previa.
3) To

4) understand the influence to mother and fetus of placenta previa, as well as

the importance of early treatment.

2. Content:

1) Generally explain the etiology of placenta previa.

2) Emphatically explain the clinical findings and classifications of placenta previa.

Based on the relationship of placenta to the cervix, the placenta previa is
classified into three types: complete placenta previa, partial placenta previa and
marginal placenta previa.
3) Generally explain the diagnosis, differential diagnosis, complications and
precautions of placenta previa.
4) Emphatically explain the treatment of placenta previa.

3. Question:

5) The atypical symptoms of placenta previa.

6) The classification of placenta previa.

4. Practice:

Viedo:Demonstration of the classification, clinical findings, axillary examinations

and treatment of placental abruption.

Chapter9 Complications of Labour

Section1. Postpartum Hemorrhage

1. Objective:

1) To master the definition, etiology, clinical findings and diagnosis of

postpartum hemorrhage.
2) To understand the precautions of postpartum hemorrhage.

3) To

4) master the treatment of postpartum hemorrhage.

2. Content:

1) Emphatically explain the definition of postpartum hemorrhage: ≥500ml blood

loss in first 24 hour after delivery.
2) Emphatically explain the main causes of postpartum hemorrhage:uterine atony,
obstetric laceration, retained placental tissue and coagulation defects.
3) Emphatically explain the clinical findings of postpartum hemorrhage caused by
different factors
4) Generally explain the significance of antenatal care and perinatal management.
 5) Elaborate the treatment of postpartum hemorrhage caused by different factors.
The principles as follows:
I. Hemostasis according to different causes.

II. Blood & fluid transfusion.

III.Prevent infection.

3. Question:

1) The main causes of postpartum hemorrhage.

2) The treatment of postpartum hemorrhage caused by uterine atony.

4. Practice:

1) Case discussions.

2) Viedo: Demonstration of the clinical findings and treatment of postpartum

hemorrhage caused by different factors.

Section2. Amniotic Fluid Embolism(AFE)

1. Objective:

1) To understand the definition, etiology, clinical findings and diagnosis of amniotic

fluid embolism.
2) To understand precautions and
treatment of amniotic fluid embolism.

2.Content:

1) Generally explain the definition, etiology, clinical findings and diagnosis of

amniotic fluid embolism.
2) Generally explain the precautions and guideline for
treatment of amniotic fluid

embolism.
 Chapter10 Medical Conditions Complicating Pregnancy

Section1. Heart Disease

1. Objective:

1) To understand the classification of heart disease complicating pregnancy.

2) To know the diagnosis of heart disease complicating pregnancy.

3) To know the treatment of heart disease complicating pregnancy.

2. Content:

1) Generally explain the classification of heart disease complicating pregnancy.

2) Generally explain the interaction between pregnancy and fetus.

3) Elaborate the diagnosis and differential diagnosis of heart disease complicating

pregnancy, as well as diagnosis of early heart failure.
4) Generally explain the complications of heart disease complicating pregnancy.

5) Emphatically explain the precautions and managemant of heart disease

complicating pregnancy.
6)

3. Question:

Point out three stages of heart failure usually occur in patient with heart disease
complicating pregnancy.

4. Practice:

Case discussion.
 Section2. Acute Hepatitis Virus

1. Objective:

1) To understand the interaction between pregnancy and acute hepatitis virus.

2) To know the diagnosis and differential diagnosis of acute hepatitis virus.

3) To know the precautions of acute hepatitis virus.

2. Content:

1) Generally explain the interaction between pregnancy and acute hepatitis virus.

2) Generally explain the differential diagnosis of acute hepatitis virus.

3) Emphatically explain the diagnosis and precautions of acute hepatitis virus.

4) Emphatically explain the influence to maternal and fetus of acute hepatitis virus.

Section3. Gestational Diabetes Mellitus

1. Objective:

1) To understand the interaction between pregnancy and diabetes mellitus.

2) To understand metabolic characteristic and pathogenesis of gestational diabetes

mellitus.
3) To know the diagmosis and treatment of gestational diabetes mellitus.

2. Content:

1) Elaborate the interaction between pregnancy and diabetes mellitus.

2) Elaborate metabolic characteristic and pathogenesis of gestational diabetes

mellitus.
3) Emphatically explain the screening and diagnostic criteria for gestational
diabetes mellitus.
 4) Generally explain managemant of gestational diabetes mellitus: medical
treament, indications for interminating pregnancy and choice for delivery
methods.

5)

3. Question:

1)The diagnostic criteria for gestational diabetes mellitus .

2)The proper timing of screening for gestational diabetes.

3)The proper time to interminate pregnancy.

4. Practice

Case discussion and analysis.

Chapter11 Normal Puerperium

Practice

1. Objective:

1) To know the definition of puerperium.

2) To know involution of the uterus.

3) To understand advantages of breast-feeding.

2. Content:

1) Explain the definition of puerperium.

2) Explain involution of the uterus: especially the height of fundus diminishs daily.
3) Explain advantages of breast-feeding.

4) Explain three lochia: lochia rubrua, lochia serusa and lochia alba.

3. Method:

Video and case record.

Chapter12 Gynecological History and Examination

1. Objective:

1) To master the characteristic of gynecological history-writing.

2) To know methods of history-taking from the woman.

3) To know the methods of pelvic examination.

2. Content:

1) Elaborate the methods of history-taking from the woman.

2) Emphatically explain the contents and order of gynecological history-writing.

3) Elaborate the methods of pelvic examination: bimanual examination,

rectovaginal examination and rectal examination.
4) Elaborate how to lay diagnosis and make a plan for preliminary treatment.

3. Homework:

The speciality and notice of pelvic examination.

4. Practice:

1) Video: Demonstration of history-taking from the woman and pelvic

examination.
2) Artifical human model.

3) Practising pelvic examination.

 4) Write a case record every one according to the given clinical findings.

Chapter 13 Infections of Vulva, Vagina and Cervix

1. Objective:

1) To understand clinical findings, diagnosis and treatment of non-specific

vulvitis, Bartholinitis, Bartholin cyst, senile vaginitis, and infantile vaginitis.
2) To master the etiology, transmitted approach, clinical findings, diagnosis,
differential diagnosis and treatment of trichomonal vaginitis, vulvovaginal
candidiasis(VVC) and bacterial vaginosis(BV).

3) To understand the etiology and common pathogen of acute cervicitis, master the
principles of treatment.
4) To master pathological changes, clinical findings and treatment of chronic
cervicitis.
2. Content:

1) Generally explain the origion of normal vaginal secretions and the normal
vaginal circumstances.
2) Generally explain clinical findings, diagnosis and treatment of non-specific
vulvitis, Bartholinitis, Bartholin cyst, senile vaginitis, and infantile vaginitis.
3) Emphatically explain the etiology, transmitted methods, clinical findings,
diagnosis, differential diagnosis and treatment of trichomonal vaginitis,
vulvovaginal candidiasis and bacterial vaginosis.

4) Emphatically explain pathological changes of chronic cervicitis: cervical

erosion, cervical hypertrophy, cervical polyp, Nabothian cyst and
endocervicitis.

5) Emphatically explain clinical findings of chronic cervicitis.

 6) Emphatically explain guideline for treatment of chronic cervicitis.

3. Homework:

1) The pathological changes of chronic cervicitis.

2) The atypical leucorrhoea of trichomonal vaginitis, VVC and BV.

4. Practice:

1) Microscopic examination of trichomonal vaginitis, VVC and BV.

2) Viedo:Demonstration of treatment of chronic cervicitis: conization and so on.

Chapter 14 Pelvic Inflammatory Diease

1. Objective:

1) To understand the natural preventive mechanism of female reproductive system.

2) To master the etiology, pathological changes and clinical findings of acute pelvic
inflammatory diease. To know the guideline for therapy and importance of
proper precaution.

3) To know pathological changes, clinical findings and guideline for treatment of

chronic pelvic inflammatory diease
4) To know ransmitted methods, clinical findings, diagnosis and guideline for
treatment of tuberculous peritonitis.
5) To know clinical findings, diagnosis and guideline for treatment of gonorrhea.

2. Content:

1) Generally explain the natural preventive mechanism of female reproductive

system, common pathogens and transmitted methods for inflammatory diseases of
female reproductive system.
 2) Emphatically explain the etiology, pathological changes, clinical findings,
diagnosis, differential diagnosis, precautions and treatment of acute pelvic
inflammatory diease. All three should be present in acute pelvic inflammatory
diease:
I. History of lower abdominal pain and the presence of lower abdominal
tenderness; with or without evidence of rebounding pain.
II. Cervical motion tenderness.

III. Adnexal tenderness.

3) Emphatically explain the pathological changes, clinical findings, diagnosis,

differential diagnosis, precaution and treatment of chronic pelvic inflammatory
diease.

4) Emphatically explain the transmitted methods, pathological changes, clinical

findings, diagnosis, differential diagnosis, precaution and treatment of pelvic
tuberculosis.

5) Emphatically explain the transmitted methods, clinical findings, diagnosis,

precaution and treatment of gonorrhea.
3. Homework:

1) How to prevent inflammatory diseases of female reproductive system.

2) The pathological changes of acute pelvic inflammatory diease.

4. Practice:

1)Case discussion.

2)Viedo:Demonstration of pelvic inflammatory diease and sexual transmitted

disease.
 Chapter 15 Cervical Tumor

1. Objective:

1) To understand the etiology, histological speciality, pathological diagnosis and

grade of cervical intraepithelial neoplasia(CIN).
2) To master definitions: transformation zone, squamous metaplasia, squamous
epithelization.
3) To know pathological changes and methods of spread for cervical cancer.

4) To master early diagnosis and clinical staging of cervical cancer.

5) To master guideline for treatment of cervical cancer.

2. Content:

1) Generally explain the etiology, histological speciality, pathological diagnosis and

grade of cervical intraepithelial neoplasia.
2) Emphatically explain some definitions: transformation zone, squamous
metaplasia, squamous epithelization.
3) Emphatically explain the clinical findings, diagnosis and treatment of cervical
intraepithelial neoplasia.
4) Generally explain epidemiology of cervical cancer home and abroad.

5) Emphatically explain the pathological changes of atypical displasia, carcinoma in

situ, microinvasive carcinoma and invasive carcinoma.
6) Emphatically explain the methods of spread for cervical cancer.

7) Emphatically explain staging, clinical findings and diagnosis of cervical cancer.

8) Generally explain the significance of screening for cervical cancer.

9) Emphatically explain the guideline for treatment of cervical cancer.

10) Generally explain diagnosis and guideline for treatment of cervical cancer
complicating pregnancy.
 3. Homework:

1) The early diagnosis and precautions of cervical cancer.

2) Definitions: ASC, LSIL, HSIL

4. Practice:

1)Demonstration of Pap’smear, Thin-layer Cytology Test(TCT)

2)Viedo:Demonstrate management of cervical cancer.

Chapter 16 Myoma and Endometrial Cancer

Section1. Leiomyomas of Uterous

1. Objective:

1) To understand the relationship between hormone and development of myoma.

2) To master the classification and secondary changes of myoma.

3) To master clinical findings, diagnosis and guideline for treatment of myoma.

2. Content:

1) Emphatically explain classification(intramural myoma, subserous myoma and

submucous myoma) and secondary changes of myoma(hyaline degeneration,
cystic degeneration, red degeneration, calcification and sarcomatous changes).

2) Elaborate clinical findings and diagnosis of myoma.

3) Elaborate the guideline for surgical treatment and non- surgical treatment of
myoma.
 4) Generally explain relationship between pregnancy and myma, differential
diagnosis and guideline for treatment of myoma complicating pregnancy.
3. Homework:

1) The pathological changes and classification of myoma.

2) The relationship between clinical findings and the type of myoma.

4. Practice

1)Case discussion.

2)Viedo and samples: myoma.

Section 2. Endometrial Cancer

1. Objective:

1) To master clinical characteristic, diagnosis and guideline for treatment of

endometrial cancer.
2) To know the epidemiology and pathogenic factors relating to endometrial
cancer.
3) To know clinical staging of endometrial cancer.

2. Content:

1) Emphatically explain epidemiology and pathogenic factors relating to

endometrial cancer. The classic triad:obesity, hypertension and diabetes.
2) Emphatically explain relationship between endometrial hyperplasia and
endometrial cancer, the clinical staging of endometrial cancer.
3) Emphatically explain the clinical findings of endometrial cancer:

I. Abnormal uterine bleeding is the main symptom.

II. Abnormal vaginal discharge(90%) and profuse leukorrhea(10%).

 III. Lower abnormal cramps and pain.

4) Emphatically explain the diagnosis of endometrial cancer, especially the

importance of fractional curettage. Elaborate the notice of fractional curettage.
5) Generally explain irradiation and large dose of progestins.

3. Homework:

1)The early diagnosis of endometrial cancer.

2) The relationship between endometrial hyperplasia and endometrial cancer

4. Practice:

1)Case discussion.

2)Viedo and samples: endometrial hyperplasia and endometrial cancer.

Chapter 17 Ovarion Tumor

1. Objective:

1) To understand the histopathologic categories of ovarion tumor, the pathological

and clinical characteristics of common ovarion tumor.
2) To master differential diagnosis of benign ovarion tumor and malignant ovarion
tumor.
3) To master the common complications of ovarion tumor, as well as its diagnosis
and guideline for treatment. Early diagnosis and surgery is critical to prevent
malignant ovarion tumor.

4) To know the diagnosis and guideline for treatment of ovarion tumor

 complicating pregnancy.

2.Content:

1) Generally explain general consideration of ovarion tumor.

2) Generally explain the histopathologic categories of ovarion tumor

3) Emphatically explain the clinical staging and auxiliary examinations of

malignant ovarion tumor.
4) Emphatically explain the complications of ovarion tumor: torsion, rupture,
infection and malignant changes.
5) Generally explain the differential diagnosis of benign ovarion tumor and
malignant ovarion tumor.
6) Emphatically explain treatment of ovarion tumor :surgical traetment for benign
ovarion tumor; surgical treatment combined chemotherapy and radiation for
malignant ovarion tumor.

3. Homework:

1) Differentiation between benign ovarion tumor and malignant ovarion tumor.

2) The complications of ovarion tumor, as well as their management.

4. Practice

1)Case discussion.

2)Viedo and pathological samples, clinical demonstration.

Chapter 18 Gestational Trophoblastic Disease

1. Objective:
 1) To master the definition, pathology, clinical findings, diagnosis and

treatment of hydatidiform mole and invasive mole.

2) To master the pathology, clinical findings, diagnosis, differential diagnosis and

treatment of choriocarcinoma.
2.Content:

1) Generally explain the epidemiology, categories and etiology of hydatidiform

mole.
2) Emphatically explain the pathology, clinical findings, diagnosis, differential
diagnosis, treatment and follow-up of hydatidiform mole, as well as indications
for prophylactic chemotherapy.

3) Emphatically explain pathological characteristic, clinical findings, diagnosis,

treatment and prognosis of invasive mole and choriocarcinoma.
3. Question:

1) The follow-up time and contents of hydatidiform mole.

2) The Differentiation between invasive mole and choriocarcinoma.

4. Practice:

1)Case discussion.

2) Pathological samples: Invasive mole and choriocarcinoma.

3) Film of sonography: Invasive mole and choriocarcinoma.

Chapter 19 Gynecological Endocrinism

1. Objective:

1) To master the definition, categories, etiology and diagnosis of dysfunctional

uterine bleeding.
2) To master the guideline for treatment of dysfunctional uterine bleeding

3) To understand the definition, categories, etiology, diagnosis and treatment of

amenorrhea.
4) To understand endocrinic characteristic and pathophysiological changes of
polycystic ovarian syndrome.
5) To master the clinical findings, auxiliary examination and treatment of
polycystic ovarian syndrome.
6) To know hormone replacement therapy(HRT) of perimenopause.

2.Content:

1) Emphatically explain the definition and categories of dysfunctional uterine

bleeding.
2) Emphatically explain pathological changes and clinical findings of different
type of dysfunctional uterine bleeding.
3) Generally explain the common auxiliary methods of diagnosis including basal
body temperature, cervical mucus, vaginal smear, pathology of endometrium,
levels of female hormones test and so on.

4) Generally explain the differential diagnosis of dysfunctional uterine bleeding

from abnormal pregnancy, infections of reproductive tract, genital tumors,
hematopathy and so on.

5) Emphatically explain the guideline for treatment of dysfunctional uterine

bleeding.
6) Generally explain the etiology and pathogenesis of amenorrhea.
 7) Emphatically explain the diagnosis and auxiliary methods of diagnosis
including evaluation of uterine status, evaluation of ovarian function, evaluation
of pituitary and hypothalamic function.

8) Emphatically explain how to set therapeutic plan according to different type of

amenorrhea.
9) Elaborate hormone replacement therapy: the complication, contraindication,
adverse effects and so on.
3. Homework:

1)The definition and categories of dysfunctional uterine bleeding.

2)What’s differences between adolescent and premenopausal women with

dysfunctional uterine bleeding in treatment.
3) The contraindication of hormone replacement therapy, as well as the timing of
beginning.

4. Practice:

1)Case discussion.

2)Viedo and pathological samples, clinical demonstration.

Chapter 20 Endometriosis and Adenomyosis

1. Objective:

1) To understand the etiology and pathology of endometriosis.

2) To know the clinical characteristic and diagnosis of endometriosis.

3) To know the guideline for treatment of endometriosis.

4) To understand the etiology, pathology, clinical characteristic, diagnosis and

 guideline for treatment of adenomyosis.

2.Content:

1) Generally explain the definition of endometriosis, as well as the hypothesis

related to etiology.
2) Elaborate pathology, clinical findings(dysmenorrhea, menstrual disorder,
infertility and dyspareunia) and diagnosis(laporoscopy is the“gold standord”)of
endometriosis.

3) Emphatically explain the conservative treatment and surgerical treatment of

endometriosis.
I. Observation: appropriate for those patients with mild or no discomfort, with
minimal or mild endometriosis.
II. Analgesic therapy: including nonsteroidal anti-inflammatory agents and
prostaglandin synthetase inhibiting drugs.
III. Pseudopregnancy: give progestin daily or continuous oral contraceptive
bills.
IV. Pesudomenopause: danazal, GnRH agonists and so on.

V. Surgical treatment: including excision or destruction of endometriotic tissue,

removal adhesion, restoration of pelvic anatomy, total hysterectomy,
bilateral salping-oopherectmy and excision of remaining adhesion or
implants.
4) Generally explain the etiology, pathology, clinical characteristic, diagnosis and
guideline for treatment of adenomyosis.
3. Homework:

The categories of medical therapy for endometriosis, as well as the principles.

4. Practice:

1)Case discussion.
 2)Viedo:diagnostic laparoscopy for endometriosis.

Chapter 21 Infertility

1. Objective:

1) To understand the causes relating to infertility.

2) To know the diagnositic procedures and the guideline for treatment of infertility.

2.Content:

1) Generally explain the definition of infertility, as well as the female factors and
male factors related to infertility.
2) Emphatically explain the examinations and diagnositic procedures of infertility.

I. Examination of the male: semen analysis and other factors.

II. Examination of the female:

a. Take a full history.

b. Perform a full physical examination.

c. Basal body temperature.

d. Cervical mucus examination.

e. Tubal patency test including hysterosalpingogram, hydrotubation under

real-time ultrasonography and rubin test.
f. Post coital test.

g. Endometrial biopsy.

h. Evaluation of hormone profile.

i. Laparoscopy.
 3) Elaborate the treatment of infertility, especially assisted reproductive
techniques(ART).
3. Homework:

The development and indications of assisted reproductive techniques(ART).

4. Practice

1)Case discussion.

2)Viedo:diagnostic laparoscopy for infertility.

Chapter 22 Family Planning

1. Objective:

1) To understand the significance of family planning.

2) To master the mechanism and clinical application of each contraceptive method.

3) To know the indication and contraindication for sterilization, as well as

precautions for complication.
4) To know emergency contraception.

5) To know indication and contraindication for surgical abortion, as well as

precautions for complication.
2.Content:

1) Generally explain the significance of family planning and executive principles.

2) Emphatically explain categories of contraceptive devices. Emphatically explain

mechanism, indication, contraindication and adverse effects of intrauterine
devices(IUD), as well as precautions and management for complication.
 3) Emphatically explain mechanism and categories of contraceptives, as well as
their clinical usage and safety.
4) Generally explain methods and development of female sterilization.

5) Emphatically explain indication and contraindication for surgical abortion, as

well as precautions for complication
3. Homework:

1) Mechanism of intrauterine devices.

2) Mechanism of steriod contraceptives.

3) The proper method for new couples.

4. Practice:

1) Samples of contraceptive tools.

2) Viedo relating to fammily planning.