Time: 2.5 Hours; Marks: 50

1. Human Reproductive System

  • Female reproductive organs – structure and function.
  • Menstrual cycle.
  • Male reproductive organs structure and function.
  • Process of conception.

2. Female Pelvis and Foetal Skull

  • Structure of the pelvic bones-types of pelvis.
  • Pelvic diameters.
  • Muscles and ligaments of pelvic floor.
  • Foetal skull: bones, diameters, sutures, size, shape, moulding, skull areas, fontanelles.

3. Foetus and Placenta

  • Growth and development of foctus, foetal sac and amniotic fluid and foetal circulation and changes after birth.
  • Structure and functions of Placenta, membranes and umbilical cord and abnormalities.
  • Refer SBA module of Ministry of health and Family Welfare.

4. Normal Pregnancy

  • Signs and symptoms of pregnancy.
  • Various diagnostic test for confirmation of pregnancy.
  • Physiological changes during pregnancy.
  • Minot ailments during pregnancy and their management.
  • Refer SBA module of Ministry of health and Family Welfare.

5. Antenatal Care

  • Registration.
  • Taking history of a pregnant woman.
  • Physical examination, Investigation- routine and specific.
  • Prophylactic medications.
  • Needs based health information and guidance.
  • Nutrition in pregnancy.
  • Special needs of a pregnant woman.
  • Involvement of husband and family.
  • Identification of high risks cases and referral.
  • Preparation of mother for delivery.
  • Refer SBA module of Ministry of health and Family Welfare.

6. Normal Labour

  • Onset and stages of labour, physiological changes.
  • Changes in Uterine muscles, and cervix.
  • Lie, attitude, position, denominator and presentation of foetus.
  • Foetal skull.
  • Mechanisms of labour.
  • Identification of high risk cases.
  • Foetal distress and maternal distress during labour.
  • Pantograph in the management of the normal labour.
  • Role of ANM/Female health worker and referral.
  • Refer SBA module of Ministry of health and Family Welfare.

7. Care during Normal Labour

  • History of labour.
  • Importance of five ‘C’s.
  • Monitoring progress of labour with partograph preparation of delivery.
  • Care of mother in first and second stage of labour.
  • Assist and conduct childbirth.
  • Immediate care of new-born-resuscitation, apgar score, cord care.
  • Oxytocin Misoprostol drugs: Dose, route, indication, contraindication, action, side effects, precautions, role and responsibilities of ANM/FHW.
  • Delivery of placenta and examination of placenta.
  • Care of mother in third and fourth stage: Recognise degrees of tear and appropriate care and referral.
  • Establishment of breast feeding exclusive breastfeeding.
  • Kangaroo mother care.
  • Baby friendly hospital imitative.
  • Record childbirth and ensure birth registration.
  • Refer SBA module of Ministry of health and Family Welfare Care of mother-diet, rest, exercise, hygiene.
  • Management of breast feeding.
  • Prophylactic medicines.
  • Special needs of postnatal women.
  • Need based health education.
  • Refer SBA module of Ministry of health and Family Welfare.

8. Care of New Born

  • Assessment of new-born for gestation age, risk status and abnormalities.
  • Neonatal resuscitation.
  • Monitoring of vital signs and birth weight.
  • Management of normal new-born and common minor disorders.
  • Exclusive Breast feeding and management.
  • Temperature maintenance, kangaroo mother care.
  • Immunization.
  • Care of newborn: Jaundice, infection, respiratory problems.
  • Principles of prevention of infection.
  • Educating mother to look after babies.
  • Integrate accepted practices of AYUSH.
  • Refer SBA module of Ministry of health and Family Welfare.

9. High Risk New Born

  • Pre term/Low Birth Weight babies.
  • Special needs of high risk babies.
  • Care at home- referral and follow up.
  • Care during asphyxia.
  • Convulsion, vomiting.
  • Care for thrush, cord sepsis, diarrhoea.
  • Implementation IMNCI protocol.
  • Refer SBA module of Ministry of health and Family Welfare.

10. Safe Motherhood

  • Concept and cause of maternal mortality and morbidity.
  • Safe motherhood components: RCH and NRHM.
  • Preventive measures.
  • Role of ANM/Female Health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

11. High Risk Pregnancies

  • High risk pregnancies: Identification, Risk factors, decision making and management.
  • Protocols and standing orders.
  • Referral and follow up.
  • Counselling and guidance about high risk conditions Involvement of husband and family.
  • Role of ANM/Female Health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

12. Abnormalities of Pregnancy

  • Common abnormalities of pregnancy: hyper emesis gravid arum, leaking and bleeding per vagina.
  • Anaemia of pregnant woman.
  • Eclampsia and pre eclampsia and toxaemia of pregnancy.
  • Indication of premature rupture of membrances, prolonged labour, anything requiring manual intervention, UTI, puerperal sepsis.
  • Obstetrical shocks.
  • Uterine abnormalities, ectopic pregnancy.
  • Diseases complication pregnancy – TB, diabetes.

13. Hypertension

  • Infections during pregnancy – RTI/STIs malaria, HIV, AIDS.
  • Rh factor.
  • Standing orders and protocols.
  • Role of ANM/Female Health worker.
  • Role of ANM/Female Health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

14. Abortion

  • Types of abortion, causes of abortion.
  • Need for safe abortion – referral.
  • Complications of abortions.
  • Medical termination pregnancy.
  • Care of woman who had abortion.
  • Role of ANM/Health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

15. Abnormal Childbirth

  • Common abnormalities of childbirth.
  • Abnormal presentations.
  • Abnormal uterine actions.
  • Cephalo pelvic disproportion.
  • Prolonged labour.
  • Identification, immediate management and referral.
  • Emergency care of mother during transfer to hospital.
  • Role of ANM/Female health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

16. Abnormal Puerperium

  • Postpartum haemorrhage and its management.
  • Puerperal sepsis and its management.
  • Retention of urine.
  • Breast complications during lactation and their management.
  • Refer SBA module of Ministry of health and Family Welfare.
  • Psychiatric complications.
  • Refer SBA module of Ministry of health and Family Welfare.

17. Surgical Intervention

  • Assisting in the followings:
    • Induction of labour and its management.
    • Forceps and Vacuum extraction.
    • Episiotomy and suturing.
    • Craniotomy.
    • Caesarean section.
    • Pre and post operative care.
    • Role of ANM/Female health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

18. Medications used in Midwifery

  • Pain relieving drugs.
  • Anaesthetic drugs.
  • For uterine contractions.
  • For controlling bleeding.
  • For preventing postnatal infection.
  • For preventing eclampsia.
  • Antibiotics.
  • IV fluids.
  • Role of ANM/Female health worker.
  • Refer SBA module of Ministry of health and Family Welfare.

19. Life Cycle Approach

  • Quality of life and life expectancy.
  • People’s health throughout the life cycle.
  • Role of education economic status, social status on quality of life.
  • Holistic approach to life.
  • Refer SBA module of Ministry of health and Family Welfare.

20. Status of Women and Empowerment

  • Status of women in society.
  • Factors affecting status – gender bias, sex selection tests, female foeticide and infanticide sex ratio discrimination and exploitation.
  • Effect of tradition, culture and literacy.
  • Relationship between status of women and women’s health.
  • Effects of women’s health in community: single, divorced deserted woman, widows special needs.
  • Laws related to women. Programmes for women’s empowerment.
  • Refer SBA module of Ministry of health and Family Welfare.

21. Women’s Health Problems

  • Complications related to childbirth – VVF, RVF, prolapse and incontinence.
  • Cervical erosion and leucorrhoea pruritus.
  • Cancers – cervical and breast.
  • Pap smear for detection of cancer cervix.
  • Tumours – fibroids.
  • Menstrual disorders.
  • Menopause and its implications.
  • Refer SBA module of Ministry of health and Family Welfare.

22. RTIs and STIs

  • Causes and signs and symptoms of STIs and RTIs.
  • Syndromic approach for treatment .
  • Referral treatment and follow up care.
  • Information, education and communication for prevention and treatment.

23. HIV/AIDS

  • Epidemiological facts related to spread of infection.
  • Methods of transmission.
  • Effect on immunity and signs and symptoms.
  • The AIDS patient community support and home care.
  • Counselling: process and techniques.
  • Counselling of HIV/positive patients and pregnant women.
  • Standard safety measures.
  • Voluntary counselling and testing center (VCTC)/ Integrated counselling and testing center (ICTC) activities.
  • Care continuum and Anti Retro viral Therapy (ART).
  • Prevention of parent to child transmission (PPTCT): prophylaxis and breast feeding guidelines.

24. Infertility

  • Classification and Causes of infertility in male and female.
  • Investigation and treatment.
  • Identification of couples, counselling, referral and follow up.
  • Role of ANM/Female health worker.

25. Population Education

  • Population trends in India.
  • Vital statistics birth and death rates, growth rate, NRR, fertility rate, couple protection rate, family size.
  • National family Programme trends and changes RCH-I, RCH-II programme and NRHM.
  • Target free approach for FW.
  • Role of mass media and IEC.
  • Role of ANM/health worker.

26. Family Welfare

  • Identification of eligible couples and those need contraceptive methods.
  • Information related to contraception and importance of choice.
  • Natural and temporary methods of contraception.
  • Permanent methods.
  • New methods nor-plant and injectables.
  • Emergency contraception.
  • Follow up of contraceptive users.
  • Counselling.
  • Role of ANM/female Health worker.