Skip to main content

Knowledge Area 5 – Antenatal care

Capability in practice (CiP)

  • 1: The doctor is able to apply medical knowledge, clinical skills and professional values for the provision of high-quality and safe patient-centred care
  • 6: The doctor takes an active role in helping self and others to develop
  • 12: The doctor is competent in recognising, assessing non-emergency obstetrics care

 

Summary Knowledge Requirements

PART 1 MRCOG

  • Maternal anatomical, endocrine and physiological adaptations occurring in pregnancy
  • Pathology of major organ systems, including the common haemoglobinopathies and connective tissue disorders as applied to pregnancy
  • Screening tests commonly performed in pregnancy
  • Fetal anatomy, including abnormalities, embryology, endocrine function and physiology
  • Normal fetal physiology and development, together with the aetiology of fetal malformations and acquired problems, including abnormalities of growth; this will include regulation of amniotic fluid volume and fetal interaction with the amniotic fluid
  • Development and function of the placenta in pregnancy, with specific knowledge of how the placenta handles drugs
  • Principles of inheritance and features and effects of common inherited disorders
  • Basic ultrasound findings in pregnancy
  • How to define and interpret data on maternal, neonatal and perinatal mortality
  • Impact of maternal health and other variables, e.g. social deprivation, on pregnancy outcome

PART 2 MRCOG

  • Have a high level of understanding of normal antenatal processes and progress
  • Be able to recognise and manage problems from preconceptual care through to delivery
  • Be fully conversant with the principles of prenatal diagnosis and screening
  • Understand the ways in which problems may affect the fetus, and be able to interpret and act upon any appropriate investigations
  • Have good knowledge of the use of ultrasound in the investigation and treatment of disorders of the fetus

PART 3 MRCOG

  • Have a high level of understanding of normal antenatal processes and progress
  • Be able to recognise and manage problems from preconceptual care through to delivery
  • Be able to deal with the diversity of maternal choices in antenatal and intrapartum care
  • Demonstrate skill in listening and in conveying complex information (e.g. concerning risk)
  • Show understanding of the roles of other professionals, and demonstrate skills in liaison and empathic teamwork
  • Be fully conversant with the principles of prenatal diagnosis and screening
  • Understand the ways in which problems may affect the fetus, and be able to interpret and act upon any appropriate investigations

 

Detailed Knowledge Requirements

  • Recognition of signs of domestic violence
  • Problems of teenage pregnancy
  • Awareness of drug and alcohol misuse
  • Management of normal pregnancy, birth and puerperium
  • Placental abnormalities and diseases
  • Genetic modes of inheritance, common genetic conditions the importance of screening and the diagnosis thereof.
  • Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications of: Pregnancy-induced hypertension, haemorrhage, preterm premature rupture of membranes, multiple pregnancy, malpresentation, fetal growth restriction, fetal haemolysis, prolonged pregnancy, congenital malformation
  • Social and cultural factors:
  • Immunology and immunological disorders affecting pregnancy
  • Preconception care: Sources of detailed information accessed by patients, effect of pregnancy upon disease, effect of disease upon pregnancy, principles of inheritance of disease, teratogenesis, drugs and pregnancy
  • Purposes and practice of antenatal care: Arrangements for and conduct of booking visit, arrangements for and conduct of follow-up visits, use of imaging techniques, screening for abnormality, health education, liaison between health professionals, recognition of domestic violence
  • Immunology: Immunological pregnancy tests, Rhesus and other isoimmunisation, Auto-immune diseases
  • Preterm premature rupture of membranes: Fetal pulmonary maturity, Therapy (steroids, antibiotics, tocolytics), Infection (risks, management), Delivery (induction of labour, timing, mode)
  • Haemorrhage: Placental abruption, placenta praevia, vasa praevia, placenta accreta
  • Physiology and management of normal: Pregnancy, childbirth, including delivery outside specialist unit, puerperium, including lactation, neonate, including feeding
  • Placental: Abnormalities (shape, size, implantation), chorioamnionitis, Infarction, chorioangioma, multiple pregnancy, intrauterine growth restriction, cord abnormalities, trophoblastic disease, trauma
  • Multiple pregnancy: Zygosity, Impact of assisted reproduction techniques, Placentation, Diagnosis, Management (antenatal, intrapartum, postnatal), Special procedures (prenatal diagnosis, monitoring), Feeding, Higher order multiple pregnancies (counselling, community care)
  • Malpresentation: Types (breech, brow, face, shoulder, variable lie), Diagnosis, Management (antenatal, intrapartum), Mode of delivery
  • Fetal growth restriction: Aetiology (maternal, placental, fetal), Diagnosis (clinical, imaging, biochemical, genetic), Monitoring (ultrasound, cardiotocography), Delivery (timing, method), Prognosis (fetal, neonatal)
  • Hypotensive disorders: Hypovolaemia, Sepsis, Neurogenic shock, Cardiogenic shock, Anaphylaxis, Trauma, Amniotic fluid embolism, Thromboembolism, Uterine inversion
  • Genetic: Modes of inheritance (Mendelian, multifactorial), Cytogenetics, Phenotypes of common aneuploidies (Down syndrome, Edward syndrome, Patau syndrome, Turner syndrome, Klinefelter syndrome, triple X, multiple Y), Translocation, Miscarriage, Molecular genetics (DNA transcription, DNA translation, DNA blotting techniques, gene amplification techniques, principles of gene tracking), Counselling (history taking, pedigree analysis), Population screening (genetic disease, congenital malformations), Antenatal diagnosis (chromosomal defects, inborn errors of metabolism, neural tube defects, other major structural abnormalities), Management [referral to specialist team, antenatal intervention, delivery, neonatal investigation, neonatal care (medical, surgical)]
  • Pregnancy induced hypertension: Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications, prognosis, Definitions, Aetiological theories, Prophylaxis, Assessment of severity, Consultation, Therapy, Delivery (timing, method), Complications (eclampsia, renal, haemorrhagic, hepatic, fetal)
  • Fetal haemolysis: Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications, prognosis, Relevant antigen-antibody systems, Prevention, Fetal pathology, Diagnosis, Assessment of severity, Intrauterine transfusion (indications, techniques, referral), Delivery (timing, method), Counselling
  • Prolonged pregnancy: Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications, prognosis, Risks, Fetal monitoring, Delivery (indications, methods)
  • Congenital malformation: Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications, prognosis, Screening, Amniotic fluid volume (polyhydramnios, oligohydramnios), Management: diagnosis, consultation, viability, delivery (time, place, method), counselling,
  • Specific abnormalities: Head (anencephaly, microcephaly, encephalocele, hydrocephalus, hydranencephaly, holoprosencephaly), Skeleton (spina bifida, phocomelia, chondrodysplasia, intrauterine amputation), Heart (major defects, other defects), Lungs (pulmonary hypoplasia), Urinary (renal agenesis, polycystic kidneys, urinary tract obstruction), Genital (intersex, genital tract abnormalities, ovarian cyst), Gastro-intestinal (abdominal wall defects, oesophageal atresia, duodenal atresia, diaphragmatic hernia, bowel obstruction), Other fetal disorders (cystic hygroma, Non-haemolytic hydrops fetalis, Tumours, Pleural effusion, Fetal bleeding)
  • Social and cultural factors: Epidemiology, aetiology, pathogenesis, diagnosis, prevention, management, delivery, complications, prognosis of Single parenthood, Teenage motherhood, Parent-baby relationships (factors promoting, factors interfering), Bereavement counselling, Counsel women appropriately about defibulation
  • Invasive procedures: Amniocentesis, Chorionic villus sampling, Placentesis, Cordocentesis