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STATE EXAMINATION PROCEDURE

List of academic disciplines included in the state examination:

1. «Obstetrics and Gynecology»

State examination form and procedure

The state exam is conducted in three stages: testing (50 questions for 30 minutes,

passing score – 5.00), practical skills and an oral interview.

The last stage is conducted in the form of an oral interview on tickets according

to the approved schedule of the State Examination Commission. The student draws the

ticket, prepares for at least 20 minutes, then answers the members of the State

Examination Commission.

STRUCTURE OF THE EXAMINATION CARD

The examination card for the oral interview includes four theoretical questions.

The first question includes questions of the physiological course of pregnancy,

labor and the postpartum period, pregnancy planning, perinatology, research methods

in obstetrics; the second – questions of the pathological course of pregnancy, labor and

the postpartum period; the fourth and fifth – questions of etiology, pathogenesis,

classification, clinical manifestations, diagnosis, differential diagnosis, treatment and

prevention of gynecological diseases in patients of different age groups.

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List of academic disciplines included in the state examination

1 . Anatomical and physiological peculiarities of the female reproductive system

2. Perinatology

3. Physiological Obstetrics

4. Physiological labor

5. Extragenital and gynecological pathology accompanying pregnancy

5.1. Diseases of the cardiovascular system

5.2. Endocrine pathology

5.3. Diseases of the urinary system

5.4. Blood diseases

5.5. Liver diseases

6.6. Acute surgical pathology

5.7. Gynecological pathology

5.8. Infectious diseases

6. Pathology of pregnancy and labor

6.1. Pregnancy and labor in breech birth

6.2. Wrong fetus positions and presentations

6.3. Multiple pregnancy

6.4. Incomplete and prolonged pregnancy

6.5. Hemorrhages in obstetrics

6.6. Gestosis

6.7. Anomalies of labor activity

6.8. Contracted (narrow) pelvis

6.9. Birth injury

7. Operative methods of delivery

8. Postpartum period 8.1. Physiology of the postpartum period

8.2. Postpartum period pathology

9. Gynecology

9.1. Main symptoms of gynecological diseases

9.2. Methods of the examination of gynecologic patients

9.3. Malposition of female genitals

9.4. Menstrual function and its disorders

9.5. Neuroendocrine syndromes in gynecology

9.6. Inflammatory diseases of the female genitals

9.7. Background, pre-cancer and benign diseases of the female reproductive system

organs

9.8. Gynecological diseases requiring an urgent medical aid

9.9. Operative gynecology

10. Infantile gynecology

11. Infertile marriage and family planning issues

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CONTENT OF THE STATE EXAMINATION PROGRAM

1. Anatomical and physiological peculiarities of the female reproductive

system

Peculiarities of the development and structure of female genitals at different

age periods. External and internal genitals. Mammary glands. Physiology of the

female reproductive system.

2. Perinatology The objective and tasks of perinatology. Perinatal mortality and the ways of its

decrease. Methods used to diagnose the condition of the fetus. Critical periods in the

embryo and fetus development. Effect of toxic substances and medicines on the

embryo and fetus development. Fetus congenital developmental anomalies: causes

and methods of correction. Placental insufficiency: etiology, pathogenesis, diagnosis,

treatment, prevention. Acute and chronic fetal hypoxia: etiology, pathogenesis,

diagnosis, treatment, prevention.

3. Physiological Obstetrics Planning the pregnancy. Fertilization, early embryogenesis, implantation of the

blastocyst. development and functions of the placenta, diagnostic methods. The

amniotic fluid: functions, composition, methods of investigation and their clinical and

diagnostic value. The structure and functions of the umbilical cord. A fetus as an

object of the labor. Physiological adaptive features of the female organism during

pregnancy. Diagnosis of the early and late terms of pregnancy. Pregnant women

examination: questioning and objective examination, determining the term of

pregnancy and the date of the labor

Female pelvis in terms of obstetrics. Pelvic floor, its structure and functions.

Physiological pregnancy: its course and management. Fundamentals of the

balanced diet of pregnant women, regimen and personal hygiene of pregnant women.

Principles of preparation of pregnant women to the labor. The evaluation of readiness

of the pregnant woman’s organism to the labor.

4. Physiological labor

Causes of the labor approach. Stage of expulsion. Labor precursors. The

preliminary period. Clinical course of the delivery: periods of the delivery and their

characteristics, the duration of the delivery. Management of the labor in the period of

cervix dilation. Labor pain control: indications, methods and medicines used in labor

pain control. Management of the delivery in the period of fetal expulsion. The

biological mechanism of the labor with anterior and posterior types of the occipital

delivery. Primary sanation and cleansing of the newborn, Apgar score as a method to

quickly summarize the health of a newborn child. Management of the postpartum

period. Methods of assessing postpartum hemorrhage.

Physiological changes in the body of a puerpera. Management of the

postpartum period.

Anatomical and physiological features of a newborn. Breastfeeding.

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5. Extragenital and gynecological pathology accompanying pregnancy

The circulatory system diseases. Blood diseases

Causes of hypertension in pregnant women, differential diagnosis. Pregnancy

in women with arterial hypertension, complications of pregnancy and labor for the

mother and fetus. Management of pregnancy and labor in women with arterial

hypertension, treatment.

The course and management of pregnancy and labor in women with acquired

and congenital heart defects; complications of pregnancy and labor for the mother

and fetus.

Varicose veins in pregnant women: causes, prevention of venous thrombosis.

Contraindications to pregnancy in circulatory system diseases.

Anemia and pregnancy, classification. Causes of deficiency anemias in

pregnancy, diagnosis. Complications of pregnancy, labor, postpartum and neonatal

periods in patients with anemia, prevention.

Hereditary and congenital thrombophilia, complications of pregnancy, labor

postpartum and neonatal periods. Idiopathic thrombocytopenic purpura, clinical

features, diagnosis, complications of pregnancy and labor and their prevention

Endocrine pathology

Classification of diabetes mellitus in pregnant women. Gestational diabetes,

risk factors, diagnosis. Course of diabetes mellitus at different terms of pregnancy.

Complications of pregnancy, labor and the postpartum period in patients with

diabetes. Correction of glycemia in pregnant women, parturient and puerperas. The

management of pregnancy, labor and the postpartum period in patients with diabetes,

prevention of complications. Diabetic fetopathy: causes, diagnosis, treatment.

Contraindications to pregnancy in diabetic women.

Thyroid gland diseases: hypothyroidism and thyrotoxicosis, thyroid cancer.

The course and management of pregnancy, labor, postpartum period. Complications

for the fetus and newborn in mother’s thyroid dysfunction. Iodine deficiency

diseases, prevention of iodine deficiency in pregnant women, the clinical significance

Diseases of the urinary system Urinary tract infection in pregnancy: predisposing factors and causes.

Asymptomatic bacteriuria, complications, the management of pregnancy.

Pyelonephritis in pregnancy, etiology, clinical picture, diagnosis, treatment.

Glomerulonephritis in pregnancy, etiology, clinical picture, diagnosis, treatment,

complications of pregnancy. Urolithiasis in pregnancy, diagnosis, indications for

surgical treatment. Management of the labor and postpartum period in patients with

diseases of the urinary system. Contraindications to pregnancy in diseases of the

urinary system.

Liver diseases

Viral hepatitis B and C in pregnancy, infection mechanism, diagnosis,

complications of pregnancy. Management of pregnancy, labor, the postpartum and

neonatal periods in viral hepatitis. Intrahepatic cholestasis in pregnant women:

causes, clinical picture, diagnosis, treatment.

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Acute surgical pathology

Appendicitis, pancreatitis, cholecystitis, intestinal obstruction: peculiarities of

the clinical course and diagnostics at different terms of pregnancy. Methods of

treatment. The management of pregnancy and labor, postpartum period.

Gynecological pathology in pregnancy

Uterine myoma in pregnancy: diagnosis, complications of pregnancy, labor and

the postpartum period. The clinical course of uterine myoma during pregnancy,

treatment and prevention of complications. Pregnancy after conservative

myomectomy and reconstructive surgery on the uterus.

Ovarian tumors in pregnancy: diagnosis, complications of pregnancy, labor and

the postpartum period. The clinical course of an ovarian tumor in pregnancy,

treatment, prevention of complications.

Infectious diseases

Sexually transmitted diseases (Chlamydia infection, syphilis, gonorrhea)

during pregnancy, complications for the mother, fetus and newborn; diagnosis,

treatment, prevention. Cytomegalovirus and herpes infections, influenza, rubella,

measles, listeriosis, tuberculosis, toxoplasmosis: the course and management of

pregnancy, labor and the postpartum period; complications for the mother, fetus and

newborn.

HIV infection during pregnancy, perinatal prevention of transmitting HIV from

mother to fetus and newborn.

Pregnancy and diseases of the respiratory system: pneumonia, chronic

obstructive bronchitis, bronchial asthma. Treatment and prevention of complications

of pregnancy, labor, the postpartum and neonatal periods.

Pregnancy and ocular diseases: management of labor, prevention of

complications.

6. Pathology of pregnancy and labor

Pregnancy and labor in breech birth

Etiology, classification, diagnosis and prevention of breech presentation. The

course and management of pregnancy and labor. Surgical intervention in the breech

presentation.

Wrong fetus positions and presentations

The pregnancy and labor at shoulder presentation and oblique lie of the fetus:

etiology, diagnosis, management of pregnancy.

Extension cephalic presentation: classification, diagnosis, management of

labor. Deviations from the normal biological mechanism of the labor in vertex

presentation.

Multiple pregnancy

Cases and diagnosis. The course and management of pregnancy and labor.

Incomplete and prolonged pregnancy

Spontaneous abortion: causes, clinical stages, diagnosis, treatment.

Cervicoisthmic insufficiency: causes, diagnosis, correction. Premature birth: causes,

clinical picture, diagnosis, complications. Premature rupture of amniotic membranes

in incomplete pregnancy: causes, diagnosis, management of pregnancy, prevention of

complications for the mother and fetus.

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Signs of an immature newborn, prevention and treatment of respiratory

disorders.

Prolonged pregnancy: causes, diagnosis, management of pregnancy, labor

complications for the mother and fetus.

Differential diagnosis of post-term pregnancy, and prolonged pregnancy.

Induced labor: indications, methods. Methods of inducing cervical maturation.

Hemorrhages in Obstetrics Causes of bleeding in early and late pregnancy. Etiology, pathogenesis,

classification, methods of diagnosis of bleeding during labor and the early postpartum

period.

Causes of bleeding during labor and the postpartum period. Anomalies of the

localization and attachment of the placenta: causes, clinical picture, diagnosis,

management of pregnancy and labor, prevention of complications. Premature

abruption of normal placenta: causes, clinical picture, diagnosis, management of

pregnancy and labor, prevention of complications.

Disseminated intravascular coagulation (DIC-syndrome): causes, diagnosis,

treatment, prevention. Hemorrhagic shock: clinical picture, diagnosis, treatment,

prevention.

Amniotic fluid embolism: causes, clinical picture, diagnosis, treatment,

prevention.

Preeclampsia Gestational vomiting: causes, clinical picture, differential diagnosis, treatment.

Gestational hypertention, preeclampsia, eclampsia: pathogenesis, clinical signs,

management of labor, indications for preterm delivery, complications for the mother

and fetus.

HELLP-syndrome, acute fatty hepatosis.

Anomalies of labor activity

Classification of the anomalies of labor activity, causes, clinical picture,

diagnosis, treatment, complications for the mother and fetus, prevention.

Management of labor, indications for cesarean section.

Contracted (narrow) pelvis

Contracted (narrow) pelvis in anatomical and clinical terms. Etiology,

classification and diagnosis of pelvic bone abnormalities. The course and

management of labor in various forms of an anatomically contracted pelvis.

Complications for the mother and fetus. Biological mechanism of labor in various

forms of pelvic contraction. Causes of clinically contracted pelvis.

Diagnosis of clinically contracted pelvis, labor management, complications for

the mother and fetus.

Birth injury

Causes, classification, diagnosis and prevention of birth injuries in the mother

and fetus.

The rupture of the uterus, vaginal birth injury, postpartum fistulas, pubis

diastasis and rupture, postpartum inversion of the uterus, their clinical picture,

treatment and prevention.

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Fetal and neonatal birth injury: cephalohematoma, intracranial hemorrhages,

traumas of the skeleton, peripheral and central nervous system, organs of the

abdominal cavity.

7. Operative methods of delivery

Caesarean section: indications, contra-indications and conditions for carrying

out the operation. Preoperative preparation and pain control, complications.

Management of the postoperative period.

Management of pregnancy in women with the uterine scar, methods of

delivery, complications.

Obstetrical forceps: models and structure; indications, contra-indications,

conditions for applying obstetrical forceps; pain control methods; rules and stages of

the operation of applying obstetrical forceps; difficulties and complications while

carrying out the operation; techniques of applying of outlet and “mid or law” forceps;

complications for the mother and fetus.

Vacuum extraction of the fetus: indications, contra-indications, conditions for

carrying out the operation, the operation technique, complications for the mother and

fetus.

Embryotomy operations: indications, contra-indications, conditions for

carrying out the operation, kinds of operations, complications for the mother.

8. The postpartum period: physiology and pathology Physiological changes in the puerpera’s organism. The course and management

of the postpartum period. Postpartum purulent septic diseases: lactational (puerperal)

mastitis, postpartum ulceration, endometritis, thrombophlebitis, parametritis,

pelviperitonitis, peritonitis, sepsis. Etiology, pathogenesis, classification, clinical

picture, diagnosis, treatment, prevention.

9. Gynecology

Methods of diagnosing the reproductive system diseases Clinical methods of examination: case history taking, general and objective

examination, the examination and palpation of mammary glands, examination and

exploration of external and internal genitals.

Methods of the exploration of ovary functions: functional diagnostics tests,

determining the hormone concentration in blood plasma and in the urine, hormonal

tests.

Morphological methods of exploration.

Endoscopic methods of examination: vaginoscopy, colposcopy, hysteroscopy,

culdoscopy, diagnostic laparoscopy.

Radiological methods of examination. Computer tomography. Magnetic

resonance imaging. Transabdominal and transvaginal ultrasonography.

Malposition of female genitals Causes, classification, clinical picture, diagnosis, methods of treatment of the

female genitals malposition.

Ptosis and prolapse of genitals: classification, diagnosis, clinical picture,

methods of treatment.

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Menstrual function and its disorders Neurohumoral regulation of menstrual cycle.

Causes, clinical picture, diagnosis, treatment and prevention of menstrual

disorders: аmenorrhea, dysmenorrhea, dysfunctional uterine bleeding in juvenile,

reproductive and climacteric periods.

Neuroendocrine syndromes in gynecology

Etiology, pathogenesis, classification, diagnosis and treatment of premenstrual,

post-castration, climacteric, adrenogenital syndromes; hirsutism and virilization; the

syndrome and disease of polycystic ovaries.

Inflammatory diseases of the female genitals Etiology, classification, clinical picture, diagnosis, treatment and prevention of

vulvovaginitis, bartholinitis, cervicitis, metroendometritis, salpingo-oophoritis

(adnexitis), parametritis, pelviperitonitis.

Clinical picture, diagnosis, treatment of sexually transmitted diseases:

gonorrhoea, trichomoniasis, Chlamydia infection, human papillomavirus (HPV)

infection, bacterial vaginosis, candidiasis, genital herpes.

Background, pre-cancer and benign diseases of the female reproductive

system organs

Background and pre-cancer diseases of the external genitals, cervix,

endometrium. Myoma of the uterus: classification, clinical picture, diagnosis,

preventive check-ups, treatment. Indications and the extent of surgical treatment of

the uterine myoma. Emergency conditions in the myoma of the uterus.

Tumors and tumor-like masses of ovaries: causes, classification, clinical

manifestations, diagnosis, treatment, prevention.

Endometriosis: modern theories of the pathogenesis, classification, clinical

manifestations, diagnosis, treatment, prevention.

Dyshormonal diseases of the mammary glands.

Gynecological diseases requiring an urgent medical aid Extrauterine pregnancy, spontaneous abortion, ovarian apoplexy, torsion of

ovary tumor peduncle, necrosis of a myomatous node, acute inflammatory diseases,

genital injuries, peritonitis. Etiology, pathogenesis, clinical manifestations, diagnosis

and differential diagnosis, treatment, prevention.

Operative Gynecology

Preoperative preparation and managing the postoperative period.

Reconstructive plastic operations on the uterus, uterine appendages aimed at

the preservation of women’s reproductive function. Endosurgical methods of

treatment in gynecology.

Therapeutic abortion: social and medical aspects of the issue, methods of

abortion in early and late terms, indications, contra-indications, complications,

influence on the reproductive function, prevention.

10. Infantile and Adolescent Gynecology

Sexual development disorders: pubertas precox (macrogenitosomia), sexual

development retardation, absence of sexual development. Etiology and pathogenesis,

classification, diagnosis, treatment.

Genitals development anomalies: etiology and pathogenesis, classification,

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clinical manifestations, diagnosis, treatment.

Traumas of genitals.

Inflammatory diseases in childhood and adolescence: etiology and

pathogenesis, classification, clinical manifestations, diagnosis, treatment, prevention.

Benign tumors of genitals in childhood and adolescence.

11. Infertile marriage and family planning issues

Family planning. Female and male infertility: causes, diagnosis, treatment. The

organization of rendering medical and socio-psychological aid to a married couple.

Assisted reproductive technologies.

Contraception: methods, contraindications, complications, side effects.

INFORMATION AND METHODOLOGICAL UNIT Basic:

1. Obstetrics and gynecology : textbook. In 2 vol. V. 1 : Obstetrics /

Gryshchenko, Valentyn Ivanovych [и др.] ; ed. V. I. Gryshchenko, M. O.

Shcherbina. - 2 ed. - Kyiv : AUS Medicine Publishing, 2018. - 392 p. -

Акушерство и гинекология. Т. 1. Акушерство.

2. Obstetrics and gynecology : textbook. In 2 vol. V. 2 : Gynecology /

Gryshchenko, Valentyn Ivanovych [и др.] ; ed. V. I. Gryshchenko, M. O.

Shcherbina. - 2 ed. - Kyiv : AUS Medicine Publishing, 2018. - 352 p. : 8 color

insets. - Акушерство и гинекология. Т. 2. Гинекология.

3. Dutta DC. DC Dutta's textbook of obstetrics including perinatology and

contraception / Dutta DC. – 2018. - 156 r. 42 k.

4. Dutta DC. DC Dutta's textbook of gynecology including contraception / Dutta

DC. – 2016. - 176 r. 94 k.

5. Obstetrics : textbook / ed. by V. E. Radzinskiy, A. M. Fuks, Ch. G. Gagaev. -

Москва : Гэотар-Медиа, 2019. - 876 p.

Additional:

1. Obstetrics and gynecology / Beckmann C.- Wolters Kluwer, 2014.

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COMPILERS:

Head of the Department of Obstetrics and

Gynecology of the educational institution

«Belarusian State Medical University»

L.F.Mozhejko

Associate Professor of the Department of

Obstetrics and Gynecology of the

educational institution «Belarusian State

Medical University»

E.N.Kirillova

Associate Professor of the Department of

Obstetrics and Gynecology of educational

institution «Belarusian State Medical

University», Ph.D. in Medicine

N.S.Akulich