Midwifery - Roma Azienda Ospedaliera Sant’Andrea

Activity type

Scienze ostetriche

SSD

MED/47

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

8 classroom hours

Lecturers

Raad Aris BESHARAT

Activity type

Scienze ostetriche

SSD

MED/47

Year

2nd year

Semester

2nd semester

CFU

2

Hours distribution

16 classroom hours

Lecturers

ROMOLO DI IORIO

Activity type

Scienze ostetriche

SSD

MED/47

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

8 classroom hours

Lecturers

ANDREA GIANNINI

Activity type

Interdisciplinari e cliniche

SSD

MED/40

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

8 classroom hours

Lecturers

PAOLA BIANCHI

Activity type

Primo soccorso

SSD

MED/38

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

8 classroom hours

Lecturers

GIANLUCA TERRIN

Students must have acquired the knowledge and operational procedures required to manage major obstetric, gynecological, and neonatal emergencies.

To manage emergencies effectively, it is necessary to have developed the knowledge required for diagnosis and to be familiar with the various protocols to be adopted in specific cases.

Module: TRIAGE AND ADMISSION IN OBSTETRICS AND GYNECOLOGY
Organizational models: evolution of triage in maternal-fetal care and the autonomous role of the triage midwife.
Obstetric history: assessment of gestational age, parity, course of pregnancy (physiological or high-risk), and perception of fetal movements.
Identification of the presenting symptom: management of pain (OPQRST methodology), vaginal bleeding and/or amniotic fluid loss, reduced fetal movements, fever, and pruritus of pregnancy.
Gynecological history: acute pelvic pain, non-pregnancy-related bleeding, and vulvovaginal symptoms.
5-level priority coding system: application of the regional/institutional scale (e.g., red/emergency, orange/urgent, yellow/delayed, green/minor, white/non-urgent).
Dedicated care pathways: activation of "Fast Track" protocols for obstetric emergencies (e.g., suspected placental abruption, umbilical cord prolapse, eclampsia) or gynecological emergencies (e.g., adnexal torsion).


Module: OBSTETRIC EMERGENCIES
high-risk pregnancy
miscarriage: definition, classification, causes
recurrent pregnancy loss
nausea and vomiting in pregnancy, hyperemesis gravidarum
preterm birth: definition, pathophysiology, risk factors, diagnosis, treatment
prematurity: fetal and neonatal outcomes, stimulation of fetal lung maturity, prevention of fetal neurological injury
cervical incompetence and cervical cerclage
twin pregnancy: maternal, fetal, and obstetric risks
diabetes in pregnancy
hypertension in pregnancy
intrahepatic cholestasis of pregnancy
placental abnormalities: placenta previa and placenta accreta
premature rupture of membranes (PROM) at term and preterm
oligohydramnios
polyhydramnios
post-term pregnancy
induction of labor


Module: NEONATAL RESUSCITATION
Obstetric assistance in the operating room.
Knowledge of surgical instruments.
Knowledge of the surgical stages of major obstetric procedures.


Module: GYNECOLOGIC EMERGENCIES
The course includes knowledge of gynecological emergencies that can occur both in the Emergency Room and in a Gynecology Ward. One should learn the diagnostic/therapeutic pathways in order to collaborate with medical staff in certain circumstances.


Module: OBSTETRICAL ASSISTANCE IN THE OPERATING ROOM
- Organization of care in the delivery room.
- Initial assessment of the newborn and identification of risk factors.
- Immediate interventions: thermoregulation, airway patency, ventilatory support, monitoring.
- Essential indications for neonatal resuscitation maneuvers.
- Team communication and coordination during perinatal emergencies.
- Overview of post-resuscitation stabilization and transfer to the neonatal intensive care unit.

Module: TRIAGE AND ADMISSION IN OBSTETRICS AND GYNECOLOGY
Students will be able to use the material provided by the teacher (slides and book chapters).


Module: OBSTETRIC EMERGENCIES
“Treatise on the Science and Art of Midwifery Practice” (Trattato di Scienza ed Arte della Professionalità Ostetrica), Vol. 1–5, W. Costantini, Piccin Editore, 2021
“Urgent and Emergent Situations in the Delivery Room” (Urgenze ed Emergenze in Sala Parto), A. Ragusa & C. Crescini, Piccin Editore, 2016
Istituto Superiore di Sanità (Italian National Institute of Health). National Guideline System. Guideline No. 26: Postpartum Hemorrhage – Prevention and Treatment. October 2016
Italian Preeclampsia Association (AIPE). AIPE Guidelines: “Hypertensive Disorders in Pregnancy,” 2020
SIGO, AOGOI, AGUI Guidelines: “Cardiotocographic Monitoring During Labor,” 2018


Module: NEONATAL RESUSCITATION
Teaching materials will include lecture slides, supplemented by national and international guidelines, scientific articles, and educational resources available through major scientific and bibliographic databases (e.g., PubMed, scientific society guidelines, and other relevant reference databases).


Module: GYNECOLOGIC EMERGENCIES
The study can be based on the slides provided by the teacher.


Module: OBSTETRICAL ASSISTANCE IN THE OPERATING ROOM
The teacher will provide study materials, slides, and written texts.

Module: TRIAGE AND ADMISSION IN OBSTETRICS AND GYNECOLOGY
WHO MEC 2015


Module: OBSTETRIC EMERGENCIES
N/D
Module: NEONATAL RESUSCITATION
N/D
Module: GYNECOLOGIC EMERGENCIES
N/D
Module: OBSTETRICAL ASSISTANCE IN THE OPERATING ROOM
N/D

The classes are in-person lectures.

Attendance at classes is mandatory.

Each individual instructor, in consultation with the students, will determine the format of the exam.

Management of placental abruption.
Third-trimester hemorrhage.
Ectopic pregnancy.
Neonatal resuscitation.

Module: TRIAGE AND ADMISSION IN OBSTETRICS AND GYNECOLOGY



Module: OBSTETRIC EMERGENCIES

• Emergency and urgency: definitionPrinciples regarding guidelines, clinical protocols, and diagnostic-therapeutic-care pathways (PDTA)Maternal mortality during pregnancy: epidemiology, causes


• Postpartum hemorrhage: definition, epidemiologyTone: uterine atony (clinical management, uterotonic drugs), intrauterine hemostatic balloons, uterine inversion (definition, classification, risk factors, diagnosis, clinical management, prevention)Tissue: retained placental tissue (manual removal of placenta, exploration of the uterine cavity), placenta accreta spectrum (definition, classification, clinical management), placental and umbilical cord insertion anomalies (definition, classification, clinical management), hemostatic uterine sutures, total and subtotal hysterectomy, pelvic vessel embolizationTrauma: perineal trauma (definition, classification, risk factors, diagnosis, clinical management), cervical lacerations, puerperal genital hematoma (uterine vasculature and supporting structures, classification/location, clinical management), uterine ruptureThrombin: principles of hemostasis, coagulation cascade, hemostatic agentsThromboembolism in pregnancy: epidemiology, risk factors, prevention, and treatment


• hypertensive crisis: clinical management, antihypertensive drugs in pregnancyeclampsia: definition, epidemiology, clinical managementHELLP syndrome: definition, diagnosis, clinical managementamniotic fluid embolism: definition, epidemiology, diagnosis, and treatmentsepsis in pregnancy: definition, epidemiology, diagnosis, clinical managementemergency cervical cerclage: indications, surgical techniqueumbilical cord prolapse: definition, epidemiology, fetal-neonatal outcomes, risk factors, clinical management, preventionplacental abruption: diagnosis, epidemiology, risk factors, clinical managementemergency/urgent CTG patternsurgent/emergency caesarean sectionmeconium-stained fluid: definition, etiopathogenesis, fetal-neonatal risks, clinical managementshoulder dystocia: definition, diagnosis, clinical managementmanagement of twin delivery: epidemiology, fetal-neonatal risks, clinical managementmanagement of breech delivery: epidemiology, fetal-neonatal risks, clinical management