Diagnosis of pregnancy and normal physiology
How pregnancy is confirmed and dated (urine and serum hCG, ultrasound), and the normal multi-system physiology of pregnancy.
Checked against sourcesVerified 1 November 2026
Obstetrics
Pregnancy, labour and the postnatal period, for the mother and the unborn child.
Introduction
Obstetrics is the care of the mother and the unborn child through pregnancy, labour and the weeks after birth. Two patients are always in view: what helps one should be checked against what it does to the other.
This section starts with early pregnancy and screening, then monitoring of the mother and fetus, medical disorders in pregnancy, labour and delivery, the obstetric emergencies, and the postnatal period.
Every topic uses the same layout: a short summary, what you should be able to do afterwards, the mechanism, the clinical picture, tests, treatment and the traps. Doses, thresholds and cut-offs are checked against named guidelines and shown with their source, because guidelines and countries sometimes differ.
How to study obstetrics
Learn obstetrics along the timeline of pregnancy: what is screened or checked at each visit, what is normal at each stage, and which finding changes the plan. Then learn the emergencies as drills you can say aloud: haemorrhage, pre-eclampsia and eclampsia, shoulder dystocia, cord and collapse.
Learn the numbers that change what you do: blood pressure thresholds, glucose cut-offs, gestational ages for steroids, delivery timing and anti-D, and the drug doses for magnesium sulfate and oxytocin. The check-yourself questions at the end of each topic test them a few days later.
Link obstetrics to the other chapters: many topics are the medical condition seen again with a second patient, a changed physiology and a different drug list.
Contents by part
The topics below are in teaching order. Each part builds on the one before it.
- Before and early in pregnancy. Diagnosing pregnancy, antenatal and preconception care, screening, invasive tests, drugs in pregnancy and the first-trimester emergencies.
- Diagnosis of pregnancy and normal physiology
- Antenatal care schedule and preconception care
- Prenatal screening and diagnostic testing
- Invasive prenatal testing and prenatal care
- Drugs and teratogens in pregnancy
- Hyperemesis gravidarum
- Miscarriage and recurrent pregnancy loss
- Ectopic pregnancy
- Gestational trophoblastic disease
- Monitoring the mother and the fetus. Examination, fetal heart rate monitoring, fetal surveillance, growth, fluid, multiple pregnancy and imaging.
- Medical disorders in pregnancy. Hypertension and pre-eclampsia, diabetes, heart, blood, liver, urinary and infectious disease, and thrombosis.
- Gestational and chronic hypertension in pregnancy
- Preeclampsia, HELLP syndrome and eclampsia
- Diabetes in pregnancy
- Heart disease in pregnancy
- Anaemia in pregnancy
- Venous thromboembolism in pregnancy and the puerperium
- Intrahepatic cholestasis of pregnancy and acute fatty liver
- Urinary tract infection and pyelonephritis in pregnancy
- Infections in pregnancy
- Chronic medical disorders in pregnancy
- Perinatal mental health
- Labour and delivery. Normal labour, abnormal progress, induction, instrumental and caesarean birth, malpresentation, analgesia and preterm labour.
- Obstetric emergencies. Bleeding before and after birth, shoulder dystocia, uterine rupture and inversion, collapse and maternal death.
- After the birth. Postnatal care and contraception, infection, breastfeeding and stillbirth.
Topics
Antenatal care schedule and preconception care
Schedule of antenatal contacts and preconception care for a healthy pregnancy, guided by NICE NG201 and WHO.Checked against sourcesVerified 31 October 2026Prenatal screening and diagnostic testing
Step-by-step prenatal screening and diagnostic testing for fetal chromosomal abnormalities, from nuchal translucency and quad screen to cell-free DNA, CVS.Checked against sourcesVerified 1 November 2026Invasive prenatal testing and prenatal care
Invasive prenatal tests (amniocentesis, CVS): indications, risks, consent, steps, complications, aftercare and the routine antenatal visits and tests around.Checked against sourcesVerified 1 November 2026Drugs and teratogens in pregnancy
How to judge medicines in pregnancy: the labelling rule, the main teratogens, safer choices for common conditions, alcohol, tobacco, and where to seek advice.Checked against sourcesVerified 31 October 2026Hyperemesis gravidarum
Severe nausea and vomiting of pregnancy: how it differs from ordinary morning sickness, how it is diagnosed and treated, and how to prevent Wernicke's.Checked against sourcesVerified 1 November 2026
Miscarriage and recurrent pregnancy loss
Miscarriage and recurrent pregnancy loss: types, management, septic loss, and recurrent loss work-up with supportive care.Checked against sourcesVerified 31 October 2026Ectopic pregnancy
Ectopic pregnancy: risk factors, presentation, hCG and ultrasound diagnosis, and expectant, medical and surgical management with Rh care.Checked against sourcesVerified 1 November 2026Gestational trophoblastic disease
From molar pregnancy to choriocarcinoma: what it is, how it presents, hCG staging, chemotherapy and follow-up.Checked against sourcesVerified 1 November 2026Obstetric examination and fetal heart rate monitoring
Obstetric examination, Leopold maneuvers, fundal height, Bishop score, and fetal heart rate monitoring: CTG interpretation and management.Checked against sourcesVerified 1 November 2026Antepartum fetal surveillance
Who needs antepartum fetal surveillance and how to do it stepwise: kick counts, non-stress test, biophysical profile, contraction stress test and Doppler.Checked against sourcesVerified 1 November 2026Fetal growth restriction and macrosomia
How fetal growth restriction and macrosomia are defined, screened, monitored and managed, with delivery timing and guideline differences.Checked against sourcesVerified 1 November 2026Polyhydramnios and oligohydramnios
Too much or too little amniotic fluid in pregnancy: definitions, causes, fetal and maternal risks, diagnosis cut-offs, and management by current guidelines.Checked against sourcesVerified 1 November 2026Multiple gestation
How multiple pregnancy is classified by chorionicity and amnionicity, screened, monitored and delivered across current NICE, RCOG, ACOG, SMFM and WHO.Checked against sourcesVerified 1 November 2026Rhesus alloimmunisation
Rh D alloimmunisation in pregnancy: why it happens, how anti-D prevents it, and how affected pregnancies are monitored and treated.Checked against sourcesVerified 1 November 2026Pregnancy-related imaging, radiation and surgery
Imaging, radiation and non-obstetric surgery in pregnancy: safe modalities, fetal dose thresholds, anaesthesia, laparoscopy, appendicitis and trauma.Checked against sourcesVerified 31 October 2026Gestational and chronic hypertension in pregnancy
How gestational and chronic hypertension in pregnancy are defined, classified, treated and monitored, differentiated from preeclampsia, with NICE, ACOG.Checked against sourcesVerified 1 November 2026Preeclampsia, HELLP syndrome and eclampsia
How pre-eclampsia, HELLP syndrome and eclampsia are defined, recognised, treated, followed up, and prevented, with current NICE, ACOG, RCOG and WHO guidance.Checked against sourcesVerified 1 November 2026Diabetes in pregnancy
Gestational and pregestational diabetes in pregnancy: screening, targets, treatment, monitoring, fetal growth, delivery timing and postpartum follow-up.Checked against sourcesVerified 1 November 2026Heart disease in pregnancy
How pregnancy stresses the heart, how risk is graded with mWHO, and how valve disease, peripartum cardiomyopathy and anticoagulation are managed.Checked against sourcesVerified 31 October 2026Anaemia in pregnancy
Definitions, causes, investigation and management of anaemia in pregnancy: iron deficiency, B12 and folate, and haemoglobinopathies.Checked against sourcesVerified 31 October 2026Venous thromboembolism in pregnancy and the puerperium
How pregnancy raises clot risk and how to assess, prevent, diagnose and treat VTE safely.Checked against sourcesVerified 31 October 2026Intrahepatic cholestasis of pregnancy and acute fatty liver
Pruritus and bile acids in ICP, ursodeoxycholic acid and delivery timing, plus AFLP and the HELLP differential.Checked against sourcesVerified 31 October 2026Urinary tract infection and pyelonephritis in pregnancy
How urinary infection changes in pregnancy: screening for asymptomatic bacteriuria, cystitis and pyelonephritis, safe antibiotics, risks and complications.Checked against sourcesVerified 1 November 2026Infections in pregnancy
Screening, prevention of vertical transmission, and treatment of infections during pregnancy, including GBS, HIV, syphilis, hepatitis, TORCH infections.Checked against sourcesVerified 31 October 2026Chronic medical disorders in pregnancy
Epilepsy and antiepileptic choice, thyroid disease and TSH targets, asthma control, and lupus with antiphospholipid syndrome in pregnancy.Checked against sourcesVerified 31 October 2026Perinatal mental health
Perinatal mental health: baby blues, depression, anxiety, postpartum psychosis, screening with EPDS, and psychotropics in pregnancy and breastfeeding.Checked against sourcesVerified 31 October 2026Normal labour and delivery
How a normal term labour and birth unfold, from the cardinal movements to the third stage, monitoring, active management and immediate postnatal care.Checked against sourcesVerified 31 October 2026Labour stages and failure to progress
Stages of normal labour, the partograph, the three Ps, and how delay or arrested labour is defined, augmented and managed using current guidelines.Checked against sourcesVerified 1 November 2026Induction of labour and operative vaginal delivery
How labour is induced, when operative vaginal birth is used, and how perineal tears are repaired.Checked against sourcesVerified 31 October 2026Obstetric analgesia and anaesthesia
Labour analgesia and caesarean anaesthesia: neuraxial, opioid, nitrous oxide and pudendal block techniques, with preparation, complications and aftercare.Checked against sourcesVerified 1 November 2026Premature rupture of membranes and preterm labour
PROM and PPROM: diagnosis, chorioamnionitis, tocolysis, antenatal corticosteroids, magnesium neuroprotection, GBS prophylaxis, management and prognosis.Checked against sourcesVerified 1 November 2026Fetal malpresentation
How breech, transverse, face and brow presentations are classified, found and managed, including external cephalic version and current RCOG, ACOG, NICE and.Checked against sourcesVerified 1 November 2026Caesarean section and episiotomy
Caesarean birth and episiotomy: indications, technique, complications, vaginal birth after caesarean and perineal tears using current RCOG, ACOG, NICE and.Checked against sourcesVerified 1 November 2026Antepartum haemorrhage: placenta praevia and abruption
Painful and painless third-trimester bleeding from placenta praevia, abruption, vasa praevia and uterine rupture, with ultrasound and emergency management.Checked against sourcesVerified 1 November 2026Postpartum haemorrhage
Bleeding of 500 ml or more within 24 hours of birth: causes, recognition, diagnosis and step-by-step management using RCOG, ACOG, NICE and WHO guidance.Checked against sourcesVerified 1 November 2026Shoulder dystocia
Obstetric emergency in which the fetal head delivers but a shoulder is impacted; recognition, stepwise manoeuvres, complications and prevention.Checked against sourcesVerified 1 November 2026Uterine inversion, uterine rupture and Sheehan syndrome
Uterine inversion, uterine rupture and Sheehan syndrome: recognition, immediate management and postpartum haemorrhage.Checked against sourcesVerified 1 November 2026Cord prolapse, amniotic fluid embolism and collapse
How to recognise and manage cord prolapse, amniotic fluid embolism and maternal collapse, including resuscitation changes and peri-mortem caesarean.Checked against sourcesVerified 31 October 2026Maternal mortality and near-miss review
How maternal deaths and near misses are defined, measured, reviewed and prevented, from global causes and the three delays to MEOWS and severe morbidity audit.Checked against sourcesVerified 31 October 2026Postnatal care and contraception after birth
Postnatal checks for mother and baby, pelvic floor recovery, lochia, and contraception after birth, including lactational amenorrhoea.Checked against sourcesVerified 31 October 2026Postpartum infection
Postpartum infection: causes of fever after birth, from endometritis to mastitis and septic pelvic thrombophlebitis, and how to investigate and treat them.Checked against sourcesVerified 1 November 2026Lactation, breastfeeding and mastitis
How milk is made and moved, how to start and support breastfeeding, when drugs are safe, and how to recognise and treat mastitis and breast abscess.Checked against sourcesVerified 1 November 2026Stillbirth and perinatal bereavement
Stillbirth after 24 weeks: causes, investigation, labour care, bereavement, memory making, and planning the next pregnancy.Checked against sourcesVerified 31 October 2026