OBGYN

Abnormal lie, presentation and labor progress are where intrapartum care turns dangerous in low-resource settings — neglected obstruction ends in uterine rupture, fistula and fetal death, while shoulder dystocia and cord prolapse kill within minutes if the team hesitates. This module trains the decision pathways: breech classification, ECV criteria and the hands-off assisted breech technique; mento-anterior vs mento-posterior face, brow and transverse lie delivery routes; the HELPERR sequence for shoulder dystocia; Bandl's ring and impending rupture; and cord decompression for cord prolapse.

Obstetric hemorrhage is the leading cause of direct maternal death in Uganda — women bleed to death in hours from placenta praevia, abruption, rupture and postpartum atony when recognition or protocolized resuscitation fails. This module trains the bedside differentiation of third-trimester bleeding (painless praevia vs painful abruption vs uterine rupture), the absolute prohibition of the digital vaginal exam, the '4 Ts' framework for PPH, the Uganda MoH uterotonic/TXA pharmacopoeia, mechanical escalation (bimanual compression, condom-balloon tamponade, NASG), surgical hemostasis, and 1:1:1 massive transfusion.

Surgical interventions decide whether obstetric emergencies end in survival or catastrophe — and poorly judged or badly executed ones cause the harm they were meant to prevent. This module covers the operative arm of Ugandan intrapartum care: elective and emergency caesarean section (LSCS vs classical), TOLAC candidate selection and scar-rupture recognition, assisted vaginal delivery (vacuum and forceps under the ABCDEFGHIJ safety prerequisites), mediolateral episiotomy and perineal repair, induction/augmentation protocols (Bishop score, Foley catheter, the 25 mcg misoprostol rule, oxytocin titration), and essential procedures (manual removal of placenta, MVA, cervical cerclage).

The week after delivery decides two lives at once — uterine involution, lochia, sepsis, breast complications and mental health on the mother's side, and thermal care, feeding and resuscitation on the newborn's. This module covers puerperal physiology and the Uganda MoH 4-contact PNC schedule, puerperal pyrexia and sepsis (the '5 Ws' differential and triple-antibiotic bundle), lactational breast disorders (engorgement, mastitis, abscess), postpartum VTE and mental-health disorders, the 60-minute Essential Newborn Care bundle, Helping Babies Breathe resuscitation, and Kangaroo Mother Care for the small and preterm infant.

Menstrual complaints are the most common gynecological presentation — and the workup is won or lost on physiology, not guesswork. This module covers HPO-axis neuroendocrine control of the normal cycle, AUB terminology and the FIGO PALM-COEIN classification with medical and emergency management, the diagnostic algorithms for primary and secondary amenorrhoea (breast/uterus matrix, progesterone challenge, gonadotropin compartments), PCOS by Rotterdam criteria and tailored therapy, primary vs secondary dysmenorrhoea and PMS/PMDD, and menopause physiology with HRT selection rules.

Lower genital infections are common and mostly curable — but mismanaged they ascend into infertility, ectopic pregnancy and chronic pain. This module covers the three vaginitis etiologies (BV, candidiasis, trichomoniasis) with their pH/microscopy signatures, Ugandan syndromic management of vaginal discharge and genital ulcer disease, the STI spectrum (syphilis, HSV, chancroid, LGV, warts), PID diagnosis by minimum criteria and its tubal sequelae, outpatient vs inpatient antibiotic regimens, and Bartholin's duct cyst/abscess with marsupialization.

Benign doesn't mean harmless — fibroids bleed, ovaries twist, fistulas leak, and prolapse descends. This module covers uterine leiomyomas by FIGO subtype and their degenerations, medical vs surgical management by fertility goal, endometriosis vs adenomyosis, benign ovarian cysts and the Risk of Malignancy Index, ovarian torsion and cyst-rupture emergencies, congenital Müllerian anomalies, pelvic organ prolapse by compartment and Baden-Walker staging, the incontinence spectrum, and vesicovaginal fistula classification and delayed-repair principles.

Gynecological cancers are staged by what the surgeon can see — and treated by what the exam reveals. This module covers cervical carcinogenesis (HPV, E6/E7, CIN), Uganda screening protocols (VIA, HPV-DNA, Pap), CIN management, FIGO clinical staging and the operable/inoperable treatment split (radical hysterectomy vs chemoradiation), endometrial cancer's dualistic model and PMB workup, ovarian cancer histologies and CA-125 limits, vulvar/vaginal malignancies, and gestational trophoblastic neoplasia with hCG surveillance and WHO-scored chemotherapy.

Reproductive health ends where it began — with choices. This module covers contraceptive mechanisms and the WHO Medical Eligibility Criteria (MEC 1–4), comparative method profiles (COCs, POPs, DMPA, implants, IUDs, sterilization), missed-pill and emergency-contraception protocols, post-abortion care and the PAFP integration mandate (ovulation returns in 11–14 days), the female infertility workup (ovulation, tubal patency, uterine cavity), WHO semen-analysis interpretation, and ovulation induction plus ART.