STATE OF PALESTINE ‫دولـــة فلسطيــــن‬

Nablus University
for ‫جامـعـة نابلــــــس‬
Vocational & Technical Education ‫للتعليم المهني والتقني‬
- Ibn Sina College for Health Professions - - ‫ كلية ابن سينا للمهن الصحية‬-

Course out line

Gynecology

MW 433

5 credit hours

Fall 2021-2022

Instructor:
Wafaa AL-Amleh

Credit Hours = 5
Theory = 3
Clinical = 1
Simulation : 1

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Course Description:
This course is 5 credit hours, it will be covered by 3 hours theory, 1credit hours clinical and 1 hour
simulation designed to enable the students to understand the role of the midwife in dealing with the
gynecological disorders. It focuses on the importance of assessing & caring for women with
gynecological problems & undergoing surgeries.

Purpose:
The purpose of this course is to provide the student midwife with updated gynecological issues, & to
assess them in applying certain procedures regarding the gynecological clients.

Objectives:
At the end of this course, the student midwife will be able to: -
1) Describe certain menstrual abnormalities , abnormal uterine bleeding, (menorrhagia,
metrorrhagia),amenorrhea , menstrual cycle and discomfort ( dysmenorrhea . PMS ) causes,
and management
2) Discuss cancer related to female reproductive system focusing on breast cancer.
3) Recognition of proper way of self breast examination for early detection.
4) Discuss the sexual transmitted disease & the preventive measures.
5) Describe certain uterine, ovarian, cervical & vaginal anomalies & diseases.
6) Identify certain diagnostic procedures related gynecological disorders.
7) Identify the causes & treatment of infertility on the Palestinian couple’s life.

Teaching methods:
- Lectures.
- Discussions.
- Simulation lab
- Active learning

Evaluation:
- First Exam 20%
- Second Exam 20%
- Quizzes & Participation 10%
- Group project 10 %
- Final Exam 40%
Total 100%

Text:-
1) Schuiling, K. (2013).Women’s Gynecologic Health.(2nd Ed ):Jones &Bartlett Learning.USA
2) Varney,H.( 2015). Varney's Midwifery.(5th ED) Jones &Bartlett Learning.USA.

References:
1) London, M.(2014). Maternal and Child Nursing Care .(3rd Ed): Pearson, New Yourk
2) Dutta, D.(2013).Textbook of Gynecology.(6th Ed):Jaypee Brothers Medical
Publishers.London.

Course Outline

Subject Class Week Lecturer

Hours
Menstrual Disorders:

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 1- Abnormal uterine bleeding
- Menorrhagia 1
- Metrorrhagia. 1
2- Menstrual cycle pain and discomfort
- Dysmenorrhea 1
- Premenstrual syndrome 1
3- Amenorrhea 1
Urinary Incontinence 1
Gynecological cancer
Breast cancer 4

Genital malignancy;
-Valval cancer 1
- Cervical cancer 2
Pap smear 1
Colposcopy 1

First Exam 1

-Endometrial cancer 1
-Ovarian cancer 2

Benign gynecolical condition

- Cervical polyps 1
- Uterine fibroid ( Myomas) 1
- Ovarian cysts 1
- Endometriosis
1

- Uterine Congenital Anomalies. . 1

- Prolapse. 1
- Rectocele 1
- Cystocele 1
Operative in gynecology
- Hysterectomy. 1
- Laparoscopy. 1
- D & C & E&C 1
- Hystrosalipingiography 1

Second Exam 1

Pelvic pain;
Pelvic Inflammatory Disease. 2

Infertility:
- Causes & Investigations. 2
- Counseling & Rx Options. 1

Sexual Transmitted Diseases:

- Bacterial Vaginosis. 1
- Candida albicans.

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- Trichomonas vaginalis. 1
- Syphilis. 1
- Herpes Genitalis. 1
- HIV & AIDS. 1
- Gonorrhea. 1
- Human papillomavirus. 1
- Cytomegalovirus. 1
- Hepatitis B virus. 1
- Chlamydia. 1
- Scabies. 1
- Molluscum- (contagiousum virus) M. C 1
1

Final Exam

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 State of Palestine

Ministry of Health

Ibn Sina College For Health Sciences

GYNECOLOGY

5 credit hours

Course Syllabus

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 Menstrual disorders: - Discussion -Review
1. Menorrhagea: - Lecture -Quiz
- Define menorrhagea - Definition - Black board
- Illustrate the causes of Menorrhagea - Etiology: - Anatomic lesion - Case studies
- Inflammatory process - Transparencie
- Dyscrasias s
- Systemic diseases
- Carcinoma
- Hormonal change.
- Identify the diagnosis test used in - Diagnosis
Menorrhagea - Management
- Determine the management of Menorrhagea - Depend on causes
according to the cause. -Midwife role:
- Care
- Give teaching and counseling according to - Teaching and counseling
women's condition.

- Define Metrorhagea 2. Metrorrhagea:

- Understand causes of Metrorhagea - Definition
- Identify the diagnostic investigation used to - Causes
confirm metorrhages - Investigation
- Management
- Care for women with Metrorhagea. -Medical or surgical (deepen on
causes)
- Midwife role: - Care
- Teaching and counseling

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 3. Amenorrhea
- Define amenorrhea - Definition
- Define primary and secondary amenorrhea. - Types – 1- Primary
- Illustrate the causes of each type 2- Secondary
- List sign and symptoms of each type - Causes of each type
- List the diagnostic investigation - Sign and symptoms of each type
- Differentiate between amenorrhea and other - Investigation
diseases - Differential diagnosis
- Understand the surgical and medical - Management
treatment used in primary and secondary - Surgical - Medical
amenorrhea - Midwife role in
- Care for women with amenorrhea - Care (intervention)
- Support woman and decrease level of anxiety - Teaching and supportive

- Define meaning of breast cancer

- List risk factors of breast cancer Breast cancer
- Classify the type of breast cancer - Definition - Lecture - Review
- Arrange stage breast cancer - Risk factors - Discussion - Quiz
- List singe and symptoms of cancer - Classification - Picture - Redemonstr-
- Define SBE and it's important - Stages - Transparencie ation
- Demonstrate SBE - Signs and symptoms s
- Define mammogram - Self breast exam (SBE) - Model
- List advantages and disadvantages of - Technique - Demonstratio
mammogram - Finding n
- Define meaning of biopsy - Definition, Advantages, Indications, - Film
- List advantage and disadvantage of Biopsy Complications of: - Mammogram
- Illustrate treatment methods of cancer - Biopsy
- List the prevention methods of breast cancer - Management – Surgery
- Be familiar with midwife role in teaching & - Prevention methods
counseling - Teaching and counseling
- Discuss the indication for mammogram and
biopsy
- List the complication for mammogram &biopsy.

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- Define valual cancer Malignant disease of vulva
- List the causative agent - Definition - Review
- Recognize type pf valuate cancer - Causative agent - Lecture
- Distinguish between each type according to - Types - Discussion
clinical finding - Clinical finding & laboratory finding
- Illustrate the factors that affect the prognosis of - Treatment – 1- Surgical
valual cancer 2- Non surgical
- Understand treatment method - Prognostic factors
- Describe the action of midwife in order to care - Midwife role in care, support and teaching
for, and teach women with vulva cancer

Vagina - Review
1) Rectocele - Lecture
- Define rectocele - Definition - Discussion
- Name the risk factors of rectocele - Risk factors
- List the singe and symptoms of rectocyle - Clinical manifestation
- Explain the degree of rectocyle - Degree
- Examine women with rectocyle - Diagnosis
- Protect women from farther complication - Complication
- Recognize the surgical and non-surgical - Management
treatment - Surgical and non-surgical treatment
- Teach patient about self-care, diet pessary - Midwifery role
used and kegel exercise - Diet - Pessary
- Kegels exercise - Patient aducation

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 2) Cystocele - Review
- Define cystocele - Definition - Lecture - Quiz
- Specify people who are at risk - Risk factors - Discussion
- Explain the pathophysiology of cystocele - Incidence - Demonstration
- List singe and symptoms of cystocele - Pathophysiology
- Describe procedure used to diagnosis - Clinical manifestation
cystocele - Degree of cystocele
- Diagnosis
- List complication of cystocele - Complication
- Illustrate the surgical & non surgical treatment - Treatment: - Surgical
- Non surgical: - Kegels exercise
- Teach women how to use peccary - Pessary
- Demonstrate kegels exercise with patient - Estrogen
- Discuss the steps tube taken in order to prevent - Teaching and counseling
further complication. - Self _ care
- Discuss with women how to care for herself - Prevention of complication

- Define urinary incontinence 3) Urinary incontinence

- Categorize urinary incontinence - Definition
- Name incidence of urinary incontinence - Categories
- Incidence - Review
- List the main cause and risk factors of urinary - Etiology - Lecture
incontinence - Risk factor - Discussion
- Illustrate procedure used to diagnose urinary - Clinical manifestation
incontinence - Diagnosis
- List complication - Complication
- Advice patient regarding dietary management - Management
- Explain the medical and surgical management - Medical management
- Discuss with women about personal hygiene - Dietary management
- Support women and decrease level of anxiety - Surgical management
- Midwife management:
- Die - Hygiene - Peccary -Supportive

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 Cervix
- Draw anatomy of the cervix 1) Cervical cancer
- Explain the pathophysiology of cervical cancer - Introduction
- List types of cervical cancer - Pathology
- Types of cervical cancer
- Squamous cell carcinoma
- List the most common singes and symptoms - Adenocarcinoma
- Specify people who are at risk - Sarcoma
- Demonstrate pap smear on model - Melanoma
- Name advantages and disadvantage of cone - Metastasic cancer - Review
biopsy - Signs and symptoms - Lecture
- Illustrate method of treatment - Differential diagnosis - Discussion
- Educe pt anxiety and dissatisfaction - Risk factors
- Teach pt about self - Screening - Pap smears - Colposcopy
_ care and how to prevent father complication - Cone biopsy
- Prevention and teaching

Uterus
- Understand the origin development of uterus Uterine congenital anomalies - Review
- Classify types of uterus abnormalities - Origin of uterus - Lecture - Quiz
- Write singe and symptoms of each types - Prevalence of abnormalities - Discussion
- Explain the pregnancy out come for each type - Classification, Definition , - Demonstration
of abnormalities Signs & symptoms:
- List the most common complication - Septet uterus
- Recognize surgical management for each type. - Bicornuat uterus
- Diclelphys uterus
- T_ Shaped uterus
- Absent or unicornuate uterus
- Pregnancy out comes
- Complication
- Treatment
- Surgical - Teaching

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- Define Myomas Uterine fibroid (Myomas) - Review
- List type of Myomas - Definition - Lecture - Feed back
- Type - Discussion
- Interstitial.
- Submucosal
- Subserosal
- Intraligamentous
- Pedunculated
- Compare between each type according to - Clinical presentation
clinical presentation. - Complication
- Specify the complication of Myomas - Differential diagnosis
- Distinguish between Myomas and others - Management - Data collection
differential women with Myomas - Intervention
- Care for women with Myomas. - Counseling & teaching
- Medical treatment

Hysterectomy - Review
- Define hysterectomy - Definition - Lecture - Question
- List types of hysterectomy - Classification - Discussion - Presentation
- Abdominal
- Vaginal
- Specify indication for each type - Indication for each type
- List contraindication - Contraindication each type
- Identify the advantages and disadvantages of - Advantages and disadvantage for
each type each type
- Care for women with hysterectomy - Pre operative role in teaching and
- Teach women about the outcome of counseling
hysterectomy.

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 Laparoscopy - Lecture - Review
- Define laproscopy - Definition - Discussion - Question
- List indication and contraindication for - Indication and contraindication - Presentation
laproscopy - Complication - 2nd exam
- Prepare women for laproscopy - Preoperative and postoperative care
- Care for women with laproscopy

-List indication for D and C Dilatation & Curettage (D&C)

-Illustrate the complication - Definition
- Teach women about the care after the - Indication and contraindication
procedure. - Complication
- Teaching and counseling

Ovaries and tubes - Lecture - Review

1. Ovarian cancer - Discussion - Question
- Review anatomy of ovary and tube - Introduction Transparencies - Feed back
- Recognize people who are at risk - Risk factors
- List classification of ovarian cancer - Classifications:
-Epithelial tumors
-Germ cell tumors
-Stormal tumors
- Illustrate staging of ovarian cancer - Staging
- List signs and symptoms - Symptoms
- Name metastasis methods - Metastasis method
-Peritoneal fluid
-Direct invasion
-Lymphatic
-Venous system
- Management
-History
- Examine women with ovarian cancer -Physical examination

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- Determine lab test done for detecting of -Laboratory test
ovarian cancer - Treatment
- Illustrate treatment method for ovarian cancer -Surgical
-Radiation examination
-Laboratory
-Biologic therapy
- Determine the preventive way to decrease - Prevention methods
incidence of ovarian cancer - Teaching and supportive care
- Teach women about possible out comes of
ovarian concern 2. Ovarian Tumor
- Support patient and decreases level of anxiety. - Definition of benign tumors
- Causes of enlargement in ovary
- Non neoplastic lesions of the ovary
- Functional ovarian cyst. - Lecture - Review
- Define benign tumors - Follicular cyst - Discussion - Question for
- Recognize the cause of enlargement n ovary - Corpus luteum cyst feed back
- List the type of non nepotistic lesions. - Poly cystic ovaries
- Theca_lute in cyst
- Hypersreactio lute in alis luteoma
- Neoplastic ovarian tumors
1. Ovarian tumors of surface
epithelial cell origin
- List the type of neopotistic ovarian tumors - Serious tumors
- Mucinous tumors
- Endometrial tumors
- Brenners tumors
2. Ovarian tumors of stromal cell
origin gonadal stromal tumors:
- Granulosa all tumors
- Fiber the coma
- Sertoli_leydig cell tumors
- Hillus cell tumors
- Gynadro blastoma

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 3. Ovarian tumors of germ cell origin
- Teratoma
- Gonado blastoma
- Dysgerminoma
- Yolk savor endo dermal sinus
tumor
- Teaching and counseling

3. Pelvic inflammatory disease (PID)

- Definition
- Teach mother about self care - Etiology
- Signs and symptoms
- Diagnosis - Feed back
- Define PID - Lecture
- List the etiological factor of PID - Discussion
- Recognize the signs and symptoms of PID 4. Hysterosalipingograph Transparencies
- Recognize diagnosis methods of PID - Definition - Pictures
- Contract medium
- Technique - Quiz
- Advantages and disadvantages
- Define hystersalpingograph - Therapeutic aspects
- Recognize contract medium
- Understand the technique of PID
- Know the advantages and disadvantages of
hysterosalipingograph
- Explain therapeutic aspects of
hysterosalipingograph

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- Define bacterial vaginosis Sexual transmitted diseases - Lecture - Review for
- List the causes of BV. 1. Bacterial Vaginosis - Discussion presentation
- Diagnose BV according to clinical presentation - Definition
- Distinguish BV from others differential - Causes
diagnosis - Clinical presentation
- Identify with medical management for BV - Differential diagnoses
- Explain the laboratory test needed to detect - Management
BV -Data collection
- Teach women about self care regarding BV. -Laboratory testing
-Medical treatment
-Teaching and counseling

- Define Candida 2. Candida: - Lecture - Question for

- Identify the main causes of Candida - Definition - Pictures feed back
- List the predisposing factors for Candida - Etiology - Discussion
- Predisposing factors Transparencies
- Name the differential diagnosis with Candida. - Clinical presentation
- Differential diagnoses
- Management
- History
- Analyze lab rotary finding regarding Candida - Laboratory testing
- Discuss Candida medical treatment, - Treatment regimens
-Advice women regarding health care to prevent - Treatment for recurrent
complication - Teaching and counseling

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 - Lecture - Review
- Define trichomonas 3. Trichomonas - Discussion - Quiz
- Identify the course of trichomonas - Definition
- Name way of transmission - Etiology
- Way of transmission:
- Direct
- Examine women complaining of trichomonas - Indirect
- Clinical presentation
- Management
-History
-Physical examination
- Illustrate midwife role in teaching and -Laboratory testing
counseling. -Treatment
- Teaching and counseling
- Lecture
- Black Board - Review for
- Define gonorrhea. 4. Gonorrhea - Discussion presentation
- Determine the causes of gonorrhea - Definition Transparencies
- List ways of transmission - Etiology and transmission
- List common complication for gonorrhea - Clinical presentation
- Collect data regarding gonorrhea - Complication
- Analyze laboratory finding regarding - Differential diagnoses
gonorrhea. - Management
- Guide women regarding personal hygiene and -History
health care. -Laboratory testing
-Treatment
- Teaching and counseling

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 - Lecture - Review
- Define Syphilis 5. Syphilis - Discussion - Question for
- Illustrate causes of syphilis - Definition presentation
- Write way of transmission. - Etiology and transmission
- List types of Syphilis - Clinical presentation
- Types
- Primary syphilis
- Secondary syphilis
- Latent syphilis
- Compare between each type - Tertiary syphilis
- Distinguish between syphilis and other - Differential diagnoses
diseases - Management
- Care for women with syphilis - Data collection
- Advice women regarding follow up care. - Laboratory testing
- Treatment
- Follow-up teaching

- Lecture
- Define herpes genitalis 6. Herpes genitals: - Discussion - Review
- List causes and risk factors of herpes genitals. - Definition - Question for
- Specify way of transmission - Etiology and transmission presentation
- Differentiate between primary and recurrent - Risk factors
herpes genitals - Clinical presentation
- Primary episodes
- List complication - Recurrent episodes
- Identify the differential diagnosis - Complications
- Advice women to prevent complication - Differential diagnoses
- Illustrate midwife role in teaching and self care. - Management
- Data collection
- Laboratory testing
- Treatment
- Teaching and self-help measures

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 - Discussion
- Define AIDS 7. HIV and AIDS Transparencies
- Identify etiology of AIDS - Definition - Explanati
- List way of transmission - Etiology on
- Determine people who are at risk - Transmission
- Illustrate the pathology of AIDS - Risk factors
- Specify the clinical presentation of AIDS - Pathology
- Explain the laboratory test - Clinical presentation
- Identify the treatment if AIDS - Screening and diagnosis
- Illustrate midwife role to prevent transmission - Complications
of AIDS in community and health team - Management
- Illustrate the effect of Aids on pregnancy and - Physical examination
fetus - Laboratory testing
- Care for patient with Aids - Treatment
- Teaching and counseling
- Effect on fetus and pregnant
women
- Prevention
- Define Infertility
- List types of infertility Infertility:
- Definition -Programmed - Feed back
- Types: Lecture - Questions
- Primary - Pictures - Evaluation
- Identify causes of female and male infertility - Secondary - Discussion of role play
- Causes: - Brain
- Female infertility: Storming
1. Unexplained
2. Failure of ovulation
3. Tubal damage
4. Endometriosis
5. Irregular cycle (an ovulation)
6. Coital failure
7. Uterine and cervix factors

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- Recognize diagnostic tests for female and
male infertility.
- Discuss different approaches of infertility
management.
- List complications that may occur during
management.
- Discuss psychological effects of infertility and
it's treatment.
- Discuss some ethical issues related to
infertility and It's treatment.
Ran
- Male infertility:
1. Environmental
2. Sperm disorder or deficit.
- Diagnosis:
- History of both couples
- Physical Exam of both couples
- Lab tests:
- Cervical Cultures
- Endocrine testing
- Blood test
- Ovulation assessment
- Post coital test
- Semen Evaluation
- Fallopian tubes
assessment.
- Management:
- Infertility counseling
- Ovulation induction
- Assisted
Reproductive
- Technology (ART)
- IVF, Gift, ZIFT.
- Ovum & Sperm
Donation
- Complications of assisted reproductive
pregnancies
- Psychological effects of infertility and
ART
- Bio ethical & Legal Issues.
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