Core Curriculum: CiP 12

Manages pre-existing medical conditions in the pregnant woman

• Demonstrates the ability to provide preconceptual advice to women and sensitively discuss risks during pregnancy to create tailored management plans with liaison with other specialties where appropriate.
• Identifies, assesses and manages pre-existing medical conditions in the pregnant or postnatal woman.
• Understands the impact of pregnancy on disease and of disease on pregnancy.
• Formulates appropriate and individualised management plans for pregnancy, birth and the postnatal period in consultation with other specialties and obstetric anaesthesia.
• Prescribes safely and understands the challenge of safe prescribing in pregnancy, making changes to medications where necessary.

Manages medical conditions arising in pregnancy

• Demonstrates the ability to recognise when conditions related to pregnancy develop.
• Demonstrates the ability to perform a focused history and undertake an appropriate physical examination of the pregnant patient taking into account the physiological and anatomical changes of pregnancy.
• Identifies, assesses and manages pregnancy-specific conditions, and considers the impact on both maternal and fetal health.
• Demonstrates the ability to order and interpret appropriate investigations to monitor conditions during pregnancy.
• Formulates appropriate and tailored management plans for pregnancy and birth.
• Prescribes medications and antimicrobials appropriately in line with the latest evidence and reviews and monitors therapeutic interventions.

Manages fetal concerns

• Demonstrates ability to perform focused history appropriate examination and order clinically indicated investigation.
• Facilitates timely and appropriate investigation, management and referral to tertiary centres if required.
• Demonstrates knowledge and ability to work within local clinically managed networks.
• Demonstrates ability to discuss concerns and clinical uncertainties in a sensitive manner. 
• Formulates appropriate and individualised management plans for pregnancy and birth.

Manages mental health conditions in pregnancy and the postnatal period

• Demonstrates ability to effectively and sensitively screen for mental health concerns arising in pregnant people.
• Demonstrates ability to formulate the initial diagnosis and management of mental health conditions with appropriate liaison and involvement of mental health services.
• Manages perinatal mental health emergencies in the antenatal and postnatal period effectively.
• Understands the impact that birth, birth trauma and adverse outcomes may have on future mental health and is able to signpost women and their families to support services.

Manages complications in pregnancy affected by lifestyle

• Understands the significant impact that lifestyle factors may have on maternal and fetal health.
• Demonstrates ability to perform a focused history, appropriate examination and to order clinically indicated investigations.
• Sensitively enquires about lifestyle factors to facilitate disclosure.
• Understands and demonstrates ability to manage pregnancies where lifestyle factors cause complications.
• Formulates appropriate individualised management plans for pregnancy, birth and the postnatal period.
• Uses support services appropriately according to local provision and taking into account the wishes of the woman and the needs of the fetus/neonate.

Supports antenatal decision making

• Identifies risk factors relating to previous pregnancy outcomes.
• Effectively estimates risks to advise and inform decision making for individuals and their families.
• Formulates appropriate and individualised management plans for pregnancy and birth.

Manages the postnatal period

• Manages a postnatal consultation.
• Demonstrates ability to sensitively debrief women and their families after an unexpected birth experience or when a baby is admitted to the neonatal unit.
• Advises on the impact of events in this pregnancy on future health and pregnancies.
• Demonstrates ability to discuss and advise on postnatal contraception and administer/fit different contraceptive methods
• Uses support services appropriately according to local provision, taking into account the wishes of the woman and her family.
• Ensures effective handover and discharge to primary care.