O&G Cases · Antenatal care — medical disorders of pregnancy
Severe ICP at 35 weeks — communication and management station
Communication station: counselling a woman with severe ICP on the rationale for expedited delivery, the limits of CTG surveillance, the UDCA evidence, and her partner's concerns. Includes assessor key and marking domains.
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Format. Communication and management station, approximately 12 minutes. You are the obstetric registrar on the antenatal ward. The midwife has briefed the woman but she has questions; the partner is visibly upset. The assessor plays the woman and partner.[1]
Candidate instruction. Counsel the woman on the diagnosis, the rationale for expedited delivery, the limits of CTG surveillance, the UDCA evidence, and address her partner's concerns. Obtain consent for induction tomorrow. Demonstrate empathy, plain language, and structured information.[11]
References3ShowHide
- [1]Ovadia C, Seed PT, Sklavounos A, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses Lancet, 2019.PMID 30773280
- [2]Chappell LC, Bell JL, Smith A, et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial Lancet, 2019.PMID 31378395
- [11]Westbrook RH, Dusheiko G, Williamson C Pregnancy and liver disease J Hepatol, 2016.PMID 26658682