AJGP Clinical Challenge July 2018: Women's health

To provide guidance for the general practitioner on current guidelines for cervical cancer screening, HPV vaccination and issues relating to pregnancy.

Relevance to General Practice

The July issue of AJGP highlights two important aspects of women’s reproductive health: cervical cancer prevention and pregnancy care. Screening for cervical cancer has undergone a major change and new Australian guidelines were released in 2017. Given that cervical cancer screening is undertaken in general practice, it is essential that GPs are aware of the new screening guidelines and updates to HPV vaccination schedules.
The incidence of recurrent miscarriage was found to have almost doubled between 2003 and 2012. A similar increase in the incidence of gestational diabetes (GDM) has also occurred. It is now recognised that optimising the health of both men and women prior to conception improves health outcomes for the child. General practice is the first point of contact for women who are pregnant or planning a pregnancy. It is essential, therefore that GPs are aware of the recommendations for optimising care before and during pregnancy.

Learning outcomes

List the different human papillomavirus (HPV) nucleic acid testing assays that satisfy the requirements for use in Australia

Discuss the rationale for the use of the nonavalent HPV vaccine, expected outcomes and updated dose scheduling requirements for HPV vaccines

Discuss the evidence for preconception care and strategies to increase primary care access

Describe the assessment and management of pelvic girdle pain in pregnancy

Summarise the aetiology, investigations and management of recurrent pregnancy loss, outline the diagnosis and management of gestational diabetes mellitus

Domains of General Practice

D1. Communication skills and the patient-doctor relationship

Ways in which health can be optimised and maintained are communicated to patients, family members and carers

D2. Applied professional knowledge and skills

Diagnosis and management is evidence-based and relevant to the needs of the patient

D3. Population health and the context of general practice

The patterns and prevalence of disease are incorporated into screening and management practices

D4. Professional and ethical role

Professional knowledge and skills are reviewed and developed

D5. Organisational and legal dimensions

Curriculum Contextual Units

Women's health
Sexual and reproductive health