118 Pregnancy

Question 1

How many weeks is classed as ‘term’?

Answer 1

37-42

Question 2

At how many weeks can the foetal heart rate be heard by a doppler?

Answer 2

12

Question 3

What is the normal position of the baby’s head when palpated in vaginal examination + what is the diameter?

Answer 3

Direct occipito anterior

9.5cm

Question 4

What part of the baby’s head is being felt in relation to the ischeal spines when palpating the station of the baby’s head?

Answer 4

Parietal eminences

Question 5

What is ‘effacement’ of the cervix?

Answer 5

Incorporation of the cervical canal into the lower uterine segment

Question 6

What stage of labour does cervical effacement occur?

Answer 6

Phase 1 - throughout the latent phase

Question 7

Describe the steps in the delivery of the baby

Answer 7

1. Extension of the head through the birth canal
2. Restitution to allow delivery of the shoulders
3. Baby born by lateral flexion as the anterior shoulder slips under the pubic bone

Question 8

What is the Brandt-Andrews manouevre?

Answer 8

Controlled cord traction when the placenta is being delivered

Question 9

What is operculum?

Answer 9

Blood stained mucous discharge

Question 10

What is syntocinon and why is it given?

Answer 10

Synthetic oxytocin and octapeptide - causes rhythmical contractions of the uterus during labour

Question 11

What effect does IV ergometrine have on labour?

Answer 11

Produces more sustained uterine contractions

Question 12

When is syntometrine given during labour?

Answer 12

• Injected into the cervix when the anterior shoulder is at the pubic bone
• Reduces the risk of post-partem haemorrhage and to detatch the placenta

Question 13

What is the APGAR score used for?

Answer 13

To assess the newborn post-delivery

• Appearance
• Pulse
• Grimace
• Activity
• Respiration

Question 14

What is placenta praevia?

Answer 14

When the placenta is situated partially/fully over the lower uterine segment

Question 15

Why is IOL indicated in prolonged pregnancy?

Answer 15

If pregancy >42 weeks - risk of uteroplacental insufficiency and increased risk of perinatal mortality

Question 16

What are the tests in the quadruple test antenatally?

Answer 16

• inhibin AA
• AFP
• nCH
• unconjugated oestriol

Question 17

Which type of anaemia is most common during pregnancy?

Answer 17

Iron deficient

Question 18

Name 3 causes of bleeding during pregnancy

Answer 18

• threatened miscarriage
• placenta preavia
• placental abruption
• ectropian

Question 19

What is cervical ectropion?

Answer 19

• When there are endocervical columnar epithelium present on the vaginal portion of the cervix
• metaplasia from columnar to stratified squamous

Question 20

Where are VTEs most commonly found in pregnant women?

Answer 20

• Proximally in the left leg
• increased pressure intra-abdominally (slight compression of the L iliac vein as it crosses the iliac artery)
• venous stasis

Question 21

Name a complication to the newborn of maternal diabetes in pregnancy

Answer 21

Macrosomia causing shoulder dystocia

Question 22

Which condition during pregnancy shows the following:

• pruritis
• no rash
• derranged liver function

Answer 22

Obstetric cholestasis

Question 23

Why is vitamin K given to newborns shortly after delivery?

Answer 23

• VItamin K is important for clotting and clotting factors in newborns is 30-60% of adults
• risk of bleeding if not received
• risk of brain damage, stroke etc