4th Year Obstetrics Additions

Question 1

define uterine hyperstimulation

Answer 1

> 5 contractions in 10 minutes

Question 2

management of uterine hyperstimulation

Answer 2

tocolytics e.g. nifedipine or atosiban

Question 3

what is pre-term pre-labour rupture of membranes (PPROM)

Answer 3

breakage of the amniotic sac before the onset of labour

Question 4

causes of PPROM

Answer 4

infection
cervical incompetence
over-distension of uterus
abruption

Question 5

diagnosis of PPROM

Answer 5

speculum
USS (oligohydramnios)
avoid vaginal examination as risks infection

Question 6

management of PPROM

Answer 6

admission
delivery if >34 weeks
erythromycin

Question 7

red flags in perinatal psych

Answer 7

1. recent significant change
2. new thoughts or acts of self-harm
3. expression of incompetence/ estrangement

Question 8

what is telogen effluvium?

Answer 8

hair loss after pregnancy

Question 9

rashes during pregnancy

Answer 9

prurigo of pregnancy
polymorphous eruption of pregnancy
pemphigoid gestationitis

Question 10

what gestation can CTG be used?

Answer 10

from 26 weeks

Question 11

when can FBS (foetal blood sampling) be done?

Answer 11

from 34 weeks

Question 12

indications in the mother to do CTG?

Answer 12

bleeding

raised HR, BP or temp

Question 13

baseline HR in CTG

Answer 13

110-160bpm

Question 14

when does variability indicate hypoxia?

Answer 14

prolonged >50 minutes of reduced or increased indicates hypoxia

absence is serious (<2bpm)

Question 15

when is variability reduction normal?

Answer 15

quiet sleep (if >40 minutes then worrying)

Question 16

what does a sinusoidal pattern on CTG indicate?

Answer 16

severe foetal anaemia

risks hydrops foetlias

Question 17

what is hydrops foetalis?

Answer 17

accumulation of fluid in at least 2 compartments

Question 18

define acceleration

Answer 18

increase above baseline by 15bpm for at least 15 seconds

Question 19

what are accelerations a sign of?

Answer 19

usually good

Question 20

what does absence of accelerations indicate?

Answer 20

quiet sleep
maternal medications
saving energy due to hypoxia

Question 21

define deceleration

Answer 21

drop from baseline by >15bpm for >15 seonds

Question 22

classification of decelerations

Answer 22

1. early= start of contraction (benign)

2. late= foetal acidosis

Question 23

define PET

Answer 23

disorder of the placenta where there is failure of trophoblast invasion within spiral arteries which leads to uroplacental ischaemia and widespread endothelial dysfunction

Question 24

indications for IOL

Answer 24

post-maturity
PROM
suspected IUGR
obstetric cholestasis
GDM
PET
maternal request

Question 25

medical IOL

Answer 25

vaginal prostaglandins (PGE2)
oxytocin infusion

Question 26

surgical IOL

Answer 26

membrane sweep
amniotomy (artificial rupture of membranes)
cervical balloon

Question 27

what does ovarian hyperstimulation syndrome risk?

Answer 27

capillary permeabiliy > ascites, pleural effusion, renal and resp failure

Question 28

indications for CTG monitoring in labour

Answer 28

pre-term
meconium-stained liquor
decelerations
IUGR
oxytocinon use