6. Obs and Gyn TOP 5 Flashcards
1
Q
Top 5 physiological changes in normal pregnancy.
A
- CARDIAC; stroke volume increases, slight HR increase, CO increase.
- RESP; RR unchanged, tidal volume increases.
- ENDOCRINE; increased thyroxine demand due to fetal use and also urine losses.
- HAEM; increased clotting factors. Also increased iron consumption, increased plasma and therefore iron deficiency anaemia.
- GI; delayed gastric emptying. Reduced peristalsis causing constipation.
2
Q
Top 5 maternal labour ward emergencies.
A
APH
PPH
Eclampsia
Maternal collapse
Uterine inversion
3
Q
Top 5 fetal labour ward emergencies.
A
Shoulder dystocia
Cord prolapse
Fetal distress i.e. hypoxia, acidosis
Malpresentation
Failed operative delivery
4
Q
The definition of antepartum haemorrhage is ‘bleeding from the vaginal tract after 24 weeks of pregnancy until completion of the second stage of labour’. What are the top 5 causes of APH?
A
- Uteroplacental; placental abruption, placenta praevia, uterine rupture
- Cervical lesions
- Vaginal infections
- Vasa praevia (fetal bleeding)
- Unexplained
5
Q
Top 5 causes of PPH.
A
- aTonic; failure of uterus to contract post delivery.
- Trauma; perineal or vaginal wall tear, cervical tear, broad ligament tear can occur during CS.
- Tissue; retained placenta
- Thrombin; clotting factor deficiencies can precede PPH, or be due to PPH.
- uTerine inversion; prolapse of uterus through vagina causes severe maternal shock.
6
Q
Top 5 risk factors for PPH.
A
- Uterine distension e.g. macrosomia, multiple pregnancy, polyhydramnios.
- Prolonged labour +/or operative delivery
- Fibroids
- Grand multiparity
- APH
7
Q
Top 5 fetal complications of shoulder dystocia.
A
- fetal hypoxia
- fetal death
- brachial plexus injury
- fractured clavicle
- fractured humerus
8
Q
Top 5 maternal complications of shoulder dystocia.
A
- 3rd/4th degree perineal tear
- PPH
- Uterine rupture
- Rectovaginal fistula
- Symphyseal separation and associated neuropathy
9
Q
A
