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CP2 OBGYN > ANC > Flashcards

ANC Flashcards

1
Q

How many conceptions per year int he UK?

A

850,000

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2
Q

Which is the only age group not to decreased in conception rates?

A

> 40 y/o

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3
Q

How many abortions in the UK per year?

A

200,000

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4
Q

Which vitamin should you not take too much of?

A

Vit A

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5
Q

How many mg of folic acid should you take. When should you start and stop taking it?

A

400ug
Every day before your pregnant
Until you’re 12 weeks pregnant

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6
Q

6 reasons to take a higher dose folic acid

A 
You/your babys father has NTD
You/your babys father have FHx NTD
You have DM 
You've had previous pregnancy affected by NTD
You take anti-epilepsy meds 
You take ARV Dx for HIV
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7
Q

Which other vits/mins should you take/include in your diet pre-conceptually?

A

Vit D
Iron
Vit C
Calcium

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8
Q

What is the Healthy start scheme?

A

Provides vouchers to pregnant women + families

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9
Q

When does the Booking Screen take place?

A

Before 10 weeks

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10
Q

Who does the Booking Screen?

A

The midwife

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11
Q

What is the aim of the Booking Screen?

A

To ID any RF that might indicate need for > surveillance

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12
Q

Components of examination in The Booking Screen

A

W + h –> BMI
BP
Urinalysis
Palpating uterine size abdominally

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13
Q

Investigations undertaken in the Booking Screen (7)

A 
FBC
Haemoglobin electrophoresis 
Blood group + ab screen 
Antibody screen 
Screening for BBV
CO
USS
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14
Q

Which component of FBC is normally raised in pregnancy?

A

Neutrophils

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15
Q

What 2 components of FBC are we most interested in @ Booking screen?

A

Anaemia/Hb

Platelets

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16
Q

What could a rising antibody titrate at booking indicate?

A

Fetal anaemia

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17
Q

What 4 BBV are routinely screened for @ Booking?

A

Rubella
Syphilis
Hep B
HIV

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18
Q

What can high CO levels –>

A

Small baby

Cot death

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19
Q

What is the USS at booking looking at?

A

Fetal viability
Gestational age
ID/exclude multip
Nuchal translucency

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20
Q

How to estimate due date?

A

Add 9 months + 7 days to 1st day of LMP

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21
Q

Advise on exercise in pregnancy?

A

Safe to continue but easier to strain a mm because of increased progesterone levels

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22
Q

How to wear seatbelts in pregnancy?

A

Above/below month

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23
Q 
Why avoid these foods in pregnancy?
Soft cheese
Unpasteurized milk + cheese 
Uncooked fish 
Chill-cook meals
A

Listeria –> miscarriage or stillbirth

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24
Q

Why avoid these foods in pregnancy?
Unwashed fruit/veg/salad
Raw/rare meat
Unpasteurized milk

A

Toxoplasma –> miscarriage, still birth or LT disability

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25
Q

Why avoid these foods in pregnancy?
Shellfish
Uncooked egg

A

Salmonella/food poisoning –> ppt premature labour

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26
Q

Define antepartum haemorrhage

A

Bleeding from genital tract after 24 weeks gestation

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27
Q

Common causes APH (3)

A

Undetermined origin
Placental abruption
Placenta praevia

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28
Q

Rarer causes APH (3)

A

Incidental genital tract pathology
Uterine rupture
Vasa praevia

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29
Q

Prevalence placenta praevia

A

0.4%

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30
Q

Define placenta praevia

A

Where the placenta is fully/partially implanted in the lower uterine segment

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31
Q

What are the 2 main types of placenta praevia?

A

Minor placenta praevia

Major placenta praevia

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32
Q

What is minor placenta praevia?

A

Placenta is low, doesn’t cover internal os

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33
Q

What is major placenta praevia?

A

Placenta lies over internal os

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34
Q

Risk factors for placenta praevia (7)

A 
Previous C section 
High parity 
Maternal age >40 
Multiple pregnancy 
Prev placenta praevia 
Hx uterine infection 
Curettage to endometrium after miscarriage/termination
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35
Q

Clinical features placenta praevia

A

intermittent painless vaginal bleeding

Uterus usually not tender on palpation

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36
Q

Baby on examination in placenta praevia?

A

Baby often in breech + transverse lie

Foetal head high + not engaged

37
Q

What must you NOT do in placenta praevia

A

Perform a VE

38
Q

What is placenta accreta

A

If placenta implants in previous C section scar

39
Q

What is placenta percreta

A

If placenta penetrates uterine wall into surrounding structures e.g. bladder

40
Q

What investigations would you do for placenta praevia?

Which is for definite diagnosis?

A

USS ** definite diagnosis
CTG
FBC, clotting, cross-match, G+S

41
Q

Management P.praevia

A 
A-E 
Scan @20W 
If minor - repeat @ 36W
If major - repeat @32W 
If bleeding - Admit 
Steroids if <34weeks 
C-section @ 39W
42
Q

Prevalence placental abruption

A

1%

43
Q

What is placental abruption?

A

Where part/all placenta separates from wall of uterus prematurely

44
Q

What are the 2 main types of placental abruption?

A

Revealed

Concealed

45
Q

What is revealed placental abruption

A

Bleeding –> drains through cervix –> vaginal bleed within uterus –> clot retroplacentally

46
Q

What is concealed placental abruption?

A

Bleeding remains within uterus –> clot retroplacentally. Can still –> systemic shock

47
Q

RF: Age <18 (2)

A

Hypertensive disorders

IUGR

48
Q

RF: Age >38 (4)

A

Fetal chromosomal abnormality
IUGR
Stillbirth after 40 weeks
Hypertensive disorders

49
Q

RF: Weight @ booking - <45kg

A

IUGR

50
Q

RF: Weight @ booking - >100kg (4)

A

Hypertensive disorders
Impaired glucose tolerance
Shoulder dystocia
Thromboembolism

51
Q

RF: Primaparous

A

Pre-eclampsia

52
Q

RF: Grandmultiparous (>4) (5)

A 
Anaemia 
IUGR
Malpresentation 
Unstable lie 
PPH
53
Q

RF: Previous removal placenta (3)

A

Recurrence retained placenta
P. praevia
PPH

54
Q

RF: Previous C-section

A

Placenta praevia

55
Q

RF: Prev baby >4kg

A

Shoulder dystocia

56
Q

RF: Hypertension

A

Hypertensive disorders

57
Q

RF: Insulin dependent DM (6)

A 
Miscarriage 
Stillbirth 
Congenital anomaly 
Macrosomia 
Shoulder dystocia 
Neonatal hypoglycaemia
58
Q

RF: Epilepsy (5)

A 
Cardiac abnormalities 
Palate abnormalities 
NTD
Haemorrhage disease of newborn 
Labile drug levels
59
Q

RF: Thyroid disease (2)

A

Maternal thyroid storm

Neonatal hypo/hyperthyroidism

60
Q

RF: Recurrent UTIs (2)

A

Premature labour

IUGR

61
Q

RF: Psychiatric disorders

A

Acute exacerbation in post natal period

62
Q

RF: Anorexia nervosa

A

IUGR

63
Q

RF: Cone biopsy

A

Cervical incomptency and midtrimester miscarriage

64
Q

RF: Genital herpes

A

Neonatal herpes encephalitis

65
Q

RF: Diabetes

A

Impaired glucose tolerance
Macrosomia
Organomegaly

66
Q

RF: Domestic violence (4)

A

Physical injury
Depression + suicide
Premature labour
IUGR

67
Q

RF: Cigarettes + cannabis (4)

A

IUGR
Neonatal respiratory distress
Cot death
Childhood asthma + ear infections

68
Q

RF: Alcohol - >4 units /day

A

Foetal alcohol syndrome - cardiac defects

69
Q

RF: Alcohol >8 units/day

A

Foetal alcohol syndrome - abruption

70
Q

RF: Cocaine (4)

A

IUGR
Premature labour
Microcephaly
Cot death

71
Q

RF: Amphetamines (3)

A

Palate abnormalities
Cardiac abnormalities
IUGR

72
Q

RF: MDMA

A

MSK + cardiac abnormalities

73
Q

RF: Barbituarates

A

Neonatal withdrawal

74
Q

RF: Smoked heroin (4)

A

Miscarraige
Stillbirth
IUGR
Neonatal withdrawal

75
Q

RF: Injected heroin (3)

A

Hep B
Hep C
HIV

76
Q

RF: Methadone

A

Neonatal withdrawal

77
Q

RF: Assisted conception (3)

A

Multiple pregnancy
Premature labour
IUGR

78
Q

RF: Recurrent antepartum haemorrhage

A

IUGR

79
Q

RF: Multiple pregnancy (7)

A 
Miscarriage 
Chromosomal abnormality 
Hyperemesis 
Premature labour 
Anaemia 
IUGR
PPH
80
Q

RF: Fibroids (2)

A

PPH

Unstable lie/obstructed labour if in lower segment uterus

81
Q

For what reasons would an early pregnancy scan be carried out? (3)

A

If there has been:
Pain
Bleeding
Hyperemesis gravidarum

82
Q

What is the most accurate way to date a pregnancy on USS?

A

C-R length between 6-12w

83
Q

What is the most reliable way after 14 weeks to date a pregnancy?

A

Biparietal diameter

84
Q

What measurements on USS are used to estimate fetal weight?

A

Head circumference

Abdo circumference

85
Q

When is nuchal translucency carried out?

A

11-13 w + 6

86
Q

What may Incr NT reflect?

A

Heart failure

Chromosomal abnormalities

87
Q

When is the anomaly scan undertaken?

A

18-22w

88
Q

What does the anomaly scan involve looking at?

A 
Skull shape
Internal structures 
Abdo, spine, arms legs
Heart 
Face and lip
89
Q

What does the doppler USS measure?

A

Blood flow in uterus, placenta and fetus

CP2 OBGYN (21 decks)

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