Antenatal Care

Question 1

Risk factors for placental abruption

Answer 1

Previous Abruption, PET, FGR, PPROM, intrauterine infection, advanced maternal age, low BMI, smoking/drug use, non vertex presentation, multiparty, polyhydramnios, abdo trauma, assisted reproduction

Question 2

Risk factors for Placenta Praevia

Answer 2

Previous, previous CS, >40yrs, smoking, precious TOP, multiparty, multiple pregnancy, assisted contraception, endometrium (uterine scar, endometritis, MROP, curettage, submucuos fibroid)

Question 3

APH complications - Maternal

Answer 3

Anaemia, shock, consumptive coagulopathy, infection, renal tubular necrosis, PPH, prolonged hosp stay, psych, transfusion complications

Question 4

APH complications - Foetal

Answer 4

Hypoxia, SGA/FGR, prematurity, death

Question 5

Additional risk of miscarriage with amnio/CVS

Answer 5

Singleton 0.5%
Twin 1%

Question 6

When to perform amnio or CVS

Answer 6

Amnio >15 weeks
CVS 10-14+6 Ideally >11wks

Question 7

Comparative risks of amnio and CVS

Answer 7

Blood stained sample A-0.8% C-0
Confined placental mosaic A-0 C<2%
Maternal cell contamin both 1-2%
Rapid test failure 2%
Failed cell culture 0.5-1%

Question 8

Amnio in 3rd trimester risks

Answer 8

<37/40 labour 4-8%
<34/40 labour 3-4%
Need for 1+ needles 5%
Blood stained samples 5-10%
Culture failure 9.7%

Question 9

Most common organisms in Bacterial sepsis

Answer 9

Group A Strep
E.coli
Mixed
Urinary sepsis - coliform

Question 10

What organism may require IVIG in bact sepsis

Answer 10

If other treatments failed
IVIG for invasive Strep/Staph
Neutralises effect of exotoxins

Question 11

Anaemia in pregnancy (Hb levels)

Answer 11

1st trimester <110
2/3rd tri <105
Postpartum <100

Question 12

When to use cell salvage

Answer 12

Expected anaemia or
> 20% blood loss expected