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Gaby’s PassMRCOG repeats > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

What action should be taken if a woman presents with reduced fetal movements & no FH can be detected on Doppler?

A

Ultrasound scan

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2
Q

What is the general incidence of GBS disease?

A

0.5 per 1000

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3
Q

At what gestation is ionising radiation most dangerous to the fetus, in terms of FGR?

A

3-10/40

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4
Q

At what gestation is the greatest risk of ionising radiation, in terms of teratogenicity?

A

10-17/40

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5
Q

What are the rates of pregnancy loss with appendicitis in pregnancy?

A

1.5% of simple
6% of peritonitis
36% of perforated

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6
Q

What is the proportion of breech presentations at 28/40?

A

20%

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7
Q

What is the rate of congenital CMV with primary CMV infection in pregnancy?

A

30-40%

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8
Q

What level of spinal cord injury is associated with autonomic dysreflexia?

A

T6 & above

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9
Q

What are the major risk factors for pre-eclampsia?

A
  1. Hypertensive disease in previous pregnancy
  2. Chronic kidney disease
  3. Autoimmune disease
  4. Type 1 or 2 diabetes
  5. Chronic hypertension
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10
Q

What are the moderate risk factors for pre-eclampsia?

A
  1. Primiparity
  2. Age ≥ 40
  3. Pregnancy interval > 10 years
  4. BMI ≥ 35 at 1st visit
  5. Family Hx of PET
  6. Multiple pregnancy
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11
Q

What are the absolute contraindications to ECV?

A
  1. CS required for another reason
  2. APH within last 7 days
  3. Abnormal CTG
  4. Major uterine anomaly
  5. Ruptured membranes
  6. Multiple pregnancy (except 2nd twin)
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12
Q

What are the relative contraindications to ECV?

A
  1. SGA fetus with abnormal Doppler
  2. Pre-eclampsia
  3. Oligohydramnios
  4. Major fetal anomalies
  5. Scarred uterus
  6. Unstable lie
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13
Q

How long can cervical cerclage prolong pregnancy?

A

5 weeks

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14
Q

How should VTE risk be managed in protein S deficiency?

A

Involve haematology

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15
Q

At what gestation should ECV be offered?

A

36/40 nulliparous
37/40 multiparous

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16
Q

What is the rate of worsening of spasticity in pregnancy for patients with spinal cord injury?

A

10-15%

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17
Q

What is the rate of GBS disease if GBS in current pregnancy?

A

2 per 1000

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18
Q

What conditions are associated with low PAPP-A in 1st trimester?

A
  1. Spontaneous miscarriage
  2. Gestational hypertension
  3. Pre-eclampsia
  4. Low birthweight
  5. Preterm delivery
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19
Q

What conditions are associated with low β-hCG in the 1st trimester?

A
  1. Spontaneous miscarriage
  2. Low birthweight
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20
Q

What conditions are associated with raised AFP in the 2nd trimester?

A
  1. Fetal growth restriction
  2. Placental abruption
  3. Fetal demise after 24/40
  4. Preterm delivery
  5. Spontaneous miscarriage
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21
Q

What conditions are associated with raised β-hCG in the 2nd trimester?

A
  1. Preterm delivery
  2. Gestational hypertension
  3. Pre-eclampsia
  4. Fetal demise after 24/40
  5. Fetal growth restriction
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22
Q

What conditions are associated with raised inhibin-A in the 2nd trimester?

A
  1. Preterm delivery
  2. Gestational hypertension
  3. Pre-eclampsia
  4. Fetal demise after 24/40
  5. Fetal growth restriction
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23
Q

What conditions are associated with low unconjugated estrodiol in the 2nd trimester?

A
  1. Oligohydramnios
  2. Fetal demise after 24/40
  3. Low birthweight
  4. Spontaneous miscarriage
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24
Q

What maternal serum markers are associated with spontaneous miscarriage?

A
  1. Low PAPP-A
  2. Low β-hCG
  3. Raised AFP
  4. Low estradiol
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25
Q

What maternal serum markers are associated with gestational hypertension?

A
  1. Low PAPP-A
  2. Raised β-hCG
  3. Raised inhibin-A
26
Q

What maternal serum markers are associated with low birthweight?

A
  1. Low PAPP-A
  2. Low β-hCG
  3. Low estradiol
27
Q

What maternal serum markers are associated with preterm delivery?

A
  1. Low PAPP-A
  2. Raised AFP
  3. Raised β-hCG
  4. Raised inhibin-A
28
Q

What maternal serum markers are associated with fetal growth restriction?

A
  1. Raised AFP
  2. Raised β-hCG
  3. Raised inhibin-A
29
Q

What maternal serum marker is associated with placental abruption?

A

Raised AFP

30
Q

What maternal serum markers are associated with fetal demise after 24/40?

A
  1. Raised AFP
  2. Raised β-hCG
  3. Raised inhibin-A
  4. Low estradiol
31
Q

What maternal serum marker is associated with oligohydramnios?

A

Low estradiol

32
Q

What is the incidence of PUPPP?

A

1:200

33
Q

What action is taken when a woman has shingles close to delivery?

A

None

34
Q

What action is taken with VZV exposure when shown non-immune?

A

Give VZIg
Consider infectious for 28days

35
Q

What action is taken for HSV primary infection in 3rd trimester?

A

Aciclovir until birth

36
Q

What is first-line treatment for toxoplasmosis?

A

Spiramycin
Pyrimethamine + sulfadiazine
(if confirmed?)

37
Q

Which antiepileptic depletes vitamin K?

A

Carbamazepine as enzyme inducer

38
Q

In what cases is antenatal VTE prophylaxis prescribed?

A
  1. All high risk + refer
  2. Consider for intermediate risk
  3. 4+ general risk factors: from 1st trimester
  4. 3+ general risk factors: from 28/40
39
Q

What constitutes high risk for VTE antenatally?

A

Previous unprovoked VTE

40
Q

What are intermediate risk factors for VTE antenatally?

A
  1. Hospital admission
  2. Previous VTE related to major surgery
  3. High risk thrombophilia
  4. Medical comorbidities
  5. Surgical procedure
  6. OHSS (1st trimester)
41
Q

What are general risk factors for VTE antenatally?

A
  1. Obesity, BMI>30
  2. Parity >3
  3. Smoking
  4. IVF/ART
  5. Gross varicose veins
  6. Current pre-eclampsia
  7. Immobility
  8. Family history of VTE
  9. Low-risk thrombophilia
  10. Multiple pregnancy
42
Q

What are high risk factors for postnatal VTE?

A
  1. Any previous VTE
  2. Anyone requiring antenatal LMWH
  3. High risk thrombophilia
  4. Low risk thrombophilia with family history VTE
43
Q

What are the intermediate risk factors for postnatal VTE?

A
  1. Emergency CS
  2. BMI >40
  3. Readmission or prolonged stay
  4. Surgery in puerperium other than perineal repair
  5. Medical comorbidities
44
Q

What are general risk factors for postnatal VTE?

A
  1. Age >35
  2. Obesity >30
  3. Smoking
  4. Elective CS
  5. Family history
  6. Low risk thrombophilia
  7. Gross varicose veins
  8. Prolonged labour over 24 hours
  9. Current systemic infection
  10. Immobility
  11. Current pre-eclampsia
  12. Multiple pregnancy
  13. PTL <37 weeks
  14. Stillbirth
  15. Mid-cavity instrumental birth
  16. PPH > 1L or transfusion
45
Q

What proportion of breech babies spontaneously turn after 36/40?

A

8%

46
Q

What are the cardiovascular signs of autonomic dysreflexia?

A

Hypertension
Bradycardia

47
Q

What proportion of babies get feral varicella syndrome if mum gets chicken pox in first 20/40 & doesn’t have VZIg?

A

2.8%

48
Q

What proportion of babies get feral varicella syndrome if mum gets chicken pox in first 20/40 & doesn’t have VZIg?

A

2.8%

49
Q

If a mother had primary HSV at NVB, what are the chances of neonatal herpes?

A

40%

50
Q

What is the chance of congenital CMV if maternal recurrence in pregnancy?

A

1-2%

51
Q

What is the chance of fetal rubella syndrome depending on when mum contracts rubella?

A

< 11/40: 90%
11-16/40: 26%
> 20/40: No cases known

52
Q

What action is taken for incidental finding of short cervical length on US?

A

Progesterone

53
Q

What % of transabdominal cerclage are converted to open?

A

10%

54
Q

Which HPG subtypes are protected against by Gardasil?

A

6, 11, 16 & 18

55
Q

What is the advice for lithium management in pregnancy?

A

Stop over 4 weeks
+/- antipsychotic switch

56
Q

What is the sensitivity of amniocentesis for diagnosing fetal CMV infection?

A

75%

57
Q

What proportion of pregnancies are complicated by primary VZV infection?

A

0.3%

58
Q

What proportion of women with VZV infection in pregnancy develop proteinuria?

A

5%

59
Q

What is the risk of neonatal varicella infection if chicken pox is contracted in the last 4 weeks of pregnancy?

A

50%

60
Q

What is the acceptable cumulative background dose of radiation in pregnancy?

A

50mGy

61
Q

What is the most common impact of lithium on the fetus?

A

Cardiac defects

Gaby’s PassMRCOG repeats (8 decks)

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