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Antenatal care Flashcards

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1
Q

When can you perform an amnio to detect prenatal fetal CMV?

A

7 weeks after infection and over 21/40

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2
Q

Chicken pox timeline - VZIG and aciclovir and infectious period?

A
  1. From contact until 10 days - can give VZIG
  2. If given VZIG - infectious period is 21 days, if not 28 days
  3. If present in first 24 hours of the rash - give aciclovir if 20/40 or more
  4. Lesions take around five days to crust (and then are non-infective)
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3
Q

Risk of early onset GBS

  1. overall risk
  2. positive vaginal swab
  3. Intrapartum pyrexia
A
  1. overall risk 0.5:1000
  2. positive vaginal swab - 2.3:1000
  3. intrapartum pyrexia - 5.3:1000
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4
Q

What percentage of IUDs have chromosomal abnormality?

A

6%

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5
Q

Indications for referral to fetal medicine specialist for HDFN?

A

history of previous HDFN
IUT
Titre of 1:32 or above
Rising titres as it indicates the risk of severe fetal anaemia
anti-D level over 4IU/ml
any anti-K level
anti-d - 4-15 moderate risk - referral needed. Over 15 - URGENT referral

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6
Q

What percentage of women with OC have a family history of it?

A

14%

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7
Q

Which drugs used in solid organ transplant are teratogenic?

A

ARB
ACEi
Mycophenolate
Warfarin

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8
Q

Which drug to treat IBD should be avoided in pregnancy?

A

Fluroquinolones

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9
Q

HUS vs TTP

A

HUS has defects in complement regulation

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10
Q

When should you reduce the dose of MgSO4 and by how much

A

Half the dose of MgSO4 when urine output falls below 20mls/hr

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11
Q

What is the only anti-TNF which crosses the placenta the least so is the safest in pregnancy?

A

Certolizumab

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12
Q

What liver lesion may grow in pregnancy?

A

Haemangiomas show accelerated growth with oestrogen

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13
Q

What percentage of monochorionic pregnancies does TTTS complicate?

A

15%

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14
Q

What percentage of monochorionic pregnancies who have laser ablation for TTTS result in TAPS?

A

13%

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15
Q

when should the anomaly scan for twins take place?

A

18 to 20+6

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16
Q

when should the NT scan for twins take place?

A

11 to 14+1

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17
Q

What is the stillbirth rate in the UK?

A

1:200

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18
Q

When is the lowest risk of stillbirth in the UK?

A

39/40

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19
Q

What did the TRUFFLE study show?

A

No difference in stillbirth when ductus venosus doppler measurement was used compared to CTG

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20
Q

What did the TIPPS study show?

A

No help with placenta-related complications or change in SB rate with LMWH

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21
Q

What are the key symptoms in the diagnosis of symphysis pubis dysfunction?

A

pubic bone pain

walking, turning in bed, lifting or parting legs

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22
Q

What are the key signs in the diagnosis of symphysis pubis dysfunction?

A

Positive trendelenburg sign (sagging of one bumcheek on one leg)
Pain over SI joint or SP

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23
Q

What are the risk factors for osteomyelitis of the pubis?

A

Gynaecological surgery, urogenital procedures and operative delivery

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24
Q

What are the symptoms and signs for osteomyelitis of the pubis?

Study These Flashcards
A 
low grade pyrexia
pain at SP and pubic rami
Pain on hip abduction
NN anaemia
inc WCC and CRP
25
What is osteitis pubis?
Symmetrical pubic pain Especially on climbing stairs, kicking, pivoting on one leg Normal bloods Xray - erosions cytic changes of the pubis
26
What is pregnancy-induced osteomalacia? cause? Sx? Ix?
Vit D deficiency aches and pains Looser zones waddling gait - proximal myopathy Low serum calcium and raised ALP Low serum vit D
27
What is transient osteoporosis of pregnancy affecting the hip joint?
Usually left hip Rare Pain in the hip NOT tender on the SP Marginal rise in inflammatory markers Xrays - osteopenia - localised and involves the femoral head and acetabulum
28
What is the incubation period for rubella?
14-21 days
29
what is the period of infectivity for rubella?
7 days before and after the rash
30
When is maternal infection most likely to cause congenital rubella?
First trimester
31
What are the signs of congenital rubella?
PDA, ocular defects, sensorineural deafness and mental retardation
32
Dose of anti D up to 20 weeks?
250IU | No Kleihauer required
33
Dose of anti D after 20 weeks? Additional testing and anti D?
500IU, and a kleihauer to test for FMH over 4mls - more would be required
34
What is the rate of spontaneous reversion after ECV?
5%
35
Why do we offer CS for footling breech presentations?
High risk of cord prolapse - 7%
36
What does an absence Duffy blood group antigen provide some protection against?
P. vivax
37
Who has significant protection against P. falciparum?
haemoglobinopathies (eg: SCD) | erythrocyte enzyme defects (G6PD def)
38
What is the mortality rate of congenital tuberculosis?
50%
39
When can peripartum cardiomyopathy present?
AN (late) or up to 6 months postpartum
40
Risk factors for peripartum cardiomyopathy?
``` Afro-Caribbean Older Multip Multiple pregnancy HTN PET ```
41
Treatment of peripartum cardiomyopathy?
beta-blockers Diuretics ACEi
42
What proportion of maternal deaths due to cardiac causes are due to cardiomyopathy?
25%
43
What proportion of women with peripartum cardiomyopathy with have a spontaenous recovery?
50%
44
When is pregnancy contraindicated in a woman with Marfans syndrome?
When the aortic root is over 4-4.5cm
45
What is the treatment for severe malaria?
IV artesunate
46
What is the treatment for non-severe P. falciparum?
Oral quinine 600mg 8H and oral clindamycin 450mg 8H 7/7
47
What is the treatment for non-falciparum malaria?
Oral chloroquine 600mg followed by 300mg 6 hours later, then 300mg day 2 and day 3
48
What is the incubation period of parvovirus
13-18 days
49
What is the management for a person neg for IgG parvovirus who is exposed?
2/40 USS until 30 weeks. If normal - discharge.
50
What is the dose of anti-D given per ml?
500u for up to the first four mls, then 125u after that for each ml.
51
What is the dose of lidocaine/kg
3mg//kg
52
Previous abruption means abruption how likely in next pregnancy?
4.4%
53
Risk of postnatal depression
8-15%
54
Risk of perpeural psychosis?
0.1-2%
55
Risk of suicide in postpartum psychosis? Infanticide?
5% 5%
56
Bipolar - risk of PP psychosis
25%
57
Above what level of spinal cord injury is there a risk of autonomic dysreflexia?
T6
58
Above what level of spinal cord injury will a woman not feel labour?
T10
59
What is the risk of vertical transmission of CMV in a woman who has seroconverted during pregnancy?
1st and 2nd trimester - 40% 3rd - 65%

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