Antenatal care Flashcards
When can you perform an amnio to detect prenatal fetal CMV?
7 weeks after infection and over 21/40
Chicken pox timeline - VZIG and aciclovir and infectious period?
- From contact until 10 days - can give VZIG
- If given VZIG - infectious period is 21 days, if not 28 days
- If present in first 24 hours of the rash - give aciclovir if 20/40 or more
- Lesions take around five days to crust (and then are non-infective)
Risk of early onset GBS
- overall risk
- positive vaginal swab
- Intrapartum pyrexia
- overall risk 0.5:1000
- positive vaginal swab - 2.3:1000
- intrapartum pyrexia - 5.3:1000
What percentage of IUDs have chromosomal abnormality?
6%
Indications for referral to fetal medicine specialist for HDFN?
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
What percentage of women with OC have a family history of it?
14%
Which drugs used in solid organ transplant are teratogenic?
ARB
ACEi
Mycophenolate
Warfarin
Which drug to treat IBD should be avoided in pregnancy?
Fluroquinolones
HUS vs TTP
HUS has defects in complement regulation
When should you reduce the dose of MgSO4 and by how much
Half the dose of MgSO4 when urine output falls below 20mls/hr
What is the only anti-TNF which crosses the placenta the least so is the safest in pregnancy?
Certolizumab
What liver lesion may grow in pregnancy?
Haemangiomas show accelerated growth with oestrogen
What percentage of monochorionic pregnancies does TTTS complicate?
15%
What percentage of monochorionic pregnancies who have laser ablation for TTTS result in TAPS?
13%
when should the anomaly scan for twins take place?
18 to 20+6
when should the NT scan for twins take place?
11 to 14+1
What is the stillbirth rate in the UK?
1:200
When is the lowest risk of stillbirth in the UK?
39/40
What did the TRUFFLE study show?
No difference in stillbirth when ductus venosus doppler measurement was used compared to CTG
What did the TIPPS study show?
No help with placenta-related complications or change in SB rate with LMWH
What are the key symptoms in the diagnosis of symphysis pubis dysfunction?
pubic bone pain
walking, turning in bed, lifting or parting legs
What are the key signs in the diagnosis of symphysis pubis dysfunction?
Positive trendelenburg sign (sagging of one bumcheek on one leg)
Pain over SI joint or SP
What are the risk factors for osteomyelitis of the pubis?
Gynaecological surgery, urogenital procedures and operative delivery