Antenatal Care and Labour Flashcards

1
Q

What is a booking appointment?

A

By 10 weeks, first contact identifying risks, screen for illness and health promotion

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2
Q

Give 4 risk factors of pregnancy which should be identified at booking

A
  • > 40 or <18 years
  • Para 6+ or Para 0
  • Extremes of BMI
  • Low socio-economic status
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3
Q

Give 4 conditions which are screened for in a mother in the 1st trimester

A
  • Anaemia
  • Sickle cell disease
  • Rubella
  • HIV
  • Syphilis
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4
Q

When and how is fatal Down syndrome screening carried out?

A

11-14 week on Nuchal translucency scan (this is not diagnostic)

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5
Q

From when in pregnancy can CVS be carried out?

A

11 weeks

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6
Q

From when in pregnancy can amniocentesis be carried out?

A

15 weeks

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7
Q

In non-invasive prenatal testing of maternal blood, which things can be determined?

A

Trisomies 13, 18 and 21

X/Y

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8
Q

When is the 2nd trimester of pregnancy?

A

12-20 weeks

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9
Q

When is a fetal anomaly scan carried out?

A

Between 18-22 weeks

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10
Q

When is the 3rd trimester?

A

20 weeks - term

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11
Q

Give 4 antenatal complications which should be picked up at antenatal appointments

A
  • Polyhydramnios
  • Oligohydramnios
  • Pre-eclampsia
  • Anaemia
  • Gestational diabetes
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12
Q

Name 2 pro-labour factors

A

Oxytocin

Prostaglandins

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13
Q

Which score is used to assess cervical ripening?

A

Bishop’s score

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14
Q

How is labour diagnosed?

A

o Regular contractions and fully effaced cervix
OR
o Spontaneous ROM and regular uterine activity

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15
Q

How often should women in active labour be examined?

A

4 hours

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16
Q

What is the first stage of labour?

A

Onset of labour to full cervix dilation

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17
Q

What is the second stage of labour?

A

Full cervical dilation until the head is delivered

18
Q

What is the third stage of labour?

A

From delivery of baby until expulsion of placenta and membranes

19
Q

What is meant by station of presenting part?

A

Describes position of babies head, in cm above or below ischial spines, spines is station 0

20
Q

Define caput

A

Oedema of scalp due to pressure of head against rim of cervix (+, ++ or +++)

21
Q

Define moulding

A

Change in head shape during labour

22
Q

What is a partogram?

A

Graphic recording of clinical findings and any relevant events. Maternal BP, HR, temp…

23
Q

Define slow labour

A

Less than 2cm dilation in 4 hours due to inadequate uterine activity

24
Q

Define malpresentation

A

When babies head is not presenting part e.g. breech

25
Define malposition
Abnormal position of vertex relative to maternal pelvis
26
Give 3 indications for induction of labour
- Maternal diabetes - Twin pregnancy - Pre-labour ROM
27
If Bishop's <6 (unfavourable cervix) what is given to induce labour?
Prostaglandin gel/tablet into vagina
28
If Bishop's score >6 (favourable cervix) what is done to induce labour?
ARM | Syntocinon
29
Give 4 pharmacological analgesics used in labour
o Entonox 50:50 o IM diamorphine o Epidural/spinal o GA
30
What is a 1st degree perineal tear?
Vaginal epithelium and vulval skin injury only
31
What is a 2nd degree perineal tear?
Injury to perineal muscles but not anal sphincter
32
What is a 3rd degree perineal tear?
Injury involving anal sphincter complex
33
What is a 4th degree perineal tear?
Involves anal sphincter couples and rectal mucosa
34
Give 3 indications for an episiotomy
- Rigid perineum preventing delivery - Large tear imminent - Instrumental deliveries
35
Define pre-term labour
Gestation less than 37 complete weeks
36
How can pre-term labour be managed?
IM betamethasone or dexamethasone over 24 hr to increase pulmonary surfactant produced by fetal type II pneumocytes
37
Define direct maternal death and its main cause
Death resulting from complications of pregnancy, interventions, omissions or incorrect treatment Thrombosis and thromboembolism
38
Define indirect maternal death and its main cause
Deaths from previous/existing disease or disease developed during pregnancy not due to obstetric causes but aggravated by physiological effects of pregnancy Heart disease
39
Define coincidental maternal death
Death from unrelated causes which happen to occur during pregnancy or 6 weeks PP
40
Define late maternal death
eath of a women from indirect or direct obstetric causes within more than 42 days after but less than 1 year of end of pregnancy
41
Which programme audits risk in obstetrics throughout the UK?
MBRRACE UK