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Obstetrics and Gynaecology > Antenatal Care and Labour > Flashcards

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
Q

Define malposition

A

Abnormal position of vertex relative to maternal pelvis

26
Q

Give 3 indications for induction of labour

A
  • Maternal diabetes
  • Twin pregnancy
  • Pre-labour ROM
27
Q

If Bishop’s <6 (unfavourable cervix) what is given to induce labour?

A

Prostaglandin gel/tablet into vagina

28
Q

If Bishop’s score >6 (favourable cervix) what is done to induce labour?

A

ARM

Syntocinon

29
Q

Give 4 pharmacological analgesics used in labour

A

o Entonox 50:50
o IM diamorphine
o Epidural/spinal
o GA

30
Q

What is a 1st degree perineal tear?

A

Vaginal epithelium and vulval skin injury only

31
Q

What is a 2nd degree perineal tear?

A

Injury to perineal muscles but not anal sphincter

32
Q

What is a 3rd degree perineal tear?

A

Injury involving anal sphincter complex

33
Q

What is a 4th degree perineal tear?

A

Involves anal sphincter couples and rectal mucosa

34
Q

Give 3 indications for an episiotomy

A
  • Rigid perineum preventing delivery
  • Large tear imminent
  • Instrumental deliveries
35
Q

Define pre-term labour

A

Gestation less than 37 complete weeks

36
Q

How can pre-term labour be managed?

A

IM betamethasone or dexamethasone over 24 hr to increase pulmonary surfactant produced by fetal type II pneumocytes

37
Q

Define direct maternal death and its main cause

A

Death resulting from complications of pregnancy, interventions, omissions or incorrect treatment

Thrombosis and thromboembolism

38
Q

Define indirect maternal death and its main cause

A

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
Q

Define coincidental maternal death

A

Death from unrelated causes which happen to occur during pregnancy or 6 weeks PP

40
Q

Define late maternal death

A

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
Q

Which programme audits risk in obstetrics throughout the UK?

A

MBRRACE UK

Obstetrics and Gynaecology (10 decks)

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