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Obstetrics > Antenatal Obstetric Complications > Flashcards

Antenatal Obstetric Complications Flashcards

GIT, Pelvic Organs, UTI,VTE (Thrombophilia, DVT,PE), Substance Abuse, Oligo/Polyhydraminos

1
Q

Minor Complications

A

1.Backache
2.Symphsis Pubis Dysfunction
3.Carpel Tunnel Syndrome

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2
Q

GIT complications

A

1.Constipation
2.Hyperemesis Gravidarum
3.Gastroesophageal Reflux
4.Haemorrhoids
5.Varicose Veins

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3
Q

Antenatal Constipation

A

Increased by Iron tablets and slow gut motility

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4
Q

hyperemesis gravidarum leads to….

A

1.Imbalance of fluid and electrolytes
2. Nutritional disturbances such as vitamin deficiences (may cause Wernicke’s encephalopathy)
3. Psychological and Physical Toll
4.(May cause mallory weiss tears)
5. Adverse Preg Outcomes

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5
Q

Possible cause of Hyperemesis gravidarum

A

Increase in HCG, T4, Estrogen

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6
Q

Treatment of Hyperemesis Gravidarum

A

Fluids, Thiamine and Antiemetic (Phenothiazine)

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7
Q

Treatment of GER

A

Smoking cessation
frequent light meals
head propped up when lying down

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8
Q

Drugs used for GER

A

Antacids/ Histamine 2 receptor antagonists/ Protein pump inhibitor

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9
Q

Why are Haemorrhoids more common in pregnancy?

A

Increase in pressure on superior rectal veins, increase in circulating volume, increase in progesterone

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10
Q

Treatment of Haemorrhoids

A

Anti irritant cream
Local Anesthetic

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11
Q

If tenesmus/ bloody stool accompanies haemorrhoids, what should be done?

A

Rectal Digital Exam to check for Rectal Carcinoma

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12
Q

Varicose Veins cause and treatment

A

Cause: progestrone effect on vascular smooth muscle
Rx: Support stockings + avoid standing long periods

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13
Q

Common outcome of large varicose veins post delivery

A

Thrombophlebitis

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14
Q

Generalized oedema is a feature of

A

Pre-eclampsia

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15
Q

Leiomyomata

A

mass of smooth muscle in uterus cavity, uterine muscle or outside surface

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16
Q

Large Fibroid may cause

A

Obstruction in vaginal delivery

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17
Q

Complication of Fibroid may cause…

A

Red Degeneration

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18
Q

Explain Red Degeneration

A

Fibroid becomes ischaemic causes pain, tenderness, vomiting.

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19
Q

Severe symptoms of Red Degeneration may cause

A

Uterine Contractions leading to miscarriage or preterm labour

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20
Q

Retroversion of Uterus may cause

A

Long term bladder issues due to stretch of base of bladder and urethra

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21
Q

Complications of Bicornuate Uterus

A

Miscarriage
Preterm Labour
Preterm Prelabour Rupture of Membrane

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22
Q

Most common types of Ovarian Cysts

A

Serous and Benign Teratomas

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23
Q

Predisposing factors of UTI

A

History of recurrent cystitis
Renal Abnormalities
DM
Bladder emptying issues

24
Q

Symptoms of UTI

A

low back pain
flu-like symptoms
tachycardia
pyrexia
dehydration
(rarely, haematuria, dysuria)

25
Q

Investigations done for sus UTI

A

CBC
Mid-stream specimen of urine (MSU) +10^5 to confirm

26
Q

Treatment for UTI/ sus UTI

A

Start antibiotic (Amoxicillin/ oral cephalosporin
Fluids
Paracetamol

27
Q

Patient has Hx of recurrent UTI

A

Test MSU @ every visit + give prophylactic

28
Q

Common causes of UTI

A

E.coli (most common)
Proteus
Pseudomonas
Kleibsella

29
Q

Symptoms of Pyelonephritis

A

Dehydration
High Temp (>38.5)
Shock

30
Q

Treatment for Pyelonephritis

A

Admission
IV fluids
Opiate Analgesics
IV antibiotic (Cephalosporin/ Gentamicin)
Renal tests done
Monitor baby via CTG

31
Q

Most common cause of maternal death

A

Venous Thromboembolism (VTE)

32
Q

Why is the risk of VTE higher in pregnant women

A
  1. Due to occurence of hypercoagulable state in pregnancy (Increase in Factors 7,8,9,10,12 and Fibrinogen)
  2. Venous Stasis due to pressure of gravid uterus on IVC
33
Q

Thrombophilia

A

Increased tendency to form blood clots

34
Q

Hereditary Thrombophilia is due to

A

Anticoagulant Defieciences
Abnormal procoagulant factors
Mutated prothrombin

35
Q

Acquired Thrombophilia is due to

A

Anti-phosphlipid syndrome
Systemic Lupus Erythematous

36
Q

Risk factors for Thromboembolism (Pre-existing before pregnancy)

A
  1. Age
    2.Obesity
  2. Thrombophilia
  3. Prev Hx of Thromboembolism
  4. Severe Varicose Veins
  5. Smoking
  6. Malignancy
37
Q

Pregnancy Specific Risk Factors for Thromboembolism

A
  1. Multiple Pregnancy
  2. Multiparous
    3.Pre-eclampsia
    4.Caesarean Section
    5.Sepsis
    6.Pelvic vein damage
    7.Prolonged bed rest
38
Q

Symptoms of Deep Vain Thrombosis

A

Calf tenderness, pain
Swelling (esp if unilateral)

39
Q

How to diagnose DVT

A

Compression U/S scan
Venography

40
Q

Symptoms of Pulmonary Embolus

A

Breathlessness
Inspiratory pain
Mild Pyrexia
Slight tachycardia

41
Q

What to do if Pulmonary Embolus is suspected?

A

ECG
CHest Xray
ABG
^ to eliminate other resp. diagnoses.
if still sus, do:
ventilation perfusion scan
or
Computed tomography pulmonary angiogram

42
Q

Treatment for Venous Thromboembolism

A

Low Molecular Weight Heparin

43
Q

Why is Warfarin rarely used as treatment for VTE

A

passes placenta can cause fetal defects and intracranial hemorrhage (can be given post-partum, safe during breastfeeding)

44
Q

Tobacco use during pregnancy can cause

A

FGR

45
Q

Alcohol Abuse causes

A

FGR
Fetal Alcohol Syndrome

46
Q

Opiates (Heroin etc) abuse

A

Preterm Labour
Neonatal withdrawal

47
Q

Cocaine Abuse

A

FGR
Placental Abruption
Preterm Labour

48
Q

Oligohydraminos is

A

reduced amount of amniotic fluid

49
Q

Maximum Vertical pool and Amniotic fluid index in Oligohydraminos

A

Maximum Vertical Pool= Less than 2cm
AFI= Less than 5cm

50
Q

Oligohydraminos in abdomen exam appearance

A

Fetal poles very obvious and hard
Small for date uterus

51
Q

Oligohydraminos is caused by

A

FGR
Cystic Kidney
Renal Agenisis

52
Q

Polyhydraminos is

A

Increase in Amniotic Fluid

53
Q

MVP and AFI in Polyhydraminos

A

MVP= +8cm
AFI= +25cm

54
Q

Causes of Polyhydraminos

A

Maternal:
1. DM
Placental:
1.Chorioanginoma, 2.Arterio-venus fistula
Fetal:
1.Multi preg,
2.Eso/Dud Atresia
3.Anencephaly
4.Neuromuscular condition

55
Q
A

Obstetrics (15 decks)

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