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3a Obs and Gynae > Antenatal screening > Flashcards

Antenatal screening Flashcards

1
Q

_____ is the process of identifying apparently healthy people who may have an increased chance of a disease or condition.

A

Screening

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2
Q

Antenatal

A

Anytime during pregnancy up until delivery

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3
Q

Puerperium

A

6 week period after delivery

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4
Q

Liquor

A

Amniotic fluid around the baby

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5
Q

Lochia

A

Normal blood loss after delivery

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6
Q

Intrapartum

A

Delivery of the baby

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7
Q

What are some infectious diseases screened for in pregnancy?

A

HIV
Heb B
Syphilis

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8
Q

Why are blood tests conducted in antenatal appointment?

A

Screening for sickle cell and thalassaemia screening.

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9
Q

What are some risks that could be identified and acted on during pregnancy?

A

Venous thromboembolism
Pre-eclampsia and hypertension
Gestational diabetes
Foetal growth
Pre-existing medical conditions
Mental health

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10
Q

What are some important risks of smoking to pregnancy?

A

Premature birth
Increased miscarriage
(affects blood flow through placenta)

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11
Q

What is response to pregnant smokers?

A

Smoking cessation advice
Growth scans

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12
Q

How is pre-eclampsia or Pregnancy Induced Hypertension (PIH) managed?

A

Aspirin throughout pregnancy
Expedited delivery (37 weeks) if pre-eclampsia diagnosed.

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13
Q

How is gestational diabetes managed?

A

Growth scans
Diabetes team

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14
Q

What are risk factors for Post-Partum Haemorrhage?

A

High BMI
Previous PPH

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15
Q

When are the routine dating scans done?

A

11+2 to 14+1 weeks
Nuchal translucency done here

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16
Q

When are anatomy scan done?

A

18+0 to 20+6 weeks
Screens for 11 crucial structurally visible conditions

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17
Q

What is the most common cause of death in maternal mortality in the UK?

A

VTE

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18
Q

What is maternal death defined as?

A

Death of a patient while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by pregnancy or its management.

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19
Q

Stillbirth rate increases according to the level of _____

A

deprivation

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20
Q

True or false: both progesterone and oestrogen spike just before childbirth and then drop down.

A

True

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21
Q

Immediately following delivery, uterus contracts to what level?

A

The level of umbilicus

22
Q

Fundal height decreases in size by _cm per day post birth

A

1cm

23
Q

The uterus returns to pre-pregnancy size at _ weeks

A

6

24
Q

the muscle layer of the uterus reduces to normal thickness post-birth through ischaemia, a_____ and p_____

A

autolysis
phagocytosis

25
Q

Decidua is shed as ____

A

lochia

26
Q

GP checks up postnatally at _ weeks

A

6 weeks

27
Q

Sepsis red flags

A

Supplemental oxygen required
High heart rate
High resp rate
High lactate
Purpuric rash
Low systolic bp
V or less on AVPU

28
Q

What are the Give 3, Take 3 of managing sepsis?

A

Give Fluids
Give Oxygen
Give antibiotics

Take cultures
Take lactate (blood tests)
Take fluid balance (accurate hourly monitoring)

29
Q

Primary PPH is over 500ml blood loss within what time frame?

A

24 hours of delivery of the baby

30
Q

Minor PPH is estimated blood loss (EBL) or less than _____mls and no clinical signs of shock

A

1000mls

31
Q

Major PPH definition

A

EBL of 1000mls + and continuing to bleed or clinical shock

32
Q

For patients of 70kg, blood loss of more than __% of their total blood volume is generally regarded as life threatening

A

40%

33
Q

Secondary PPH is abnormal or excessive bleeding between 24 hours and __ weeks postnatally

A

12

34
Q

Causes of Primary PPH

A

4 Ts:
Tone - uterine atony
Tissue - retained placental tissue
Trauma - damage to reproductive tract eg tears
Thrombin - coagulopathies

35
Q

Managing Primary PPH

A

A to E approach
IV access (2 wide bore cannulae)
Identify and treat cause
Lab bloods
Crossmatch at least 2 units.

36
Q

How to manage primary PPH caused by tone

A

Bimanual compression, oxytocin analogues
Surgical measures

37
Q

Common Causes of Secondary PPH

A

Endometriosis (uterine infection)
Retained placental fragments
Abnormal involution of placental site
Arteriovenous malformations

38
Q

Managing secondary PPH

A

A to E approach if haemodynamically unstable.
Assess blood loss and full examination
Send swabs
Pelvic USS

39
Q

Risk factors of VTE are scored using…

A

TRAF system

40
Q

TRAF system allows risk stratification to guide whether to give prophylactic _____

A

dalteparin

41
Q

How long is dalteparin given for in those with high TRAF score?

A

6 weeks

42
Q

How long is dalteparin given for in those with an intermediate TRAF score?

A

10 days

43
Q

How long is dalteparin given for in those with lowTRAF score?

A

No dalteparin prescription

44
Q

What is definition of pre-eclampsia?

A

Hypertension
Significant proteinuria (> 300mg in 24 hours)
> 20 week gestation

45
Q

What is eclampsia?

A

Seizure that occurs if pre-eclampsia worsens

46
Q

What is monitored in those identified with pre-eclampsia?

A

Blood pressure

47
Q

What medication is commonly used for blood pressure in those with pre-eclampsia

A

labetalol

48
Q

What medication is given if eclampsia develops?

A

MgSO4

49
Q

What are Baby Blues?

A

Brief period of feeling emotional/ tearful 3-10 days after giving birth.
Very common.

50
Q

What is post-natal depression?

A

A depressive episode within first 12 months postpartum
Less common
Severity various

51
Q

What is Puerperal psychosis?

A

Severe form of mental illness which usually starts days to weeks following delivery
Presentation variable
About 1 in 1000
Rate of recurrence is about 50%

3a Obs and Gynae (3 decks)

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