Applied anatomy and embryology Flashcards
Episiotomy
Surgically planned incision on perineum and posterior vaginal wall during second stag of labour
Caesarean section
delivery of fetus through incision in abdominal wall and uterine wall
Bladder and ureteric injury in CS
bladder - 1 in 1000
ureteric - 1 in 10 000
5 reasons for hysterectomies
PPH malignancy fibroids heavy bleeding endometriosis
Dilation of urinary tract in pregnancy more pronounced on LHS or RHS?
RHS
Leiomyomata
Fibroids
Fibroids
Most common benign tumour arising from myometrium
Symptoms of fibroids
asymptomatic
pelvic pain, heavy bleeding, dysmenorrhoea, pressure symptoms
Management of fibroids
symptom relief myomectomy hysterectomy GnRH analogues uterine artery embolization
Rare sites of endometriosis
brain, lung, eyes, muscle
Examination findings in endometriosis
adnexal masses or tenderness
nodules/tenderness in posterior vaginal fornix or uterosacral ligaments
fixed retroverted uterus
rectovaginal nodules
What LN does ovarian cancer spread to?
para-aortic
Radical hysterectomy
removal of uterus, cervix, upper part of vagina, parametrium, pelvic LN
Why may hysterectomy lead to menopause?
ovaries have same blood supply as uterus
Examples of teratogens
thalidomide, roaccutane, carbamazepine, phenytoin, tetracyclines
Binge drinking
5 or more units of alcohol
triad of rubella
sensorineural deafness
eye abnormalities
congenital heart disease
Varicella - 3 signs
limb hypoplasia
skin scarring
eye defects
When is varicella most harmful in pregnancy?
2nd trimester
Opiates in labour effect on neonate
respiratory depression
brain, skeletal and growth effects
What conditions is pre-pregnancy counselling vital?
diabetes
epilepsy
anti-coagulants and anti-hypertensives
Folic acid
400mcgms OD
5mgms - raised BMI, DM, epilepsy
vitamin D dose
10mcgms
