Clinical Obstetrics/Delivery/Operative Delivery/Procedures

Question 1

Criteria for Elective Repeat Timing

Answer 1

FHTs x 20 weeks by fetoscope or 30wks doppler
36 weeks since serum or urine hCG by lab
CRL with GA >39wks
12-20wk US confirms 39+ weeks by H&P

Question 2

Terbutaline

Answer 2

Increases intracellular cAMP > inhibits myosin light-chain kinase

Question 3

Mg

Answer 3

Decreases Ach release at motor end plate, increaswes cAMP, decreases Ca

Question 4

Indocin

Answer 4

COX inhibitor, decreases sythesis of PGs

Question 5

CCBs

Answer 5

Inhibits influx of calcium through cell membrane

Question 6

Kerr Incision

Answer 6

Low Transverse Uterine incision
Risk of Rupture ~0.5%
TOLAC success 70%
Endometritis is most common complication, can be reduced by 50-60% if receives abx at time of surgery.

Question 7

IVH

Answer 7

Gestational age
INdocin associated with increased risk of neonatal IVH
Most cost-effective diagnostic test is US

Question 8

Types of Breech, Risks of Prolapse

Answer 8

Frank, Complete, Footling, Double Footling

Frank breech with most comon, least risk cord prolapse (0.5%)

Complete breech: (criss-cross - 5%)
Footling/double footling (15%)