Common Obstetric Problems

Question 1

What blood tests are useful in bleeding during 1st trimester pregnancy?

Answer 1

Group + Save
Serum B-HCG - should increase by 60% if viable pregnancy
Progesterone -

Question 2

Give 4 indications on ultrasound that there has been a miscarriage

Answer 2

no sac
large empty sac
no metal heart beat with pole >7mm
No growth or progress in pregnancy over 10-14 days

Question 3

Where is the most common place for an ectopic pregnancy to occur?

Answer 3

The Ampule of the uterine tube

Question 4

What is the medical management for ectopic pregnancy?

Answer 4

methotrexate

Question 5

Give some risk factors for coptic pregnancy

Answer 5

Previous ectopic
previous uterine surgery
inutruterine device

Question 6

What is a molar pregnancy?

Answer 6

Complete mole - 2 sperm fertilise egg (triploidy - 69 chromosomes)
Partial mole - 2 sperm fertilise empty egg (46 chromosomes)

Question 7

What are the presenting symptoms of molar pregnancy?

Answer 7

high b-hcg
exaggerated symptoms of pregnancy
jelly like discharge

Question 8

What is the definition of antepartum haemorrhage?

Answer 8

bleeding from 24 weeks

Question 9

What are the local causes of antepartum haemorrhage?

Answer 9

trauma to vagina or carvix

neoplasia of gynae

Question 10

What is placenta Praevia?

Answer 10

A low lying placenta
Major - coves os
Minor - doesn’t cover os

Question 11

What is Vasa praevia?

Answer 11

Blood vessels lying running through the membranes above the os

Question 12

How does Placenta praevia present?

Answer 12

History or previous PP
failure of head to engage towards term
Malpresentation - breech oblique or transverse lie

Question 13

What is the management of placenta praevia?

Answer 13

regular scanning to assess progress
Worsening advice
Offer C-section

Question 14

What is the major complication of c-section in placenta praevia?

Answer 14

Bleeding is the major risk

must take steps to prepare to major blood loss

Question 15

In obstetrics what is abruption?

Answer 15

Premature detactment of the placenta from the uterine wall

Question 16

How can abruption of the placenta present?

Answer 16

Abdominal pain
Frequent contraction
vaginal bleeding
symptoms of shock

Question 17

Give 5 risk factors of abruption

Answer 17

pre-eclampsia
smoking
trauma
thrombophilia
extremes of age

Question 18

What is the definition of primary postpartum blood loss?

Answer 18

> 500ml loss within first 24 hr

Question 19

What is the definition of secondary postpartum blood loss?

Answer 19

> 500ml after first 24 hr

Question 20

How is gestational diabetes diagnosed?

Answer 20

GTT.

fasting >5.6mmol/l

Question 21

What are the effects of diabetes in pregnancy?

Answer 21

Macrosomia
miscarriage
congenital malformation
inc risk of preterm birth

Question 22

What are the complications of macrosomia?

Answer 22

shoulder dystocia
birth trauma
inc risk of CS

Question 23

What are 3 three features of pre-eclampsia?

Answer 23

Hypertension
Proteinuria
Oedema

Question 24

How may pre-eclampsia present?

Answer 24

headache
visual upset
epigastric pain
liver tenderness
clonus
hyperreflexia

Question 25

How is the risk of pre-eclampsia reduced in those with risk factors?

Answer 25

Aspirin 75mg/day 12-36 weeks

Labetolol

Question 26

What is the target blood pressure in a pre-eclampsia patient on labetolol?

Answer 26

150/100-80 mmHg