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Obstetrics > Consent Advice > Flashcards

Consent Advice Flashcards

1
Q

Hyst risk of serious complications? Number

A

2/1000

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2
Q

Hyst damage to uterus?

A

Uncommon

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3
Q

Hyst damage to bowel bladder or blood vessels?

A

Rare

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4
Q

Hyst failure?

A

Uncommon

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5
Q

Hyst risk of infertility?

A

Rare

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6
Q

Hyst risk of death? Number

A

3-8/100000 (very rare)

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7
Q

Frequent risks of hysterscopy?

A

Infection and bleeding

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8
Q

Dx lap risk of serious complications? Number

A

2/1000

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9
Q

Dx lap risk of damage to bowel bladder uterus or blood vessels?

A

Uncommon

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10
Q

Proportion of bowel injuries which are not diagnosed at the time of diagnostic lap? Number

A

15%

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11
Q

Dx lap risk of death? Number

A

3-8/100000

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12
Q

Frequent risks of laparoscopy?

A

Wound bruising, gaping, infection and shoulder tip pain

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13
Q

Risk reduction in ovarian cancer for tubal ligation? Number

A

34% (60% for BRCA 1 carriers)

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14
Q

Lap steri failure rate? Number

A

2-5/1000 at 10 years (=uncommon)

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15
Q

Failure rate of hysteroscopic sterilisation? Number

A

2/1000

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16
Q

Lap steri risk of visceral or blood vessel injury? Number

A

2/1000

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17
Q

Lap steri risk of death? Number

A

1/12000 (=~8/100000 i.e. Same as risk of death for diagnostic lap)

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18
Q

Risk of laparotomy after lap steri? Number

A

3/1000

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19
Q

Failure rate of vasectomy? Number

A

1/2000

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20
Q

TAH risk of serious complications? Number

A

4/100 (common)

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21
Q

TAH damage to bladder &/ ureter? Number

A

7/1000

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22
Q

TAH risk of long term bladder dysfunction?

A

Uncommon

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23
Q

TAH damage to the bowel? Number

A

4/10000

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24
Q

TAH risk of haemorrhage requiring blood transfusion? Number

A

23/1000 (common)

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25
Q

TAH risk of return to theatre for bleeding, wound dehiscence etc? Number

A

7/1000

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26
Q

TAH risk of pelvic abscess / infection? Number

A

2/1000

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27
Q

TAH risk of VTE? Number

A

4/1000

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28
Q

TAH risk of death within 6 weeks? Number

A

32/100000 (main causes are PE and cardiac disease)

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29
Q

Frequent risks of TAH?

A

Wound infection, pain, bruising, delayed wound healing, keloid, numbness, tingling, burning, urinary frequency, uti, ovarian failure

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30
Q

Prolapse surgery risk of damage to bladder / urinary tract? Number

A

2/1000

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31
Q

Prolapse surgery risk of damage to bowel? Number

A

5/1000

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32
Q

Prolapse surgery risk of excessive bleeding necessitating return to theatre? Number

A

2/100

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33
Q

Prolapse surgery risk of pelvic abscess? Number

A

3/1000

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34
Q

Prolapse surgery risk of failure / recurrence?

A

Common

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35
Q

Prolapse surgery risk of death within 6 weeks? Number

A

37/100000 (venous thrombosis common, PE uncommon)

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36
Q

Frequent risks of prolapse surgery?

A

Urinary infection / retention / frequency, vaginal bleeding, postop pain, difficulty / pain with intercourse, wound infection

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37
Q

Vag hyst risk of blood transfusion? Number

A

2/100

38
Q

Amino success rate? Number

A

94% if experienced operator

39
Q

Amino risk of blood stained sample? Number

A

0.8% (with continuous US guidance)

40
Q

Amino risk of miscarriage? Number

A

1%

41
Q

Amino risk of chorio and severe sepsis? Number

A

<1/1000

42
Q

Amino frequent risks?

A

Mild discomfort equivalent to venepuncture

43
Q

Complication rates of Emcs vs elcs? Number

A

24/100 vs 16/100

44
Q

Complication rate of emcs at 9-10cm vs 0-1cm dilated? Number

A

33/100 vs 17/100

45
Q

CS risk of hysterectomy? Number

A

7-8/1000

46
Q

CS risk of repeat surgery (including curettage)? Number

A

5/1000

47
Q

CS risk of ITU admission? Number

A

9/1000

48
Q

CS risk of VTE? Number

A

4-16/10000

49
Q

CS risk of bladder injury? Number

A

1/1000

50
Q

CS risk of ureteric injury? Number

A

3/10000

51
Q

CS risk of death? Number

A

1/12000

52
Q

CS risk of uterine rupture in subsequent delivery? Number

A

2-7/1000

53
Q

CS increased risk of antepartum Stillbirth? Number

A

1-4/1000

54
Q

CS increased risk of praevia and acceptance in subsequent pregnancies? Number

A

4-8/1000

55
Q

CS frequent risks?

A

Persistent wound / abdo discomfort 9/100, increased risk of CS in future pregnancy 1/4, readmission 5/100, haemorrhage 5/1000, infection 6/100, fetal laceration 1-2/100

56
Q

ERPC risk of perforation?

A

5/1000

57
Q

ERPC risk of trauma to cervix?

A

Rare

58
Q

ERPC impact on future fertility?

A

No effect

59
Q

ERPC risk of blood transfusion?

A

1-2/1000

60
Q

ERPC need for repeat surgical evacuation?

A

5/100

61
Q

ERPC risk of localised pelvic infection?

A

3/100

62
Q

ERPC common risks?

A

Bleeding up to 2 weeks, repeat ERPC, localised pelvic infection

63
Q

ERPC risk of intra abdominal trauma?

A

0.1%

64
Q

Lap salpingectomy risk of serious complications and risk of death? Number

A

2/1000 and 3-8/100000

65
Q

Lap salpingotomy risk of persistent trophoblastic tissue? Number

A

4-8/100

66
Q

Lap salpingectomy what are the serious risks?

A

Damage to bladder / bowel / uterus / blood vessels, failure of laparoscopic entry therefore requiring laparotomy

67
Q

What are the frequent risks of laparoscopic salpingectomy?

A

Negative laparoscopy, bruising, shoulder tip pain, wound gaping, infection, port site hernia

68
Q

What proportion of bowel injuries during lap salpingectomy are not identified at the time?

A

15%

69
Q

What proportion of patients treated with methotrexate for ectopic require a second dose? And how many require surgical intervention?

A

14% second dose, 10% surgery

70
Q

3/4 tear repair - common / uncommon / rare risks?

A

Incontinence of stool/faeces common, future CS uncommon, haematoma rare, secondary repair / sacral nerve stimulation rare, rectovaginal fistula very rare

71
Q

3/4 tear repair risk of faecal urgency? Number

A

26/100

72
Q

3/4 tear repair perineal pain and dyspareunia? Number

A

9/100

73
Q

3/4 tear repair wound infection? Number

A

8/100

74
Q

Factors increasing risk of failure with operative vaginal delivery?

A

High bmi, >4kg / clinically large, op, mid-cavity or of 1/5 palpable pa

75
Q

OVD risk of 3/4 tear? Number

A

1-4/100 ventouse, 8-12/100 forceps

76
Q

OVD risk of extensive or significant vulval / vaginal tear? Number

A

1/10 ventouse, 1/5 forceps

77
Q

OVD risk of subgaleal haematoma? Number

A

3-6/1000

78
Q

OVD risk of intracranial haemorrhage? Number

A

5-15/1000 (1/100)

79
Q

OVD risk of PPH? Number

A

1-4/10

80
Q

OVD risk of cephalhaematoma? Number

A

1-12/100

81
Q

OVD facial or scalp lacerations? Number

A

1/10

82
Q

OVD jaundice? Number

A

5-15/100

83
Q

OVD retinal haemorrhage? Number

A

17-38/100

84
Q

OVD risk of episiotomy? Number

A

5-6/10 ventouse, 9/10 forceps

85
Q

CS for praevia emergency hysterectomy? Number

A

11/100

86
Q

CS for praevia need for repeat laparotomy? Number

A

75/1000

87
Q

CS for praevia VTE? Number

A

3/100

88
Q

CS for praevia future placenta praevia? Number

A

23/1000

89
Q

CS for praevia MOH? Number

A

21/100

90
Q

CS for praevia and previous CS, risk of hysterectomy? Number

A

27/100

Obstetrics (13 decks)

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