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women's 3a > dr clark OBS > Flashcards

dr clark OBS Flashcards

1
Q

what are the types of lie?

A

longitudinal
transverse
oblique

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2
Q

what are the types of presentation?

A

cephalic
breech
shoulder

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3
Q

what is the best way to estimate the gestational age of a pregnancy?

A

1st trimester US (12/40)

crown rump length

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4
Q

what is the risk of footling breech?

A

cord prolapse

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5
Q

what is polyhydramnios?

A

excessive accumulation of amniotic fluid

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6
Q

causes of polyhydramnios?

A

a twin or multiple pregnancy

diabetes in the mother – including diabetes caused by pregnancy
(gestational diabetes)

a blockage in the baby’s gut (gut atresia)
a problem with the placenta
the baby’s blood cells being attacked by the mother’s blood cells (rhesus disease)

a build-up of fluid in the baby (hydrops fetalis)
a genetic problem in the baby

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7
Q

what is Oligohydramnios?

A

a deficiency of amniotic fluid

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8
Q

is a partogram what is the rate of cervix dilation rate?

A

1cm per hour

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9
Q

reasons to induce labour?

A

growth problems in baby.

lack of amniotic fluid surrounding baby.
diabetes.

high blood pressure.

preeclampsia.

uterine infection.

placental separation from the uterus.

Rh-blood disease.

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10
Q

what is increased Nuchal translucency (NT) an indication of?

A

down symdrom

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11
Q

when is nichal translucency test done?

A

between 11 weeks and 14 weeks of pregnancy. unreliable after this time.

1st trimester

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12
Q

what is the combined screening test in the 1st trimester?

A

NT ultra sound scan and 2 serum markers

hCG and Pregnancy associated protein

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13
Q

what is the quadruple test?

A

alpha-fetoprotein

hCG

unconjugated oesteriol

inhibin-A

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14
Q

what is terbutalin used in pregnancy?

A

Terbutaline is a medication used to delay preterm labor. It is in a class of drugs called betamimetics, which help prevent and slow contractions of the uterus.

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15
Q

what is preterm pre-labour rupture of membranes?

A

rupture <37 weeks

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16
Q

gestational diabesties causes what?

A

SMASH

shoulder dystonia
macrosomia
amniotic fluid excess
stillbirth
hypertension/hypoglycasmia
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17
Q

what are the risk factors for down symdrom>

A

maternal age, especially over 45

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18
Q

crown rump length is unreliable at what week?

A

less accurate >20/40 weeks

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19
Q

nuchal translucency is less acurate beyond what week?

A

2nd trimester

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20
Q

external cephalic version contraindications?

A

< 37 weeks gestation, dont wanna induce labout

previous c-section

placenta praevia

multiple preganancy

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21
Q

what is the detection of polyhydramnios?

A

increased symphysiofundal height

large amniotic fluid index

22
Q

polyhydramnio causes

A

DITCH

diabetes
idiopathic
twins
congential
heart failure
23
Q

polyhydramnio risks?

A

Px6

placenta abruption
pretty unsual lie
premature labour
prolapse cord
PPH
perinatal mortality
24
Q

stages of labour?

A

Stage 1: from painful contraction to full cervical dilation ~8hrs

> latent phase to 4cm
active phase to 10 cm

stage 2: from full dilation to fetal delivery~1-2 hrs

stage 3: from fetal delivery to placenta delivery~30 mins

25
Q

mechamism of labour

A

every decent female I crown rules lovingliy

Engagemet
D decent
F flexsion
I inversion
Crown, extension of head
R  resitution (external rotation)
L  lateral flextion of head to deliver shoulders
26
Q

4 main indications of induction?

A

Px4

post date
pre-labour reupture of membranes
pre-eclampsia
plue diabeties

27
Q

induction of labour in PROM

A

after membrame rupture most go into labout within 24 hrs, to reduced the risk of ascending infection induction of labour should commence

the guidence is less clear in pre-term (<37 weeks)

28
Q

what are the options of induction of labour?

A
  1. Membrane sweep (can increase the chance of natural labour)
  2. AROM
29
Q

three stage of labour induction? (monitor with CTG)

A

1.cervical ripening (akin to latent phase). Prostin (prostaglandin)

risk of hyperstimulation

  1. AROM
  2. cervical dilation(akin to active phase). IV oxytocin used to generate uterine contractions

risk of hyperstimulation, can be reversed with terbutaline (relaxes smooth muscles)

30
Q

when does getational diabetes show in pregnancy?

A

unlikely until 2nd trimester

31
Q

does gestational diabeties have micro/macrovascular complications?

A

no

32
Q

risk factors for pre-eclampsia?

A 
previous pre-eclampsia
1st pregnenacy
chronic hypertension
renal disease
obsety/smoking
family history
33
Q

drug not to be used in the treatment of pre-eclampsia

A

ACEI–> risk of congential malformation

diuretics–> reduce maternal plasma volume

34
Q

red flag symptoms in pre-eclampsia?

A

headache
visual disturbances
Epigastric pain (hepatic infarction/distension)
breathlessness(pulmonary oedema)

35
Q

red flag signs of pre-eclampsia?

A

peri-orbital oedema
hyper-reflexia
clonus
fits (eclampsia)

36
Q

diagnosis of pre-eclampsia?

A

> =140/90

proteinuria>300mg/24hr

no UTI

37
Q

how long do you treat pre-eclampisa for after birth?

A

6 weeks post partum.

38
Q

what is antepartum haemorrhage?

A

bleeding in pregnancy after 24 weeks

39
Q

what is bleeding < 24 weeks called?

A

threatened miscarriage

40
Q

what are the causes of antepartum haemorrhage?

A

Uterine:

placental abruption
placenta praevia/ vase praevia
marginal bleeding (bleeding from placental edge)

Cervical:
“show” loss of mucus plug from cervix
cervical cancer
cervical polyp/ectropion

Vaginal:
Trauma/infection

41
Q

what is placenta abruption?

A

premature separation of the placenta from the uterus (occurs in 1%)

42
Q

what are the causes of placental abruption?

A

smoking, previous abruption, hypertensive disorder, cocaine, thrombophilias

43
Q

what colour id the bleeding from placental abruption?

A

usually dark red.

44
Q

what does the uterus of placental abruption feel like?

A

woody hard uterus 9blood in the myometrium)

45
Q

what is placenta praevia?

A

a placenta that is wholly/partially implanted in the lower segment of the uterus.

46
Q

what is vasa praevia?

A

placental vessels running over the cervical os in the membrane (rare)

47
Q

why do yu need to give anti d in placental praevia?

A

If the woman with a placenta previa is bleeding and she is Rh-negative she might receive a dose of RhoGam (anti-D immunoglobulin) to prevent Rh sensitization or the formation of antibodies in response to the fetus’s Rh-positive blood cells.

48
Q

what is primary post partum haemorrhage?

A

loss of >500ml within 24 hrs

is when you lose 500ml (a pint) or more of blood within the
first 24 hours after the birth of your baby.

Primary PPH can be minor, where
you lose 500–1000ml (one or two pints), or major, where you lose more
than 1000ml (more than two pints)
49
Q

what si secondary post partum haemorrhage?

A

abnormal or heavy vaginal

bleeding between 24 hours and 12 weeks after the birth

50
Q

what cause primary post partum haemorrhage?

A

4 Ts

Tone
Tissue
Trauma
thrombin

51
Q

what causes srawberry cervix?

A

trichomonas vaginalis

women's 3a (9 decks)

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