dums obstetrics Flashcards
chadwick’s sign
non pregnant = pink cervix
pregnant = purple/blue discolouration to cervix due to increased vascularity
how does the variation in GnRH release effect?
rapid GnRH = leads to LH
slower GnRH release = FSH
FSH vs LH
FSH = stimulates follicle development
LH = triggers ovulation
what does oestrogen do
develops female characteristics - vulva, vagina, uterus, endometrium
thins cervical mucus - allows sperm to penetrate egg
develops breast ductal system
DECREASES FSH + LH production
increases size of uterus
how does follicular phase end
with massive surge in oestrogen, which induces GnRH from hypothalamus
- decreased oestrogen
- increased LH
what antibody can pass through placenta?
IgG
changes to drugs in pregnancy + impact of this?
increased plasma volume + fat stores –> increased vol of distribution
increased liver metabolism of some drugs -> more stress onto liver (eg phenytoin)
decreased protein binding (due to lower albumin levels) –> increases amount of free drug in body
effect of ACEi/ARBs + aspirin in pregnancy
teratogenic
ACEi/ARBs-> renal hypoplasia
aspirin -> Reyes syndrome
period of greatest teratogenic risk
wks 4-11
drugs to avoid while breastfeeding
phenobarbitine
amiodarone - neontal hypothyroidism
benzodiazepines
bromocriptine -> decreased lactation
cytotoxis - bone marrow suppresion
tetracycline + doxycycline –> teeth discolouration
whos is at higher risk of neural tube defects + require 5mg folic acid?
previous NTD
taking anti-epileptics
coeliac disease
diabetes
thalassamia trait
BMI >30
how long are all women given folic acid for ?
up until 12th week gestation
can ibuprofen be given in pregnancy?
NSAIDS around 20wks or later - can cause serious kidney problems for baby
-> probs avoid
what is cyclizine given for?
nausea + vomiting
ferguson reflex
baby’s head presses again cervix –> oxytocin release
oxytocin = promotes uterus contractions
uterine contractions -> babys head presses on cervix
hormones involved in uterin contractility
progesterone (Prevents) = decrease contractility of uterine myocytes, prevents formation og gap junctions
oestrogens (opens) = increases uterus contractility, promotes prostaglandin production
oxytocin = stimulates + maintains uterine contractility
prostaglandins = stimulates uterine contactions
braxton-hicks contractions
can occur throughout pregnancy
- once/twice per hour
- few times a days
- irregular + do NOT increase in frequency/strength
first stage of labour
onset of true labour -> full cervical dilation
latent = 0-4cm - 6hrs
active = 4-10cm - 1cm/hr
when is the second stage of labour prolonged
nulliparous
- >3hrs with regional anaesthesia
- >2hrs without
multiparous
- >2hrs with
- > 1hr without
