dums obstetrics

Question 1

chadwick’s sign

Answer 1

non pregnant = pink cervix

pregnant = purple/blue discolouration to cervix due to increased vascularity

Question 2

how does the variation in GnRH release effect?

Answer 2

rapid GnRH = leads to LH

slower GnRH release = FSH

Question 3

FSH vs LH

Answer 3

FSH = stimulates follicle development

LH = triggers ovulation

Question 4

what does oestrogen do

Answer 4

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

Question 5

how does follicular phase end

Answer 5

with massive surge in oestrogen, which induces GnRH from hypothalamus
- decreased oestrogen
- increased LH

Question 6

what antibody can pass through placenta?

Answer 6

IgG

Question 7

changes to drugs in pregnancy + impact of this?

Answer 7

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

Question 8

effect of ACEi/ARBs + aspirin in pregnancy

Answer 8

teratogenic
ACEi/ARBs-> renal hypoplasia

aspirin -> Reyes syndrome

Question 9

period of greatest teratogenic risk

Answer 9

wks 4-11

Question 10

drugs to avoid while breastfeeding

Answer 10

phenobarbitine
amiodarone - neontal hypothyroidism
benzodiazepines
bromocriptine -> decreased lactation
cytotoxis - bone marrow suppresion

tetracycline + doxycycline –> teeth discolouration

Question 11

whos is at higher risk of neural tube defects + require 5mg folic acid?

Answer 11

previous NTD
taking anti-epileptics
coeliac disease
diabetes
thalassamia trait
BMI >30

Question 12

how long are all women given folic acid for ?

Answer 12

up until 12th week gestation

Question 13

can ibuprofen be given in pregnancy?

Answer 13

NSAIDS around 20wks or later - can cause serious kidney problems for baby

-> probs avoid

Question 14

what is cyclizine given for?

Answer 14

nausea + vomiting

Question 15

ferguson reflex

Answer 15

baby’s head presses again cervix –> oxytocin release

oxytocin = promotes uterus contractions
uterine contractions -> babys head presses on cervix

Question 16

hormones involved in uterin contractility

Answer 16

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

Question 17

braxton-hicks contractions

Answer 17

can occur throughout pregnancy
- once/twice per hour
- few times a days
- irregular + do NOT increase in frequency/strength

Question 18

first stage of labour

Answer 18

onset of true labour -> full cervical dilation

latent = 0-4cm - 6hrs
active = 4-10cm - 1cm/hr

Question 19

when is the second stage of labour prolonged

Answer 19

nulliparous
- >3hrs with regional anaesthesia
- >2hrs without

multiparous
- >2hrs with
- > 1hr without