Examination

Question 1

OGTT screening indications

Answer 1

Family Hx diabetes (first degree)
Raised BMI > 35
Prev Hx of Macrosomic baby and or polyhydromnias
Prev Hx of GDM or IGT
2nd episode of glucosuria

Question 2

Causes of enlarged SFH for dates?

Answer 2

Multiple pregnancy
Polyhydromnias
Incorrect dates
Big baby ( macrosomia)
Full bladder

Question 3

H

Question 4

How do you manage a large for GA pregnancy?

Answer 4

Recheck the gestational age by reviewing the initial method used
Ensure the bladder is empty
Use ultrasound to check for multiple pregnancy
Check the AFI for polyhydromnias

Question 5

Causes of a gestation age smaller than SFH?

Answer 5

Incorrect dates
IUGR
IUD
ROM
Oligohydramnios

Question 6

What are the risk factors of IUGR?

Answer 6

Multiple pregnancy
Previous IUGR baby
Smoking
Low SES : Poor Nutrition
APH
Pre- ecclampsia

Question 7

What are the clinical findings of IUGR?

Answer 7

SFH smaller for GA
Small hard head
Oligohydramnios
Irritable uterus

Question 8

Causes of decreased foetal movements

Answer 8

Sleep
IUD
Oligohydramnios
IUGR
Abruptio placentae

Question 9

Causes of CTG baseline tachycardia?

Answer 9

Maternal exhaustion, maternal pyrexia, infection, fetal anemia, medication

Question 10

Causes of CTG baseline bradycardia?

Answer 10

Fetal hypoxia, Maternal beta blockers, hypothermia, hypoglycemia

Question 12

Indication of the administration of MgSO4

Answer 12

Imminent of eclampsia ( tachy, severe epigastric pain, headaches, increased deep tendon reflexes, Visual disturbances) and increased BP

Question 13

What are signs of MgSO4 toxicity?

Answer 13

Bradycardia, loss of deep tendon reflexes, oliguria (urine output less than 30ml/hr)

Question 14

Management imminent ecclampsia

Answer 14

4g in 200ml of normal saline over 30 minutes
then at an infusion rate of 50mls/ hr

Question 15

Antidote for MgSO4 toxicity

Answer 15

10% calcium gluconate 10ml IV in 10min

Question 16

What are the complications of cpd?

Answer 16

Shoulder dystocia
Intracranial haemorrhage
Umbilical cord prolapse
Fetal distress

Question 17

What is PPH and what are the risk factors?

Answer 17

Excessive blood loss via the genital tract after delivery of more than 500ml in NVD and 1000ml in C-Section.

APH, Previous PPH, Multigravida, prolonged pregnancy,

Question 18

4 causes of post partum haemorrhage

Answer 18

Tone, tissue, trauma (tears) , thrombin

Question 20

What are the contraindications of a VBAC?

Answer 20

Prev 2 C Sections, classical C section, maternal refusal, macrosomic baby, multiple pregnancies, placenta previa