General obstetrics Flashcards
GnRH is released from ? and acts on ?
Hypothalmus and acts on anterior pituitary
GnRH stimulates the release of?
LH and FSH
What cells secrete oestrogen
Theca granulosa cells
Staging for puberty ?
Tanner
What provides negative feedback for LH and FSH
Oestrogen
What can affect age of puberty
Fat (aromatase in adipose tissue)
Skin changes in pregnancy and cause
Increased melanocyte stimulating hormone
Melasma, linea nigra
What produces hCG
synctiotiotrophoblast
Causes of raised hCG
Twins and molar pregnancy
hCG main function
Maintain corpus luteum (which produces progesterone)
Where is progesterone produced after 5 weeks?
Placenta (instead of corpus luteum)
Oestrogen function: (4)
Breast tissue development
Growth and development of female sex organs
Blood vessels in uterus
Development of endometrium
Progesterone function: (3)
Thicken and maintain endometrium
Thicken cervical mucus
Increase body temperature
oligohydramnios meaning
Low amniotic fluid levels
Meigs syndrome
Triad of ascites, benign ovarian tumour (fibroma) and pleural effusion
Drugs ending in -relin and function
GnRH agonist
Drugs ending in -relix
GnRH antagonist
Goserelin class
GnRH agonist
Mnemonic for CTG reading
DR C Bravado
Degarelix class
GnRH antagonist
G? P? Patient is pregnant and had one previous baby
G2 P1
G? P? Patient is currently pregnant and had two previous deliveries
G3 P2
Gravity and parity
Gravity = number of times pregnant Parity = number of times pregnant past 24 week
What is Mendelson’s syndrome
Aspiration of gastric juices into maternal lungs during analgesia in child birth
Methods for labour induction (3)
Vaginal prostoglandins
Amniotomy
Membrane sweep
How do prostaglandins induce labour
Ripen cervix and help smooth muscle of uterus contract
Drug to increase strength and frequency of contractions
Syntocinon (artificial oxytocin)
When is membrane sweep offered to most women
40 and 41 weeks to nulliparous
41 weeks to multiparous
Score to access cervical ripeness
Bishops
Bishops score cut offs (2)
7 or above: cervix is ripe
Less than 4: labour is unlikely to progress naturally
Common complications of IOL
failure (15% - give further cycle), uterine hyper stimulation (5% - give tocolytic agent like terbutaline), pain, infection, further intervention, rupture
OVD meaning
Operative vaginal delivery. Use of instrument to aid delivery
Terbutaline
Treats uterine hypersensitivity. Tocolytic.
Two types of OVD
Ventouse and forceps
Complications of forceps use
Higher rate of 3/4 degree tear
When would you expect delivery after pushing begins (time to use OVD)
2 hours in NP
1 hour in MP
Pre-requisites for instrument delivery
Fully dilated, ruptured membranes, cephalic presentation, metal head at ischial spine, empty bladder
P-PROM vs PROM
P-PROM is before 37 weeks
PROM is after 37 weeks (takes longer than 1 hour to then enter labour)
Stage 1 of labour
Onset of true contractions till 10cm dilation
Latent phase of labour
0 to 3cm dilation - progressing at 0.5cm an hour
Active phase of labour
3-7cm dilation - progressing at 1cm an hour
What are Braxton-hicks contractions
Occasional irregular that do not indicate labour