Gyn Obs

Question 1

Antibiotic of choice for UTI in pregnancy?

Answer 1

Cephalecin

If cannot give that: nitrofurantoin
Coamoxyclav

Question 2

What are the contraindications to vaginal Delivery in breach presentation?

Answer 2

1. Cord presentation.
2. Any presentation other than Frank or complete breach with a flexed or neutral head attitude.
3. Clinically inadequate maternal pelvis.
4. Fetal Anomaly incompatible with vaginal delivery
5. Fetal weight less than 2.5 kilograms or more than 3.8 kg

Question 3

What are the maternal risk factors for breach presentation

Answer 3

1. Nulliparity.
2. Grand multiparity
3. Previous breach birth.
4. Placental abnormalities.
5. Uterine anomalies.
6. OligoHydramnios.
7. Polyhydramnios.
8. Multiple gestations.

Question 4

At how many weeks of gestation should nulliparous women be offered ECV?

Answer 4

36 weeks

Question 5

At how many weeks of gas station should multiparous women be offered ECV?

Answer 5

37 weeks

Question 6

How do you treat deep vein thrombosis in pregnancy above the knee?

Answer 6

Six months of lower molecular weight heparin at the therapeutic dose
Change to unfractionated heparin four weeks before delivery.
Change over to warfarin after delivery and continue for six weeks

Question 7

What is the difference between treatment of DVT above and below the knee during pregnancy?

Answer 7

Above the knee, six months of therapeutic dose, low molecular weight heparin
Below the knee only three months

Question 8

What are the three types of indications for cervical cerclage?

Answer 8

1, history indicated
2. Ultrasound indicated.
3. Rescue indicated

Question 9

What are the indications in history for cervical cerclage ?

Answer 9

1. Two or more second trimester pregnancy losses in the presence of cervical shortening.
2. Each loss earlier than the previous pregnancy.

Question 10

What are the indications in the ultrasound scan for cervical cerclage?

Answer 10

Progressive cervical shortening on serial ultrasound scans and external os closed

Question 11

What are the rescue indications for cervical cerclage?

Answer 11

1. Cervix dilate more than two centimeter with no perceived uterine contractions
2. Premature cervical effacement more than 50%
3. Presence of pelvic pressure.
4. Heavy mucoid vaginal discharge or bulging membranes through the cervical os

Question 12

When should cervical cervlage be removed?

Answer 12

At 36 to 37 weeks

Question 13

What are the antiemetics used in hyperemesis gravidarum?

Answer 13

First line IV metochlopramide
Second line IV Ondansetrone
Third line steroids