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Obs > History taking and examination in obstetrics: > Flashcards

History taking and examination in obstetrics: Flashcards

1
Q

List 5 additional features you may wish to clarify from an obstetric presenting complaint:

A

PC:

  • Nausea/vomiting (hyperemesis gravidarum)
  • Abdominal pain (may need imaging)
  • Vaginal bleeding - fresh/clots/tissue
  • Dysuria/urinary frequency
  • Bowel habits
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2
Q

How is the Estimated Delivery Date (EDD) calculated without use of US scan?

A

LMP + 9 months + 7 days

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3
Q

When do foetal movements usually start to be felt?

A

18-20 weeks

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4
Q

What is gravidity?

A

The number of times that a woman has been pregnant

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5
Q

What is parity?

A

The number of times that she has given birth to a foetus with a gestational age of 24 weeks or more (regardless of whether the child was born alive or was stillborn).

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6
Q

A woman who is nulliparous is…

A

has not given birth previously (regardless of outcome)

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7
Q

Primagravida is…

A

a woman in her first pregnancy

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8
Q

Primaparous is..

A

a woman who has given birth once

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9
Q

A lady who is G2 P2 is said to have had…

A

Has had two pregnancies and two deliveries after 24 weeks.

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10
Q

A lady who is G2 P0 is said to have had..

A

Two pregnancies, neither of which survived to a gestational age of 24 weeks.

Sometimes a suffix is added to indicate the number of miscarriages or terminations a woman has had. So this lady who has had two miscarriages would be annotated as G2 P0+2

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11
Q

If a lady who was previously G2 P2 and G2 P0 is pregnant again, what denoted their current gravidity and parity ?

A

G3 P2 and G3 P0 respectively.

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12
Q

What does SROM mean?

A

Spontaneous rupture of membranes (water breaking).

May occur before contractions start or remain intact until delivery

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13
Q

What is important to note about membrane is women/amniotic fluid which is visible?

A

Colour:

  • Clear
  • Blood-stained
  • Yellow/green
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14
Q

What is a miscarriage defined as?

A

Loss of pregnancy before 24 weeks

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15
Q

What does IUFD mean?

A

Foetus’ with no sign of life in utero

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16
Q

What is neonatal death defined as?

A

The death of a baby within the first 28 days of life

17
Q

What is a partogram?

A

Graphical record of key data (maternal and foetal) during labour.

Measures include:

  • Cervical dialtion
  • Foetal HR
  • Duration of labour
  • Vital signs
18
Q

When is the uterine fundus able to be palpated?

A

After week 12

19
Q

From where is the fundal height measured from?

A

Pubic symphysis.

20
Q

What are the 4 different presenting parts of a foetus?

A
  • Normal
  • Transverse/shoulder
  • Face/brow
  • Breech (complete/footling/frank)
21
Q

What are the 3 different lies of a foetus?

A
  • Longitudinal
  • Transverse
  • Oblique
22
Q

Where is the ‘zero line’ in terms of the station during labour?

A

The zero-line is an imaginary line drawn between the ischial spines of the pelvis.

23
Q

When is a babys head said to be engaged into the pelvis?

A

Once it passes the zero-line

24
Q

When is a baby said to be crowning?

A

When it passes 5cm inferiorly to the ‘zero-line’.

25
Q

What examination is contraindicated in late pregnancy and why?

A

Digital vaginal examination is contraindicated in late pregnancy until Placenta Praevia can be excluded (RISK OF HAEMORRHAGE)

26
Q

What cervical changes undergo during pregnancy?

A

Becomes softer and enlarged due to increased vascularity.

There is a thick plug of viscid cervical mucus produced by the endocervical glands that occlude the cervical os

27
Q

What are the 3 planes of the pelvis?

A

Inlet
Midplane
Outlet

28
Q

What do 2/3 of women who die in pregnancy die of?

A

Pre-existing health problems. 1/3 die due to direct complications of pregnancy.

29
Q

What are the top 5 causes of maternal deaths?

A

1) Other indirect causes
2) Cardiac Disease
3) Neurological
4) Thrombosis
5) Psychiatric disorders

30
Q

What measures can be taken prior to pregnancy to minimise the effects any chronic conditions may have?

A
  • Optimise disease control, defer pregnancy until medical condition is stable
  • Rationalise drug therapy to minimise effects on baby - alter medication to drugs ‘safe’ in pregnancy
  • Effective contraception until ready to conceive
31
Q

Give one example of a condition that could worsen during pregnancy and one example of a condition which may improve?

A

Worsen - mitral stenosis

Improve - RA

32
Q

What additional care may be provided to mothers it increased risk of complications surround delivery and postpartum care?

A
  • “safest” mode of delivery
  • Neonatal support
  • Anaesthetic expertise
  • HDU/ITU facilities
  • Ongoing care postpartum - maternal condition may initially deteriorate

Obs (11 decks)

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