Hypertensive disorders in pregnancy Flashcards
What is the leading cause of death among pre-eclamptic women?
intra-cranial heamorrhage
What can fluid overload in pregnant women cause?
Pulmonary oedema
What does a uterus large for dates and glycosuria suggest?
Gestational diabetes with polyhydraminos
What could abnormal posture, limb position and possibly polyhydraminos indicate?
Fetal dyskinesia disorder
What is a circumvallete placenta?
Circumvallate placenta is a placental disease in which the fetal membranes (chorion and amnion) “double back” on the fetal side around the edge of the placenta. After delivery, a circumvallate placenta has a thick ring of membranes on its fetal surface.
What problems can a circumvallete placenta cause?
Circumvallate placenta often causes persistent vaginal bleeding beginning in the 1st trimester, premature rupture of the membranes (PROM), preterm delivery, and placental abruption and is thus associated with poor pregnancy outcomes
What is tapipes equniovarus?
Club foot
What can DIC after birth be an indication of?
amniotic fluid emboli
What is uterine inversion?
When the placenta fails to detach from the uterus
What happens to the patient when there is uterine inversion?
They become hypotensive and shocked and often a post-partum heamorrhage occurs.
Can you perform a cervical smear in pregnancy if you suspect malignancy?
Yes
How could a congential infection such as congenital CMV present in a newborn?
IUGR, petechaie, jaundice and hepatosplenomegaly.
Name uterotonic drugs which are used for active management of the third stage of labour?
Oxytocin, ergometrin and a mixture of the 2- syntometrin.
When should ergometrin not be used as active management of the third stage of labour?
it is contraindicated in cardiac disease
What can commonly be confused with a breech position?
A face presentation
So, if there is face presentation, it can either be mento-anterior or mento-posterior. Mento anterior is the mentum (chin). Which one is incompatible with a vaginal delivery?
Mento-posteior. ie chin at the bum
What is the risk of a transverse lie to the mother and the fetus.
Mother- obstructed labor, ruptured uterus. and the fetus- chord prolapse
How can uterine hyperstimulation be caused in labor and how can it be treated?
It occurs in response to vaginal prostaglandins and you see increased frequency in contractions (7 in10). You need to achieve uterine relaxation with tocolytic such as SC terbutaline.
What is the benefit of active management of the third stage of labour?
It reduces the risk of post-partum hemorrhage and the need for blood transfusion
What is considered high blood pressure in pregnancy?
systolic > 140 mmHg or diastolic > 90 mmHg
or an increase above booking readings of > 30 mmHg systolic or > 15 mmHg diastolic
What is Johnson’s manoeuvre?
Uterine repositioning is best done manually and quickly, firstly using Johnson’s method. This involves slowly and steadily pushing the uterus upwards towards the umbilicus. If this fails, O’Sullivan’s technique can be utilised, which involves infusion of warm saline into the vagina.
What do you manage high bp in an asthmatic in pregnancy?
Oral nifedipine
What do the degree tears involve?
first degree: superficial damage with no muscle involvement
second degree: injury to the perineal muscle, but not involving the anal sphincter
third degree: injury to perineum involving the anal sphincter complex (external anal sphincter, EAS and internal anal sphincter, IAS):
3a: less than 50% of EAS thickness torn
3b: more than 50% of EAS thickness torn
3c: IAS torn
fourth degree: injury to perineum involving the anal sphincter complex (EAS and
IAS) and rectal mucosa
