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Obs & Gynae > Intro > Flashcards

Intro Flashcards

1
Q

What 4 purposes does the 12-week pregnancy dating scan have?

A
  • Find out how many weeks pregnant and also EDD
  • Find out how many babies pregnant with
  • Find out if baby is growing in correct place
  • Find out about baby’s development
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2
Q

At which gestational age is the pregnancy dating scan carried out at?

A

12 weeks

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3
Q

At what gestational age does the initial booking clinic occur?

A

Before 10 weeks gestation

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4
Q

What education topics are covered at the booking clinic?

A

What to expect at different stages of pregnancy
Lifestyle advice in pregnancy (e.g. not smoking)
Supplements (e.g. folic acid and vitamin D)
Plans for birth
Screening tests (e.g. Downs screening)
Antenatal classes
Breastfeeding classes
Discuss mental health

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5
Q

What booking bloods are taken at the booking clinic?

A

Blood group/antibodies/rhesus D status

FBC (anaemia)

Thalassemia/Sickle cell

Rubella IgG

Chromosomal abnormalities and Hb-opathies

Also offered HIV/Hep B/Syphilis screening

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6
Q

What test is done for Down’s syndrome and at what gestational age?

A

Combined test - 11 weeks onwards

Involves ultrasound scann with blood test

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7
Q

Which conditions does the 11 week combined test screen for?

A

Down’s syndrome
Edward’s syndrome
Patau’s syndrome

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8
Q

Nuchal translucency scan tests for which condition?

A

Down’s syndrome, Edward’s, Patau’s

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9
Q

If nuchal translucency test is not possible, which blood screening test can be offered later (14-20 weeks)?

A

Quadruple test

Only screens for Down’s and is not as accurate as combined test

Or even later… Mid-pregnancy scan

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10
Q

Aside from blood tests, what other measurements are taken during the booking clinic?

A

Weight, height, BMI

Urine (?protein, ?bacteria)

BP

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11
Q

What psychosocial issues are discussed during booking clinic? (List 2)

A

FGM

Domestic violence

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12
Q

Booking clinic tests for following risk factors:

Rhesus -ve
Gestational diabetes
Fetal growth restriction
VTE
Pre-eclampsia

If the following are positive what will you give for each?

A

Rhesus -ve: anti-D prophylaxis

GDM: OGTT test

FGR: additional growth scans

VTE: prophylactic LMWH

Pre-eclampsia: aspirin

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13
Q

In Down’s syndrome, what nuchal translucency thickness is expected?

A

Greater than 6mm

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14
Q

In the combined test, which 2 blood tests are used?

If positive, what would you expect for each?

A

Beta-HCG - higher result

PAPPA (pregnancy-associated plasma protein A) - lower result

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15
Q

Triple test is performed between which gestation age?

A

14-20 weeks gestation

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16
Q

Which tests does the triple test include?

If positive, what would you expect for each?

A

Only 3 blood tests:

Beta-HCG - higher
Alpha foetoprotein (AFP) - lower
Serum oestriol - lower

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17
Q

What extra blood test does the quadruple test include (compared to the triple test)?

If positive, what would you expect for this test?

A

Inhibin A

Higher = greater risk

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18
Q

If the Down’s syndrome risk is great (shown by screening), what 2 invasive antenatal tests can be offered for the woman?

A

Amniocentesis

Chorionic villus sampling

Foetal cells are sampled and karyotyped for definitive Down’s diagnosis?

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19
Q

What alternative non-invasive test can be offered for Down’s?

A

NIPT

Non-invasive prenatal testing. Blood test from mother containing fragments of foetal DNA.

20
Q

First trimester is from which gestational ages?

A

Start of pregnancy -> 12 weeks

21
Q

Second trimester is from which gestational ages?

A

13 weeks -> 26 weeks

22
Q

Third trimester is from which gestational ages?

A

27 weeks -> birth

23
Q

At which age do foetal movements start?

A

20 weeks

24
Q

Which measurement allows an accurate gestational age to be taken?

A

Crown - Rump length (CRL)

25
Q

Which 2 vaccines are offered to ALL pregnant women?

A

Pertussis (16 weeks)

Flu (autumn/winter)

26
Q

Which vaccine group is to be avoided in pregnant women?

A

Live vaccines - e.g. MMR

27
Q

What supplements are recommended in pregnancy? (List 2)

A

Folic acid

Vitamin D

28
Q

Which vitamin is to be avoided in pregnancy and why?

A

Vitamin A - teratogenic!

29
Q

Why is unpasteurised dairy and undercooked poultry to be avoided?

A

Listerosis

Salmonella

30
Q

What advice can you give regarding sports, sex and flying?

A

Sports - good but avoid contact sports

Sex - safe

Flying - increases VTE risk so avoid

31
Q

During which months is alcohol most destructive in pregnancy?

A

First 3 months

32
Q

Alcohol in pregnancy can lead to which risks?

A

Miscarraige
SGA
Preterm delivery
FAS

33
Q

What features can be seen in FAS?

A 
Microcephaly
Thin upper lip
Smooth, flat philtrum
Short palpebral fissure
Learning disability
Behavioural difficulty
Hearing/vision problems
Cerebral palsy
34
Q

Smoking in pregnancy increases risk of? (List at least 4)

A 
FGR
Miscarriage
Stillbirth
Preterm labour/delivery
Placental abruption
Pre-eclampsia
Cleft lip/palate
SIDS
35
Q

Which obstetric disorders have a high recurrence rate with future pregnancies?

A 
Preterm labour
SGA
FGR
Stillbirth
Antepartum/Postpartum Haemorrhage
Congenital anomalies
Rhesus disease
Pre-eclampsia
GDM
36
Q

What medical conditions put women at increased risk of pregnancy problems and require specialist input?

A 
HTN
Diabetes
Autoimmune disease
Haemoglobinopathies
VTE
Cardiac disease
Renal disease

Other serious illnesses

37
Q

When is the earliest opportunity that drugs in pregnancy can be changed to more safer ones?

A

Preconceptual counselling visits

38
Q

Which pregnancy related issues can linked to family?

A

GDM (1st degree relative has DM)

HTN

VTE

Autoimmune disease

Pre-eclampsia

39
Q

At which age can the foetal heart be auscultated with an electronic monitor?

A

12 weeks

40
Q

What are tests for itching in pregnancy?

A

Jaundice? (rare)

LFT
Bile acids

41
Q

Management of pelvic girdle pain?

A

Physio
Corsets
Analgesics

Auto-resolves post delivery

42
Q

How is heartburn managed in pregnancy?

A 
Avoid supine (use extra pillows)
Antacids - ranitidine

Careful of pre-eclampsia which presents with epigastric pain

43
Q

Management of constipation when given oral iron?

A

High fibre diet

Stool softeners

44
Q

Management of backache/sciatica?

A

Physio
Posture/lifting advice
Firm mattress
Corset

Auto-resolves post delivery

45
Q

Management of slow onset ankle oedema towards end of pregnancy?

A

Raising foot of bed at night

Avoid diuretics unless sudden increase in oedema (in this case do BP, assessment and urinalysis) - ?pre-eclampsia

46
Q

How is vaginitis treated in pregnancy?

A

Clotrimazole vaginal pessaries

Obs & Gynae (13 decks)

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