Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction and sexual health > Large for dates > Flashcards

Large for dates Flashcards

1
Q

What is the definition of large for dates

A

symphyseal fundal height >2cm for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list causes for being large for dates

A 
wrong dates
foetal macrosomia 
polyhydramnios 
diabetes mellitus
multiple pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What might happen if the dates are wrong

A

Late booker
concealed pregnancy
travelled from abroad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does foetal macrosomia mean

A

big baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you diagnose foetal macrosomia

A

USS scan
estimated foetal weight (EFW) >90th centile
abdominal circumference (AC) >97th centile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the risks of having a big baby

A

anxiety to mother and clinician
labour dystocia
shoulder dystocia
post partum haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is diagnosing foetal macrosomia most accurate

A

<38 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

USS overestimates baby’s size, true or false

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of foetal macrosomia

A

exclude diabetes
reassure
surveillance
discuss delivery options

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

if a baby is >4.5kg, what delivery option should be considered

A

c-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is polyhydramnios

A

excess amniotic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose polyhydramnios

A

Amniotic Fluid index AFI > 25cm
Deepest Pool DP >8cm
Subjective impression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the causes for polyhydramnios

A

maternal: DM
foetal: anomaly, monochorionic twin pregnancy, hydrops fetalis, viral infection
idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms + signs of polyhydramnios in the mother

A 
Abdominal discomfort 
pre labour rupture of membranes 
pre term labour 
cord prolapse = obstetric emergency 
large for dates 
malpresentation 
tense shiny abdomen 
inability to feel foetal parts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Investigations for polyhydramnios

A

OGTT to exclude DM
USS - anomalies, multiple pregnancies
serology
Ab screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of polyhydramnios

A

explain and discuss
surveillance
IOL by 40 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define multiple pregnancy

A

presence of more than 1 foetus in the uterus

twins, triplets etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk factors for multiple pregnancy

A 
Assisted conception (less so now)
Ethnicity - African 
FH 
increased maternal age 
increased parity 
tall>short
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do monozygotic twins arise

A

splitting of single fertilised egg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do dizygotic twins arise

A

from fertilisation of 2 separate ova by 2 separate sperm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe dichorionic-diamniotic twins

DCDA

A

2 placentas + 2 amniotic sacs
occurs in days 1-3
can occur in mono + dizygotic twins

22
Q

Describe monochorionic-diamniotic twins

MCDA

A

1 placenta + 2 amniotic sacs
occurs in days 4-8
monozygotic twins

23
Q

Describe monochorionic-monoamniotic twins

MCMA

A

1 placenta + 1 amniotic sac
occurs in days 8-13
monozygotic twins
at higher risk for complications

24
Q

Describe conjoined twins

A

Both babies are joined together

25
Q

When is USS confirmation done for multiple pregnancy

A

12 weeks

26
Q

What does the lambda sign on USS mean

A

DCDA twins

27
Q

What does the T sign on USS mean

A

MCDA twins

28
Q

What are symptoms and signs of multiple pregnancy in the mother

A

exaggerated symptoms eg hyperemesis gravidarum
high AFP
large for dates uterus
multiple foetal poles

29
Q

What are complications of multiple pregnancy

A 
higher mortality 
congenital anomalies 
pre term birth 
growth restriction 
anaemia 
HG
pre-eclampsia 
antepartum haemorrhage 
twin - twin transfusion syndrome TTTS 
twin anaemia polycythaemia sequence TAPS 
absent/reversed end diastolic volume
30
Q

what is TTTS

A

arteriovenous anastamosis
donor twin perfuses recipient twin
oligohydramnios - polyhydramnios (oly-poly)

31
Q

Management of TTTS

A

fetoscopic laser ablation
amnioreduction / septostomy
deliver at 34-36/40

32
Q

When should DCDA twins be delivered

A

37-38 weeks

33
Q

When and how should MCDA twins be delivered

A

after 36 weeks with steroids

34
Q

How should MCMA twins be delivered

A

c-section

35
Q

Objectives of multiple pregnancy delivery

A 
consultant led 
epidural analgesia 
foetal monitoring 
oxytocin infusion after delivery of 1st baby 
intertwin time < 30 min 
be aware of PPH
36
Q

What are types of diabetes in pregnancy

A

Pregestational - T1+2DM

Gestational - starts in pregnancy and resolves by delivery

37
Q

Complications of pregestational DM only in pregnancy

A

congenital anomalies
miscarriage
intra uterine death
worsening of diabetic complications - retinopathy, nephropathy

38
Q

complications of both pregestational and gestational DM in pregnancy

A 
pre eclampsia 
polyhydramnios 
macrosomia 
shoulder dystocia 
neonatal hypoglycaemia
39
Q

Above what HbA1c level should conception/pregnancy be avoided

A

HbA1c > 86 mmol/L

40
Q

What HbA1c level should be aimed for pre conception

A

48mmol/L

41
Q

What should be advised in pre pregnancy counselling for diabetics

A

Control HbA1c
stop teratogenic drugs
Folic acid 5mg

42
Q

How do you manage T1DM in pregnancy

A 
SC inulin
low dose aspirin from 12/40 onwards 
5mg folic acid 
continuous DM checks and screens 
growth scans every 4 weeks from 28/40 
deliver at 38/40
43
Q

How do you manage T2DM in pregnancy

A 
PO metformin (stop SURs!)
low dose aspirin from 12/40 onwards 
5mg folic acid 
continuous DM checks and screens 
growth scans every 4 weeks from 28/40 
deliver at 38/40
44
Q

What are RF for GDM

A 
previous GDM in previous pregnancy 
FH of DM 
BMI>30 
ethnicity 
previous big baby 
polyhydramnios 
foetal macrosomia diagnosed 
glycosuria
45
Q

How is OGTT carried out

A

venous fasting blood sugar taken
give 75g glucose solution to drink
minimal activity in 2 hour break
measure 2 hour venous glucose

46
Q

What are the SIGN guidelines for diagnosing GDM in OGTT

A

fasting glucose >5.1

2 hour glucose >8.5

47
Q

How many times a day should blood glucose be checked

A

x4 /day

48
Q

What are the glycaemic targets for
fasting glucose
1 hour post meal

A

fasting glucose: 3.5-5.5

1 hour post meal <7.8

49
Q

What delivery timings are advised in:

  1. GDM with insulin
  2. GDM with metformin
  3. GDM with diet control
A
  1. 38-39 weeks
  2. 39-40 weeks
  3. 40-41 weeks
50
Q

How should GDM be followed up after delivery

A

fasting blood sugar measures 6-8 weekly

annual FBS and lifestyle changes

Reproduction and sexual health (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions