March 2015 recall Flashcards
How long do you keep a CTG for?
25 years
If problems, indefinitely
Which nerve damaged- following forceps, faecal and urinary incontinence
Puedendal nerve (S2-S3)
After vaginal birth, struggling to flex hip, extend knee- which nerve damaged?
Femoral (L2-L4)
(this can also be damaged in an abdominal hyst due to retractor)
After lithotomy- foot drop and sensory loss in lateral thigh, which nerve damaged?
Common perineal which is a branch of sciatic nerve (L4-S3)
Which nerve is compressed if there is labial numbness?
Genito-femoral nerve (L1-L2)
Labial/ femoral triangle
What is the risk of having a baby affected by congenital heart disease?
0.8%
What is the risk of death for babys affected by eisenmengers syndrome?
25-40%
Which heart conditions is high risk for the mother?
Eisenmengers
Marfans (AD)
Peripartum cardiomyopathy
Hypertrophic cardiomyopathy (AD)
Autosomal dominant conditions, 50% that baby will have it
What is the histology behind pemphigoid gestationis?
Immune complex deposits, PG factor which is an IgG binds to the BP-180 in the basement membrane of the epidermis separating the layers and forming a blister.
Tx with topical steroids
What is the risk of recurrence with OC?
45-90%
How common is pemphigoid gestationis
1 in 50,000 pregnancies
Inc risk of SGA
How common is PUPPS?
1 in 250 pregnancies
What is the most common symptom in central venous thrombosis?
Headache
What is the diameter for face presentation, vertex, deflexed OP and brow presentation?
vertex and face- 9.5
deflexed OP- 11
brow- 13.5
What percentage of babies will revert to breech after ECV?
5%
How best to date pregnancy using USS?
Use CRL up to 84mm length, ~14 weeks
>100mm can measure HC
What is the risk of herpes going to the baby if mum had recurrent episode?
0-3%
What is the risk of herpes going to the baby if mum had primary episode?
41%, recommend caesarean section
When do you give MgSo4 in PTL?
Definitely 24- 30 weeks
Consider 30-34 weeks
Which maternal conditions are more common in a male fetus?
AFLD (3:1)
OC
What is the anti D antibody level needed for referral to a FMU?
> 4 for referral
(between 4 and 15, moderate risk of HDFN, >15 severe disease)
When to refer anti C antibody level to FMU?
> 7.5
(between 7.5 and 20 moderate HDFN, > 20 high risk HDFN)
Which antiepileptic drugs need monitoring in pregnancy?
Lamotagine
Which emergency contraception do you use if your patient is on an enzyme inducer eg antiepileptic?
Lng, 3mg (levonelle, double dose)
Survival rates for prematurity?
22, 24, 27, 31 weeks
22- 10%
24- 60%
27- 89%, ~10% disability
31- 95%
How early do you start USS in MCDA twins?
From 16 weeks and then every 2 weeks
Which patients with HIV would you recommend a CS to?
Viral load >400
Concurrent Hep C
Not on ART
Only taking zidovudine
Which patients with HIV would you consider CS or vaginal birth?
If viral load is between 50 and 399, consider options, discuss with patient, consider length of time on ART, adherence, obstetric factors
Which HIV ART do you need to increase your folic acid dose to 5mg?
Dolutegravir- they need 5mg a day when trying to conceive and for first trimester
All others just need the usual 400micrograms
For patients with HIV, if cs is being performed due to viral load and risk of vertical transmission, which gestation should this be performed?
38 weeks
When is it indicated to use IV zidovudine for women with HIV?
Presenting in labour or planned ELCS with viral load >1000
Untreated women presenting in labour where viral load is unknown
Can ‘consider’ if viral load between 50 and 1000
