Maternity

Question 1

Post partum haemorrhage amount of blood loss

Answer 1

Primary less than 500 ml in 24 hours

Minor between 500ml-1000ml in 24 hours

Major over 1000 ml in 24 hours

Question 2

What can apply when looking at blood loss

Answer 2

Rule of 30

Systolic bp drop by 30
Pulse increase by 30 or more
Haemoglonin decreased by 30
Haemotocrit decreased by 30

Question 3

What does misoprostol do

Answer 3

Effective at reducing bleeding

More prone to side effects then oxytocin

Synthetic prostaglandin = smooth muscle contraction

Question 4

What does syntometrine do

Answer 4

Combination of oxytocin and ergometrine

Enhance uterine contraction

Preganant women have more oxytocin receptors

Question 5

If ongoing bleeding after given maternity drugs give

Answer 5

TXA 1g in 10 minutes repeat once if necessary

Question 6

When is a miscarriage

Answer 6

Anytime before 24 weeks

Question 7

If bleeding is after 20 weeks

Answer 7

The uterus is above umbilicus consider placenta abruption/ praevia

Question 8

Placenta previa is

Answer 8

When the placenta partially or completely covers the cervix

Question 9

Signs and symptoms of pre eclampsia

Answer 9

Hypertension 
Abdo pain 
Oedema 
Headaches, blurred vision 
Protein in urine

Question 10

If seizure when pregnant give diazepam

Answer 10

In 2-3 minutes rather than 5

Question 11

What to do in breach birth

Answer 11

Allow to move spontaneously
Guide head
Do not touch baby or umbilical cord

Question 12

What to do if won’t come out

Answer 12

Mcroberts

Suprapubic pressure

All fours

Question 13

Hormones involved in birth

Answer 13

Oxytocin
Melatonin
Adrenaline - reduces effect on oxytocin

Question 14

Why is semi-recumbent position not ideal for giving birth

Answer 14

Aorta and vena cava compression by uterus

Pushing uphill

Question 15

What to do if baby born in amniotic sac

Answer 15

Find where it is rupture and pull over the babies head

Question 16

What to do if baby is born in amniotic sac with maternal wall of placenta attached

Answer 16

use fingers push straight through

If need scissors pinch and cut so don’t catch baby

Question 17

Newborn resus

Answer 17

Can perform still attached to mother 
Less than 22 weeks we do not resus 
More than 22 weeks thermal care, inflation breaths 
No chest compressions below 24 weeks 
No ecg dots below 32 weeks

Question 18

What to do in water birth

Answer 18

Instruct to get out and tell partner 
PPE - use gloves, sleeve, aprons 
Temp water - 37 C 
Don’t let Bob in and out of water 
Let mother bring baby up out of water 
Get woman out of pool to deliver placenta

Question 19

What to do after birth

Answer 19

Skin to skin contact
If baby is warm leave hat off as the smell is most in the head
Try to get baby to latch on

Wait for cord to stop pulsating - flat white and opaque. Allows the placenta to drain the blood, stem cells and antibodies

Question 20

What to do after birth placenta

Answer 20

1 hour = retained

After 20 minutes at risk of pph should cannulate and be going to hospital