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3A > monday 9th > Flashcards

monday 9th Flashcards

1
Q

When is anti D given?

A

28 and 34 weeks

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2
Q

When is an USS done in placenta praevia?

A

32 weeks

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3
Q

what are 4 things looked at on CTG?

A

baseline rate (110-160 is reassuring)
variaibility (5-25 is reassuring)
accelerations (good)
descelerations (prolonged are bad)

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4
Q

what are the movements of the fetus in labour

A

descent
engagement
neck flexion
internal rotation
crowning
extension of the presenting part
restitution
external rotation
lateral flexion

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5
Q

what are the two stages of the first stage of labour?

A

latent (0-3cm)
active (3-10cm)

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6
Q

how is active management of the third stage managed?

A

IM oxytocin and controlled cord traction- when the placenta is detached there will be lengthening of the umbilical cord, explusion of blood and ascension of the uterus in the abdomen

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7
Q

what are 2 definite indications for active management of the third stage?

A

haemorrhage or passive management taking over 60 minutes

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8
Q

what are the 5 things considered in bishops scoring and what score indicates induction is needed

A

cervical effacement
cervical consistency
cervical position
cervical dilation
fetal station

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9
Q

what antibiotics will be given for asymptomatic bacteriuria in the first trimester and in the third trimester

A

first- nitrofuratoin
third- amoxicilin

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10
Q

what test for syphilis is done at booking appointment

A

VDRL test

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11
Q

what three things will be assessed in determining the risk of premature birth?

A
  • part history of premature birth
  • cervical length on transvaginal USS (if less than 25mm it is likely)
  • fetal fibronectin (if <50 then unlikely
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12
Q

what two things can be done to prevent premature birth and why would one be chosen?

A
  • vaginal progesterones
  • cervical clerclage

Cervical clerclage will be done if previous premature labour, or if cervical trauma such as cone biopsy

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13
Q

when should someone with gestational diabetes be delivered?

A

38 weeks

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14
Q

when should someone with obstetric cholestasis be delivered?

A

37 weeks

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15
Q

what are some indications for induction of labour

A

post maturity
decreased fetal movements
conditions such as gestational diabetes (38) and obstetric cholestasis (37 weeks)
pre-eclampsia
fetal death
PPROM

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16
Q

What bishops score needs induction of labour ?

A

5 or below

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17
Q

what are 4 methods that will be used in induction of labour

A

Membrane sweep
Vaginal prostoglandins E2
Balloon catheter
Amniotomy and IM syntocinon

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18
Q

what is the main complication of induction of labour and what would it be characterised?

A

uterine hyperstimulation (indicated by >5 contractions in 10 mins)

19
Q

what defines miscarriage, what is early and what is late?

A

spontaneous termination of a pregnancy before 24 weeks
early = <12 weeks
late= 12-24 weeks

20
Q

before what gestation can medical management of a miscarraige be used?

A

before 13 weeks

21
Q

what defines recurrent miscarriages ?

A

3+ miscarriages

22
Q

what are the main causes of recurrent miscarriage

A

anti-phospholipid syndrome
endocrine - poorly controlled diabetes
smoking
uterine abnormality

23
Q

what may be given to those with recurrent miscarraiges ?

A

low molecular weight heparin and aspirin

24
Q

what sign may be seen on transvaginal USS of ectopic

A

blob sign

25
Q

criteria for expectant management of a ectopic?

A

<35mm, no heartbeat, asymptomatic, hCG < 1000, not ruptures

26
Q

criteria for medical management of an ectopic?

A

<35mm, no heartbeat, asymptomatic/no significant pain, hCG <1500, not ruptures

27
Q

when should surgical management of an ectopic be used?

A

> 35mm, heartbeat visible, ruptures, symptomatic, hCG>5000

28
Q

what are some risk factors for molar pregnancy?

A

extremes of maternal age, multiple pregnancy, oral contraceptive, previous

29
Q

how is molar pregnancy treated?

A

surgical evacuation

30
Q

what two different surgical options are there for termination of a pregnancy and when can each be done?

A

cervical dilation and suction-> before 14 weeks
cervical dilation and forceps removal-> before 24 weeks

31
Q

when should anti-D be given in termpination of a pregnancy?

A

if the mother is rhesus negative and it was terminated after 10 weeks

32
Q

what is antepartum haemorrhage?

A

vaginal bleeding after 24 weeks gestation

33
Q

what are some causes of painless vaginal bleeding in pregnancy?

A

placenta praevia
vasa praevia

34
Q

what are some causes of painful vaginal bleeding in pregnancy ?

A

placental abruption
placental accreta/percreta
uterine rupture

35
Q

what are the different classifications of antepartum haemorrahge

A

spotting
minor- <50ml
major- 50 to 1000ml
massive >1000ml or signs of shock

36
Q

when should USS be done done for placenta praevia?

A

at 32 weeks then again at 36 weeks

37
Q

what are some RF of placenta praevia?

A

previous placenta praevia
previous caesarean
increased maternal age
smoking
structural uterine abnormalities
IVF

38
Q

RF of placental abruption

A

pre-eclampsia
smoking
polyhydramnios
abnormal fetal lie
increasing maternal age
maternal trauma
multiple pregnancy
multigravity

39
Q

who is given intrapartum ABx during labour

A

any woman in preterm labour
women who are GBS positive
women with a previous baby with early or late onset GBS disease
women with pyrexia during delivery

40
Q

what antibiotic is given for intrapartum Abx

A

benzylpenicillin

41
Q

when is low molecular weight heparin given for VTE prophylaxis in pregnancy

A

from 28 weeks if 3 RF
from 12 weeks if 4+ RF

42
Q

RF for VTE in pregnancy

A

smoking
parity over 3
BMI>30
age >35
reduced mobility
family history of DVT
multiple pregnancy
pre-eclampsia
varicose veins
immobility
IVF
thrombophilia

43
Q
A

3A (42 decks)

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