More O&G Things I Don't Know ;) Flashcards
examples of AD inherited conditions?
marfans
neurofibromatosis
huntingtons
what foods should be avoided to prevent toxoplasmosis?
underpasturised milk
raw meat
soil
what is toxoplasmosis?
parasite that can cause congenital infections eye problems reduced IQ miscarriage still birth
what infection can be picked up from pate?
listeria
what is liver high in?
vitamin A
what is soft cheese associated with?
listeria
caffeine in pregnancy?
> 200 micrograms associated with IUGR and miscarriage
features of foetal alcohol syndrome?
deformed facial features reduced IQ kidney defects ADHD microcephaly flattened philtrum IUGR ongoing short stature deformed fingers heart problems also associated with still birth
routine blood tests in pregnancy at booking?
FBC (check for anaemia) rhesus status syphilis HIV Hep-B
what haemoglobinopathies are screened for at booking?
sickle cell
thalassaemia
optional trisomy screening bloods offered at booking?
PAPP-A and HCG (downs)
AFP, oetradiol and inhibin
1st trimester screening for downs?
PAPP-A
HCG
nuchal thickness on USS
diagnostic tests for downs if deemed high risk of trisomy?
amniocentesis (after 15 weeks)
CVS (11-14 weeks)
routine bloods at 28 weeks?
random glucose
FBC
group and save
look for antibodies?
second trimester screening for downs?
AFP
oestrogen
inhibin??
what trisomies are screened for?
downs (21)
edwards (18)
pataus (13)
features of edwards?
microcephaly micrognathia (small jaw) low set ears hands clenched into fists low set ears mental impairment clubfoot
features of pataus?
microcephaly micrognathia low set ears small, close set eyes (eyes can be absent) cleft lip/palate severe mental retardation extra fingers or toes
biggest risk factor for downs syndrome?
maternal age (increased over 30??, 1 in 100 risk if over 40)
what GI anomalies are screened for at 20 week anomaly scan?
gastroschisis
exomphalos (bowel contents contained within sac)
which has worse prognosis - gastroschisis or exomphalos?
exomphalos
bc its associated with severe genetic defect such as edwards or pataus
also higher risk as more abdominal contents can be outside of body in the sac
can be tested for on amnio or CVS
who should get high dose folic acid (5mg)?
diabetes
obesity
history of neural tube defect
women taking anti-epileptics or nay enzyme inducing drugs
what other vitamin should all pregnant women be taking?
vit D
19 week pregnant woman whos rhesus negative and has PV bleeding, does she need anti D?
yes
who needs anti D?
over 12 weeks, rhesus negative with PV bleeding suggesting a sensitising event
what is a sensitising event?
might be foetal blood cells getting into maternal circulation causing mum to create an immune response to the foetal blood cells
includes miscarriage or termination if after 12 weeks
women with haemolytic disease of newborn in previous pregnancy due to known D antigens requires anti D in next pregnancy?
no
already sensitised in previous pregnancy so already has D antigens so anti-D wont stop immune response
blood test to look for amount of foetal blood cells in mothers circulation to help give right dose of anti-D?
kleinhauers test
done after 20 weeks (as <20 weeks there isnt that much blood so standard anti-D dose will definitely be enough)
are all rhesus negative women without known D-antigens (previous sensitising event) given anti-D routinely?
yes
all get it once or twice just to cover asymptomatic bleeding
if potentially sensitising event occurs they get another additional dose
what ethnicities are associated with sickle cell?
afro caribbean
what ethnicities are associated with thalassaemia?
cypriot eastern mediterranean asian indian middle eastern
is thalassaemia microcytic or macrocytic?
micro
is sickle cell micro or macrocytic?
normocytic
can termination be done if foetus has haemoglobinopathy?
yes
should have counselling with haematology though to make sure they understand the condition
how is foetal anaemia identified if suspected in the feotus?
titres of antibody levels increase which suggests foetal anaemia
look at middle cerebral artery on doppler US to identify waveform suggesting anaemia
presentation?
which part of foetus is presenting at foetus
malpresentation?
any presentation other than vertex
position?
relationship of presenting part to maternal pelvis (eg occiput/sacrum)
lie?
longitudinal/transverse
station?
relationship of foetal presenting part to level of ischial spine (-3 to +2)