Mrcog Flashcards
Notes
Risk of death from acute infection in hepatitis B
1%
Risk of death from chronic infection in hepatitis B
25% from cirrhosis and liver cancer
How many of chronic carriers in hepatitis B get cirrhosis and liver cancer
10-30%
How effective is hepatitis B vaccine in eliminating infection
90%
How many percentage of acute infection are asymptomatic /mild with no jaundice
60-70%
Risk of becoming chronic carrier in hepatitis B
Infants 90%,Children <5 - 30% and adults 2-6%
Vertical transmission of hepatitis B in first trimester
10%
Risk of vertical transmission of Hepatitis B in third trimester
Upto 90%
UK prevalence of Hepatitis B in pregnancy
0.1-1%
What’s chronic carrier status in hepatitis B
HBsAg more than 6 months
Nuvaring composition
EE 15 mcg daily +etonorgestrel 120 mcg daily
Pre-eclampsia risk of recurrence
15% (1 pregnancy affected), 30%(2 previous pregnancies affected)
Delivery due to pre-eclampsia between 20-28 weeks recurrence risk
40%
Recurrence risk pre-eclampsia if between 29-32 weeks
30%
Pre-eclampsia Recurrence risk if delivery between 33-36 week
20%
Risk of recurrence of pre-eclampsia if delivery was 37+
10%
If very preterm delivery due to pre-eclampsia 27 weeks then recurrence rate
50-55%
Recurrence rate of pre-eclampsia if delivery was < 34 wks
25%
Recurrence rate of pre-eclampsia if delivery was < 28 weeks
50%
Sensitivity of USG for NTD
100%
USG can detect this percent of cardiac defects
50-60%
USG can detect this percent of trisomies markers
30-40%
How many percentage of NTD are detected by serum alphafetoprotein
85% as compared to almost 100% of USG
CS rate in IDDM
30-50%
No. 1 killer in IDDM
Fetal abnormalities
Does risk of iugr correlate with HbA1C level
No
How effective is anti D?
99%
For dating which parameters are used?
CRL at 9 weeks (for early dating) and cerebellar diameter at 22 week
How effective is aspirin in reducing fetal and maternal morbidity?
15% reduction in pre-eclampsia risk and 15% reduction in fetal death
How well does AC predict SGA?
AC <10th percentile predicts 85% of SGA
HELLP more common in multiparty than primipara?
True
Incidence of HELLP in antepartum period
70%
Incidence of HELLP in postpartum period
30%
What is overall recurrence risk of HELLP
20-25%
What is risk of developing pre-eclampsia with HELLP syndrome?
55%
What is the risk of recurrent placental abruption after 1 abruption?
5-16%
What is the risk of recurrent placental abruption after 2 previous abruption?
25%
Risk of recurrence after inversion in subsequent pregnancy?
Upto 50%
What is the rate of infection complicating LSCS wound?
5%
Which is most common tumor of newborn?
Sacral coccygeal teratoma
What is good sign for prognosis of sacral coccygeal teratoma?
If diagnosed after 30 weeks
What percentage of pediatric AIDS is secondary to vertical transmission?
80%
What percentage of hypertension in pregnancy is attributed to chronic hypertension?
1-5%
What is incidence of HELLP in pre-eclampsia?
4-12%
What is maternal mortality in HELLP?
2%
What is the range of AST, ALT in HELLP?
200-700
What is the range of AST, ALT in hemorrhage or infection?
> 1000
What are advantages of routine induction at 41 weeks?
Reduction in LSCS rate, perinatal mortality rate, meconium stained liquor
What remain unaltered with routine reduction at 41 weeks?
Instrumental delivery, MAS, neonatal seizure
What is advantage of amnioinfusion?
Improves Apgar score. With no improvement in mortality.
Does amnioinfusion increase risk in increase in maternal infection?
No
Effect of pregnancy on GFR?
Increased by upto 60% in first trimester. Predisposing to uti and glycosuria
Incidence of asymptomatic bacteriuria more than 105 cfu/ml in pregnancy?
3-8%
What percentage of women with asymptomatic bacteriuria will get acute cystitis /pyelonephritis if not treated?
15-45%
Precocious puberty in females?
Before 8 years
Precocious puberty in male?
Before 9 years
MOA of precocious puberty in McCune Albright disease?
Gonadotropin independent. Low FSH /LH
Sign of impending pulmonary edema?
Failing o2 saturation
At what CVP level pulmonary edema occurs?
> 6 mm Hg
What is risk of epilepsy if one of parent is epileptic?
3-4%
What is the risk of epilepsy if sibling has epilepsy?
10%
What is the risk of epilepsy if both parents are epileptic?
15-20%
What is the risk of tonic clonic convulsion in peripartum period?
1-5%
Drugs causing acute pancreatitis?
Tetracycline, thiazide
Define perinatal mortality rate
Stillborn babies (>24 completed weeks) +early perinatal death (within first week) /1000 total births
Incidence of lupus anticoagulant in general Obstetric population?
1%
Incidence of lupus anticoagulant in unexplained recurrent miscarriage?
20%
Significant lupus antibodies tire can lead to what percentage of fetal loss?
80%
What are tests of lupus anticoagulant?
In vitro - increased clotting time, in vivo- thrombotic tendency
IUFD rate in listeriosis?
Upto 20%
Drug of choice in listeriosis?
Ampicillin for 21 days
Incubation period of listeriosis?
3 weeks
What percentage of GDM patients will develop IDDM?
Within 5 years
Recurrence rate of shoulder dystocia?
17 times
What is resistance index RI?
Peak systolic velocity - end diastolic velocity /peak systolic velocity (PSV-EDV/PSV)
What is normal RI?
<0.55
What is S/D ratio?
PSV/EDV
What is color doppler color scheme?
Red to denote movement towards transducer and blue away from it.
How many of twin pregnancies are monochorionic?
33%
What is the incidence of monochorionic monoamniotic pregnancy?
1%
What is the incidence of TTTS?
10-15% of monochorionic pregnancies. More common in MCDA
What is reversal rate of TTTS?
5%
What is detection rate of SGA if single scan is done at 32 weeks?
85%
Down syndrome mechanism in 96% cases?
Non dysjunction( 85% maternal, 15% paternal)
Down syndrome due to translocations?
2-3%
What percentage of miscarriage have chromosomal abnormalities?
Upto 75%
Incidence of DS?
1 in 700 live births
What percentage of DS have cardiac defects?
40%
Which are most common cardiac defects in DS?
AVSD, VSD, TOF
What is the risk of DS if AVSD is detected on USG?
15%-offer invasive test
What is incidence of epilepsy in DS?
10%
What is the risk of hypothyroidism in DS?
20-40%
What is incidence of significant size discordance in monochorionic twins in absence of TTTS?
10%
What is incidence of Edward’s syndrome?
1 in 3000 live births
What percentage of Edward’s syndrome miscarry spontaneously?
95%
What percentage of Edward’s syndrome have USG findings?
90%
What is incidence of cardiac defects in Edward’s syndrome?
80%- most common - VSD
Features of Edward’s syndrome?
Strawberry skull, exomphalos(20%),polyhydramionos
What is the recurrence risk of Edward’s syndrome?
0.75-1%
What is incidence of Patau syndrome?
1 in 5000 live births
What is the recurrence risk of Patau syndrome?
0.75-1%
Features of Patau syndrome?
Holoprosencephaly, corpus callosum agenesis, Dandy walker syndrome, cardiac defects - AVSD, VSD, hypoplastic left heart, cleft lip and palate