O&G Flashcards
How manage an OP head presentation
Likely will spontanoeusly rotate however if needs rotating after long labour ideally use kielland forceps
What is sign on examination of cocaine use causing placental abruption
Dilated pupils
Hyperreflexia
What give for hypermagnesaemia in after mag sulph
Calcium gluconate
How are ovarian masses managed
Assess on TVUSS whether any M features of cysts
If any M features then refer under 2WW
If
- under 50mm then can rescan in 3 months
- 50-70mm rescan in a years time
- over 70mm consider MRI or surgery
What do if premenopausal woman has an ovarian mass with any complex features of mass
Refer to gynae oncology and measure AFP, LDH and HCG
When refer for RFM
24 weeks
How long after a medical termination of pregnancy is pregnancy test expected to be positive
4 weeks- if longer suggests trophoblastic disease or retained products of conception
Causes of cervical tenderness
PID
Ectopic
What are sections to abortion act
2 doctors in good faith agree
A- continuing would risk life of pregnant woman
B- necessary to prevent grave physical or mental health risk of mother
C- pregnancy not exceeded 24 weeks and continuance would involve risk of injury to physical or mental health of mother
D- not exceedd 24 weeks and would involve risk to mental/physical health of existing children
E- born handicapped
Before 9+0 weeks what are options with regards to medical abortion options
Can do mifepristone and misoprostol at same time or with interval
- bleeding worse with together
- more likely to fail if together
Difference in prep for surgical abortion
All doxycycline 3 days, LMWH for 7 days and anti-D if Rh negative over 10 weeks
Before 14 weeks= oral misoprostol 1 hour before or sublingual misoprostol
14-19 weeks= osmotic dilators or vaginal misoprostol
19-23+6 weeks= osmotic dialtors and mifepristone both the day before
When is pregnancy test given post abortion
Medical up to 10+0 weeks
Is a multilevel pregnancy test which can measure HCG levels
Management of vaginal bleeding pre 6 weeks pregnant
Send home if no previous ectopic
Ask to do pregnancy test in 7 days
Return if positive or still bleeding or pain develops
If negative likely will have miscarried
What to do about anti-epileptics when breastfeeding
Any are fine except barbiturates
What type of C-section do if breech noticed whilst in labour
Category 2 C-section
What is regime for intrapartum antibiotics for GBS
Given at start then at 4 hourly intervals
When can COCP be started postnatally
3 weeks if not breastfeeding
6 weeks if are
How treat UTI if breastfeeding
Trimethoprin
What is combined test result for edwards
Low oestriol and HCG
If have been detected as having GBS in pregnancy what is management post natally
Stay in hospital for 24 hours to monitor
If woman comes in with menorrhagia, what may prompt to do hysteroscopy or TVUSS
Hysteroscopy
- persistent intermenstrual bleeding
TVUSS
- dysmenorrhoea
- bulky uterus
What is synctocinon vs synctometrine
Synctocinon= oxytocin
Synctometrine= synctocinon and ergometrine
What can iliac fossa pain with onset with exercise suggest
Ruptured ovarian cyst
Ovarian torsion
If has laparoscopy which is unremarkable but dye studies show blocked tubes, what is diagnosis
PID as endometriosis would appear on laparoscopy