O+G 3 Flashcards
Mx of urge incontinence surgically?
Before surgical consideration - do urodynamic studies
1st = Botulinium toxin type A injection (carries risk of temp urinary retention)
Percutaneous sacral nerve stimulation if overactive bladder doesnt respond to bot tox a / not willing to self catheterise
What is colposuspension used to treat?
Stress urinary incontinence (elevates bladder and anchoring to coopers ligament)
Punctuate haemorrhages in speculum?
Trichomonas vaginalis
…………. presents with massive postpartum haemorrhage, severe abdominal pain and
examination will find a uterine fundus that is not palpable abdominally
Uterine inversion
Antenatal steroid administration?
2 x dexamethasone - 24hr apart
What are the signs of MgSO4 toxiciity?
Resp depression - IMPORTANT TO MONITOR
Arrhytmias
Loss of deep tendon reflexes
Reversal of MgSO4 tox?
10 10 calcium gluconate
Stages of delivery?
Descent Engagement Flexion Internal rotation Extension Crowning External rotation Delivery of shoulders + body
FIGO staging?
1 - Uterus only
2 - Connective tissue of cervix but not outside uterus
3 - Beyond uterus and cervix but not beyound pelvis
4 - Beyond pelvis
Mx of genital herpes in pregnancy?
w/in 6w of delivery = oral aciclovir should be started immediately and should
continue until delivery + recommend planned c-section
1st / 2nd trimester = oral aciclovir from 36w and expectant vaginal delivery
Main side effect to warn about re implant contraceptive?
Irregular periods
What does this describe Common condition characterised by the presence of excoriated papules on the extensor surfaces of the limbs, abdomen, and shoulders?
Purigo of pregnancy
What does this describe?
It is a rare pruritic autoimmune disorder
characterised by the presence of blisters that begin on the abdomen and become widespread
Pemphigoid gestation
What causes linea nigra?
Thought to occur due to an increase in melanocyte-stimulating hormone produced by the placenta
Mx of shoulder dystocia?
Call for help!
Mcroberts
Suprapubic pressure
Episiotomy
Internal rotational manourvres (rubin, wood screw etc)
Place on all 4s + repeat manouvres
Last resort = symphisiotomy, cleideotomy or Zavenelli
What is the staging of urogenital prolapses?
First degree - The lowest part of the prolapse descends halfway down the
vaginal axis to the introitus
Second degree - The lowest part of the prolapse extends to the level of the
introitus and protrudes through the introitus on straining
Third degree - The lowest part of the prolapse extends through the introitus
and lies outside the vagina.
Procidentia - Severe third degree prolapse, where the uterus lies entirely
outside the vagina and is associated with complications, such as
ulceration
What is lambda’s sign and where is it found?
Lambda sign is an ultrasound feature of dichorionic pregnancies where the gap
between the two amniotic membranes forms a wedge shape
What is T sign and where is it found?
T-sign is when the junction between the intertwin
membrane and the placenta forms a right angle, and it is suggestive of a monochorionic diamniotic pregnancy
What type of pregnancy has no intertwin membrane
monochorionic monoamniotic twins
What marker is raised in endometriomas?
CA-125
What are the functional ovarian cysts?
Functional cysts
are the most common type of cyst and can either form from follicles (follicular
cysts) or from the corpus luteum (corpus luteal cysts).
As follicles are a normal
physiological phenomenon, they are only considered cysts once the diameter
exceeds 3 cm
What causes theca lutein cysts?
bilateral functional cyst that occur due to excessive stimulation by β-hCG
What are theca lutein cysts associated w?
gestational trophoblastic disease and multiple pregnancies
germ cell tumours are also known as?
dermoid cysts / mature teratomas
Which cysts are more common in PM women? what are the different types?
Epithelial cysts are most common in perimenopausal women
There are three main types: serous, mucinous, and Brenner tumours
What are tumours of the stromal part of ovary?
Sex cord
stromal tumours arise from the stromal component of the ovary — they also
have three main types: fibroma, thecoma, and granulosa cell tumour
Mx of HIV in pregnancy - when is vaginal delivery allowed? what f/u in this case?
Patients should also be
monitored closely by measuring viral load every 2–4 weeks, at 36 weeks, and after delivery
Planned vaginal delivery is possible in patients who have a viral load less than 50 copies/mL at 36 weeks’ gestation
Elective vaginal delivery with 4–6-week course of zidovudine for the baby
What is medical mx of ToP + where?
Mifepristone and misoprostol at clinic
