O&G revision lecture Flashcards
What does FSH do in the follicular phase?
Stimulates development of the follicles and granulosa cells to produce oestrogen
What does oestrogen do to the follicles?
Inhibits FSH production
When does the LH surge occur?
Occurs 36 hours before ovulation
What does the corpus luteum produce and what does this do?
The corpus luteum produces progesterone which is needed for the uterus lining
What causes growth of the endometrial glands and stroma?
Oestrogen
Which antibodies would you see in anti-phospholipid syndrome?
Anticardiolipin, lupus anticoagulant
Definition of spontaneous miscarriage
Expulsion of products of conception before 24 weeks of gestation
Causes of polyhydramnios
Duodenal atresia
Anencphaly
If the ovum is fertilised, what will is produce to maintain the corpus luteum?
If the ovum is fertilised, the implanted embryo will produce HCG, which maintains the corpus luteum
Medications, which can cause renal hypoplasia
Diuretic
ACEi
Characteristic triad of pre-eclampsia?
Hypertension, oedema and proteinuria (>0.3g/L)
If someone has pre-eclampsia and epigastric/RUQ pain what should you consider?
HELP
This medication is an alpha and beta-blocker
Labetalol
Nifedipine mechanism of action
CCB
Hydralazine mechanism of action
Vasodilator
Methyldopa mechanism of action
Centrally acting alpha agonist
Treatment of eclampsia?
IV labetalol and IV hydralazine
How does magnesium sulphate work?
Works by decreasing Ca2+ uptake by smooth muscle
Medication you can give to reverse effects of magnesium sulphate?
Calcium gluconate
When would you want to provide active management for the 3rd stage of labour, and how would you do it?
Prolonged if lasts >30 minutes
Consider prophylactic oxytocin or ergometrine, cord clamping, controlled cord traction, empty bladder, oxytocin into cord
EDFIERE
Engages Descent Flexion Internal rotation Extension Resuscitation Expulsion
Bishops score <6
Labour unlikely to start spontaneously
Bishops score >8
Vaginal delivery likely
What does a foley catheter do?
Manually dilates the cervix
What is an amniotomy and why is it good?
This is artificial rupture of membranes - stimulates prostaglandin synthesis
Medications you can give for stimulating labour?
Oxytocin/syntocinon/ergometrine
Risks of giving oxytocin/syntocinon/ergometrine?
Risk of hyperstimulation (this can increase risk of foetal distress/uterine rupture) and vasopressin-like effect causing anti-diuresis
What is atosiban?
Oxytocin receptor antagonist
What is indomethacin?
Prostaglandin synthesis inhibitor
Name three drugs that can be used to inhibit labour?
Atosiban, terbuatline, indomethacin
You can sometimes used bethamethasone in tocolysis, but when is it contraindicated?
Contraindicated in maternal or foetal bleeding or distress
What pH would you like the fetal scalp to be?
Ideally >7.25
How do you diagnose syphilis?
Serology
What does IgM ELISA mean?
Recent untreated infection (i.e. active disease)
What does TPPA mean?
Indicates ever infection
What does VDRL mean?
Active infection
This procedure carries a risk of placental mosaicism
Chorionic villus sampling
Can be used to detect cytogenic abnormalities and measure amniotic AFP
Amniocentesis
When do you need to offer emergency contraception for in cases with the combined contraceptive patch?
Need to offer emergency contraception if patch has been off for more than 48 hours and there has been unprotected sexual intercourse within the last 5 days
When do you need to offer emergency contraception in people using the contraceptive vaginal ring?
Need to offer EC if ring has been left out of vagina for more than 3 hours in weeks 1 or 2 and there has been UPSI in the 7 days before this
