Obs

Question 1

3 indications for Cx cerlage

Answer 1

History indicted (3+ previous preterm or midtri)
US indicated <25mm AND 1+ preterm or midtri
Rescue - Cx open, exposed membranes
Note: a failed rescue cerclage, as oppose to other two, does not count as an indication for future abdo cerclage
[adjuncts like tocolysis at time of cerclage lack evidence - FIGO 2021]

Question 2

DCDA Mx

Answer 2

Risks:
Transverse presentation of 2nd twin
EmCS
PPH
Mx:
USS in room
Analgesia
Risks for 2nd twin e.g. CS, head entrapment, breech extraction, monitor 2nd twin

Question 3

Stillbirth

Answer 3

Momentos, SANDS
Expectations at birth
Lactation suppression
F/u
Ix as per PSANZ guideline:
Core tests for all stillbirths then selective investigations based on findings of core investigations
- History
- Kleihauer
- External exam + clinical photos
- Autopsy - 3 types: targeted, limited, complete
- Detailed macroscopic examination of the placenta and cord + Placental histopathology + Cytogenetics (Chromosomal microarray (CMA) or karyotype if CMA is not available)

Question 4

Dolichocephaly

Answer 4

Elongated head - usually positional

Question 5

Choroid plexus cyst

Answer 5

Small are typically benign. 1% chance of associated trisomy (T18>T21)
1:50 at 20/40, 90% resolve by 26/40.