obs Flashcards
____________________ should be sent in pregnant women treated for a UTI
A test of cure MSU
The target for fasting blood glucose in gestational diabetes is_________. The target for blood glucose two hours after an oral glucose tolerance test is________.
what to do if targets aren’t met?
<5.3 mmol/L
<6.4 mmol/L
start insulin
A 19-year-old woman presents with a two day history of central lower abdominal pain and one day history of vaginal bleeding. Her last period was 8 weeks ago. On examination her cervix is tender to touch. This hx points to?
ectopic pregnancy because of the cervical excitation
If a pregnant woman reports reduced fetal movements then________________as a first step
handheld Doppler should be used to confirm fetal heartbeat
pregnant women - advice re cervical smear?
NICE guidelines suggest that a woman who has been called for routine screening wait until 12 weeks post-partum for her cervical smear.
Women who have been admitted with hyperemesis gravidarum are generally given which IV fluid?
IV normal saline with added potassium as hypokalaemia is common
A pregnancy test should be performed at ________ following medical management of a miscarriage
3 weeks
painless vaginal bleeding - what is it likely to be? What’s the Ix?
placenta praevia
Transvaginal ultrasound is used to investigate suspected placenta praevia
Oligohydraminos can be a clue that infants have ________________
renal agenesis (Potter sequence)
If fetal movements have not yet been felt by ________, referral should be made to a maternal fetal medicine unit
24 weeks
hyperthyroidism in pregnancy
1st trimester:
after 12 weeks:
1st trimester: propylthiouracil
after 12 weeks: carbimazole
After _____ weeks, same day delivery is an option.
34
SSRI risks in pregnancy (1st and 3rd trimester)
Use during the first trimester gives a small increased risk of congenital heart defects
Use during the third trimester can result in persistent pulmonary hypertension of the newborn
Paroxetine has an increased risk of congenital malformations, particularly in the first trimester
Bishop score (SCORE)
Station
Consistency
OS position
Roundness (dilatation)
Effacement
5= favourable for IoL
Pre-eclampsia risk factors: ASPIRIN
Age (increasing age)
Sugar/HTN (existing DM/HTN)
Previous hx/family hx of pre-eclampsia
Increasing pregnancy (multiple pregnancy)
Renal disease/Rotund
Immune disease
Nulliparity
fietus has’A subsequent ultrasound scan demonstrates polyhydramnios, ascites and fetal skin oedema.’ - Dx? What virus can cause it? Tx?
hydrops fetalis
Parovirus B19
treatment in-utero is foetal transfusion, whereby, red blood cells are injected into the fetus whilst in the womb
is early stages of labour a C/I to external cephalic version?
no, You can attempt external cephalic version for a transverse lie if the amniotic sac has not ruptured
Pregnant women who have a severe asthma attack
should be admitted to hospital, even if they initially improve with treatment
ARound 50% of cord prolapse occurs after ______________
artificial rupture of membranes
If a woman with known placenta praevia goes into labour
(with or without bleeding), an emergency caesarean section should be performed
Maternal intravenous antibiotic prophylaxis should be offered to women who
have a previous baby with early- or late-onset GBS disease
The largest risk factor for a baby developing Group B streptococcus growth is the mother having a previous baby who has grown it
A confirmed miscarriage can be diagnosed on ultrasound if
there is no cardiac activity and:
- The crown-rump length is greater than 7mm OR
- The gestational sack is greater than 25mm
Emergency contraception (EC) is not required before_______
day 21 postpartum
Mx of renal stones in pregnant women?
urteroscopy
OA vs OP
’ the occiput can be palpated posteriorly (near the sacrum)’ –> OP
- OP cause neck extension (OA neck flexion)
- OP cause more morbidity
- OP cause longer labour
- OP cause earlier desire to push and backache
- delivery is possible but most of the the time required augmentation or C-sec
- Kielland forcep can be used
The management of non-reassuring CTG findings, which are persistent in nature:
prepare for category 2 caesarean section
Interpreting Bishop score:
<5 –> labour unlikely to start without induction
<8: no need to do anything
<6: vaginal prostaglandins/oral misoprostol
> 6 –> amniotomy + IV oxytocin
