Obs and gynae Flashcards
what can mimic pre term labour with intermittent cramps?
placental abruption - separation of placenta from uterus
What test can exclude pre term labour?
how does it work?
fetal fibronectin
if not found pre term labour unlikely in next 1 -2 weeks
what are the two traces on a CTG
What are the normal parameters on ETG?
Baseline rate ~140bpm = normal
Normal variability ~15bpm
Accelerations present
No decelerations
Contractions present 3 every 10min
what can cause fetal tachycardia
Fetal hypoxia
Chorioamnionitis
Hyperthyroidism
Fetal or maternal anaemia
Fetal tachyarrhythmia
what can cause fetal bradycardia
Postdate gestation
Occiput posterior or transverse presentations
Severe prolonged bradycardia (less than 80 bpm for more than 3 minutes) indicates severe hypoxia.
Causes of prolonged severe bradycardia include:
Prolonged cord compression
Cord prolapse
Epidural and spinal anaesthesia
Maternal seizures
Rapid fetal descent
How do you manage pre term labour?
Tocolytic (anti contraction) - oral nifidepine 20mg 30min up to 60mg then QID
Betamethasone 11.4mg IM x2 24hrs apart
IV Antibiotics: Benzylpenicillin 1.2g stat
Neuroprotection: MgSO4 4g over 30min, then 1g/hr infusion
Disposition = Retrieval to obstetric / paediatric facility
what does no fetal pole mean?
non viable pregnancy
Missed Miscarriage / Anembryonic pregnancy / Blighted ovum
how do you manage a missed miscarriage?
Expectant Mx -see what happens
Medical Mx – misoprostol 800mg PV
Surgical Mx – suction evacuation
what are two absolute indications for surgical management of miscarriage
severe bleeding
septic miscarriage
what is the dose and route of Rh Igs
250 international units IM
