Obs and Gynae Flashcards
Bartholin’s cyst
posterior and medial labia minora
painful sex
no symptoms
Cervical ectropion/erosion
red endo cervix visible
young women, OCP, preggers
Cervical polyp
benign tumour endocervix red preggers biopsy to exclude twist and pull or liquid nitrogen
Uterine prolapse
- in vagina
- at introitus
- out of vagina
Old, preggers, heavy bleeding.
Cystocele
Prolapse anterior wall and bladder
frequency and more infections
pessaries
Rectocele
Posterior wall
Bowel symptoms
Fibroid uterus
smooth muscle tumour
common
painful periods
red degeneration in pregnancy
Rx: GnRH agonists
Hysterectomy/ myomectomy.
Gartner’s duct cyst
Remnant of mesonephric duct
Nabothian cyst
surface of cervix
ECTO grows over ENDO
impairs mucus drainage.
Ovarian torsion
risk necrosis and ovarian loss
ooporopexy
Osteitis pubis
inflammation of pubis symphysis
NO infection
Suprapubic abscess
After pelvic surgery
Addisons during pregnancy
may need more T3 to cope with stress
if not controlled may cause IUGR.
Gestational diabetes
OGTT at 24-28 weeks
Gone after
Less birth defects.
Management of hypertension in pregnancy?
Methyldopa
Epilepsy in pregnancy
lowers seizure threshold
medications cause neural tube defects.
Increase folic acid dose
Carbamazepine and lamotrigine (NOT valproate).
Epilepsy vs. eclampsia
generalised seizure in eclampsia.
Hyperthyroidism in pregnancy
may improve
but anti-thyroid Abs can cross placenta and may make baby hyperthyroid with goitre
give propylthiouracil
Hypothyroidism in pregnancy
Mum: more pre-eclampsia, miscarriages, stillbirths
MS
may get better in pregnancy but worse after.
no IFN in pregnancy
Subseptate uterus
septum at fundus
more likely to have transverse lie, recurrent miscarriages, can’t have a IUD.
SLE
better during preggers
Venous stasis eczema
due to heavy baby
will get better after
Cervical incompetence
early opening (before 34 weeks). Cerclage between 12-14 weeks and remove 34 weeks.
Cholecystasis bloods
High ALT and bile acids
normal ALP
Cholestasis
Oestrogen causes cholestasis
Resolves after delivery
May have still birth
Need Vit K.
Gallstones
More common in preggers
Pre-eclampsia
AFter 20 weeks
High BP and proteinuria
Eclampsia
tonic-clonic general seizure
during labour and after
get placenta out!
Heterotrophic pregnancy
Half in and half out of uterus
usually due to IVF
like an ectopic
Hydatidiform mole
benign non-viable v. high bHCG Snowstorm on USS Bleeding Malignant potential Remove and methotrexate to kill
Hyperemesis gravidarum
due to bHCG
1st trimester
urinary ketones
give fluids and anti-emetics
Hyperstimulation syndrome
IVF complication
Ascites, mild abdo distension, nausea, diarrhoea
MASSIVE ovaries.
Placenta praevia
bleeding late
Minor: side
Major: over outlet
Placenta accreta
Inserted to myometrium
Placenta percreta
inserted into bladder
Placental abruption
Over 20 weeks
lead to APH and PPH, DIC, Hysterectomy
Spontaneous miscarriage
Before 24 weeks.
Mifepristone and misoprostol
Anti-D
Anencephaly
Due to: epileptics, T1DM, folic acid deficiency
5mg/day for high risk.
Duodenal atresia
double bubble
treat with duodenoduodenostomy
IUGR
symmetrical: early
asymmetrical: later
Oesophageal atresia
link with polyhydramnios (may have fistula)
Rubella in pregnancy
1st tri worst
increase miscarriages, SN deafness, cataracts, congenital heart disease
blueberry muffin rash
Premature labour
24-37 weeks.
Precipitate labour
under 3 hours
increased risk of trauma, PPH, infection, aspiration of baby
Bloody show
pink/white mucus
latent stage
cervix effaced
thinning
Rupture of membranes
If rupture and then nothing- will induce after 24 hours.
Artificial rupture
amniotomy
Foetal head above pelvic brim
not engaged. abdominally palpable
Foetal head below ischial spines
When gets to positive can use instruments Bishops score (at spines=0)
Bowel perforation
category 1 c-section=emergency
Cephalopelvic disproportion
Pelvis too small for baby
Transverse lie
preterm labour
polyhydramnios
multiple pregnancy
Breech
bum first
extended (frank)
flexed (complete)
footling (undeliverable)
3rd degree tear
vagina to anal sphincter
due to obstruction, instruments, big baby, dystocia
Fitz- Hugh Curtis
Liver adhesions from chlamydia
Vaginal cancer
SCC
posterior wall upper third
Cervical cancer
SCC due to HPV
Endometrial cancer
unopposed oestrogen
USS more than 5mm
Hysterectomy and BSO
Ovarian cancer
most common serous cystadenoma
VIN
HPV pre cancer
Lichen sclerosis too
Hives
Can increase in pregnancy
POPPP pruritic urticarial plaques and papules of pregnancy
not dangerous
Allergies
can change in pregnancy
careful what you eat for baby too
