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F&C > obs and gynae > Flashcards

obs and gynae Flashcards

1
Q

what factors increase risk in pregnancy

A
  • age >40 or < 20
  • pmh C section or surgery
  • previous problems in pregnancy
  • medical issues eg diabetes, epilepsy
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2
Q

medications to avoid in pregnancy

A 
NSAIDs
ACE inhibitors
citalopram
anti epileptics
isotretinoin
carbimazole
propylthiouracil
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3
Q

name 3 meds which are safe in pregnancy

A

amoxiillin
cyclizine
metformin

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4
Q

what is the safest antiepileptic to use in pregnancy

A

lamotrigine

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5
Q

name some uterine stimulants

A 
misoprotsol
prostin
oxytocin
ergometrine
endothelin
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6
Q

name some uterine relaxants

A 
relaxin
nifedipine
nitric oxide
magnesium
terbutaline
indomethacin
atosiban
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7
Q

what are the components of the APGAR score

A 
appearance
pulse
grimace
activity
respiration
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8
Q

what is the bishops score?

A

it is a PV exam scoring system to detect if labour is likely to occur spontaneously or if it is going to need to be induced

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9
Q

what are the important components of acute obstetrics management?

A
  • -O2
  • 2x Large bore cannulas
  • IV fluids (crystalloids and colloids), FBC, G+S, Rhesus status, clotting screen
  • monitor fetal heart on CTG
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10
Q

when is the booking appointment?

A

8 weeks

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11
Q

what will the midwife do at booking

A

check maternal risk factors and demographics
ask when LMP was
dip the urine and measure BP, blood tests incl anti D

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12
Q

when is the dating scan and down syndrome testing?

A

12 weeks

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13
Q

what is the combined test for down syndrome?

A

nuchal translucency scan
PAPP-A
HCG

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14
Q

when is the anomaly scan?

A

20 weeks

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15
Q

when is glucose tolerance testing?

A

26 weeks

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16
Q

what are risk factors for gestational diabetes?

A
  • pmh GDM
  • previous baby >4.5kg
  • BMI raised
  • ethnic groups (asian, black)
  • fhx DM
  • PCOS
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17
Q

what is the schedule for giving anti D prophylaxis?

A
  • check rhesus status @ booking
  • give anti D at 28 and 34 weeks
  • give large dose if there is a sensitising event and perform the kleihauer test
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18
Q

what is external cephalic version?

A

manipulating the lie of the fetus to try to get it into a normal head first position
may give drugs to relax the womb

19
Q

what are the criteria for diagnosing GDM

A

fasting >5.6

2hr post meal >7.8

20
Q

what blood tests would you do for someone presenting with heavy bleeding?>

A

FBC, ferritin, coag, tfts, oestradiol, group and save if pregnant

21
Q

inevitable miscarriage?

A

heavy bleeding with clots and pain

cervical os is open

22
Q

what is a threatened miscarriage?

A

painless bleeding
cervical os is closed
most pregnancies continue normally

23
Q

incomplete miscarriage

A

heavy bleeding with clots and pain
cervical os is open
not all products have been expelled

24
Q

delayed miscarriage

A

no symptoms but at scan gestational sac does not contain a fetus

25
Q

antepartum haemorrhage is defined as …

A

bleeding >24 weeks

26
Q

causes of recurrent miscarriage

A 
antiphospholipid syndrome
SLE
parental chromosomal abnormalities
uterine abnormality
endocrine disorder poorly controlled eg diabetes/thyroid
27
Q

which investigations would you do if pregnant lady presents with bleeding?

A

depends on gestation but:

  • serum hcg, g&s, fbc
  • USS
28
Q

what are the options for management of miscarriage

A

expectant- follow up scan 2 weeks
medical managment with misoprostol
surgical evac

29
Q

what percentage of pregnancies miscarry?

A

between 15 and 20%

30
Q

what can you tell someone who has had an ectopic and asks if they can have another pregnancy and what they should do

A

they should watch out for ref flag symptoms
they will be offered a scan at 7 weeks to check location of future pregnancies as they are at higher risk for more ectopics

31
Q

what causes a miscarriage?

A

chromosomal abnormalities
fetal abnormalities
placental abnormalities
infections (eg varicella, rubella, cytomeglovirus, toxoplasmosis)

32
Q

threatened miscarriage

A

painless vaginal bleeding
cervical os is closed
bleeding is often less than menstruation

33
Q

incomplete miscarriage

A

pain and bleeding

not all products expelled

34
Q

inevitable miscarriage

A

heavy bleeding with clots and pain

cervical os open

35
Q

when should anti D be given ?

A

28 and 34 weeks

36
Q

what does the anti d injection do

A

contains special proteins that stop the mum mounting the antibody response to rhesus positive blood cells

37
Q

what are the rotterdam criteria?

A 
criteria to diagnose PCOS . Includes:
-polcystic ovaries on USS
-hyperangrogenism which can be: clinical signs (eg hirsutism or male pattern baldness) or
biochemicallyraised androgens
-oligo or amennorhoea

need 2/3

38
Q

treatment of fibroids

A 
medical
progestins, gnrh anologues, nsaids for pain relief , progesterone mirena coil, 
surgical
myomectomy
uterine artery embolisation
hysterectomy
39
Q

which women are at risk of pre eclampsia?

A 
HTN/pre eclampsia in prev pregnancies
CKD
autoimmunie disorders eg SLE
Type 1 or 2 DM
age <20 and >35
40
Q

HTN in pregnancy is defined as

A

> 140 sys >90 diastolic

41
Q

what can pre eclampsia cause

A 
fetal asphyxia
fetal growth restriction
prematurity
eclampsia
haemorrhage
abruption
multi organ failure
42
Q

treatment of pre eclampsia?

A 
oral labetalol
hydralazine or nifedipine 
magnesium sulphate
deliver (induce or c section)
fluid restrict
43
Q

treatment of heavy menstrual bleeding - does not want contraception?

A

mefenamic Acid or tranexamic acid

44
Q

treatment of heavy menstrual bleeding- wants contraception?

A

IUS
COCP
long acting progesterones

F&C (11 decks)

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