Obs and Gynae Flashcards
what are the 3 oestrogens?
E1-oestrone
E2-oestrodiol
E3-oestriol
what happens to the myometrium for implantation to be able to occur?
quiescence
what could be a cause of pre-eclampsia that occurs very early on?
failed endovascular invasion of blastocyst
what problem with implantation could cause PPH
morbid adherence-myometrial, could also cause poor placental separation
what are the stages of partuition?
cervical dilatation and remodelling
foetal expulsion=myometrial contraction
placental delivery then haemostasis
what is required for partuition to occur?
altered progesterone response
increased intracellular calcium
inflammatory mediators
what is the underlying mechanism of contractions?
controlled immune response
name tocolytic agents
nifedipine
atosiban
progesterone-in some ethnicities
name some induction agents
syntocinon
alpha2 agonists-ergometrine
prostaglandin mimetics (carboprost and misoprostol)
what is misoprostol used for
terminations and induction
at what point do you need to inject KCl into the foetal heart to abort it?
22w
what is the legal social cut off of abortion
23+6
define the puerperic period
6w after birth
what can you consider other than BUFALO in a pregnant woman?
delivery and VTE prophylaxis
what is secondary post partum haemorrhage
bleeding from birth canal 24hrs-12w after delivery
what causes PPH?
morbid adherence retained products of conception endometritis subinvolution of the placental site AV malformations pseudoaneurysm
what is the bishop score used for?
to assess whether or not a woman needs to be induced
what are the consequences of being an older mother?
higher risk of chromosomal abnormalities
degree of placental insufficiency (leads to increased risk of stillbirth, so they induce), smaller children and higher risk of DM in child
what are MCDA twins?
monochorionic monoamniotic twins, so they must be monozygotic
what kind of twins can be dizygotic?
dichorionic diamniotic
if 2 placentas, has to be 2 amniotic sacs, they might also be from the same zygote though
what kind of twins are at risk of twin twin transfusion syndrome?
monochorionic diamniotic
if in same sac then placenta delivers equal nutrients but if not then second twin becomes hypoxic and wastes but removing that twin would suck nutrients out of the surviving twin so that wouldn’t be useful anyway
