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AB 4th Year O+G > Obs - Antenatal Conditions > Flashcards

Obs - Antenatal Conditions Flashcards

1
Q

what is antepartum haemorrhage?

A

bleeding from the genital tract ≥24wks

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2
Q

risk factors for placental abruption?

A 
pre eclampsia
HT
smoking
drugs
multiple pregnancy
Hx
polyhydramnios
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3
Q

features of placental abruption?

A 
small blood loss
symptoms inconsistent (worse)
pain
hard woody uterys
difficulty feeling fetal parts
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4
Q

what happens in placental abruption?

A

separation of normally implanted placenta before birth of fetus

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5
Q

Tx for placental abruption?

A 
bloods
fluids
anti D
steroids <36wks
deliver baby
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6
Q

what happens in placenta previa?

A

placenta is implanted in the lower uterine segment

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7
Q

risk factors for placenta previa?

A 
age
multiparous
Hx
c section Hx
uterine abnormalities
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8
Q

features of placenta previa?

A

painless bleeding
soft uterus
high head felt

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9
Q

Ix for placenta previa?

A

US
CTG
anti D
steroids <36wks

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10
Q

what steroid is given? why?

A

betamethasone

promote fetal lung surfactant
decrease chance of neonatal respiratory distress syndrome

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11
Q

Tx for placenta previa?

A

major (os covered) - c section
minor (>2cm from os) -vaginal
prior bleeding - deliver at 37-38wks

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12
Q

what is placenta accreta?

A

placenta invades the myometrium (muscle layer)

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13
Q

features of placenta accreta?

A

severe bleeding

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14
Q

Tx for placenta accreta?

A

C section at 37wks ± hysterectomy

wait one year to give birth

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15
Q

risk factors for uterine rupture?

A 
c section 
uterine surgery
multiparous
multiple pregnancy
labour induction/prolonged
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16
Q

features of uterine rupture?

A 
blood loss
contractions stop
high fetal head
abdo pain 
fetal parts easily felt
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17
Q

what drugs can increase risk of uterine rupture?

A

syntocinon

prostaglandins

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18
Q

Tx for uterine rupture?

A

stop oxytocins

c section ± hysterectomy

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19
Q

when should placenta previae be detected on antenatal scans?

A

18-20wk scan

TVUS can then be done if still persisting at 32 wks

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20
Q

what happens in vasa previae?

A

fetal blood vessels runa cross the opening of the uterus in the membranes

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21
Q

features of vasa previae?

A

blood produced when membranes rupture

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22
Q

Ix for vasa previae?

A

US

CTG

23
Q

Tx for vasa previae?

A

emergency c section
deliver at 34-36wks
anti D
steroids <36wks

24
Q

what is rhesus?

A

antigen on the RBC

one being D antigen

25
Q

what happens is rhesus negative and exposed?

A

IgM antibodies form

too big to cross placenta

in further pregnancies, exposed to same antigen and IgG form

these can cross

cause haemolytic disease of the newborn

26
Q

when is rhesus status checked?

A

booking

27
Q

when are anti D doses given if mother is rhesus negative?

A

28wks

28
Q

in what situations should rhesus be given?

A 
APH 
fetal death
amniocentesis/CVS
miscarriage
vaginal bleeding >12wks
molar pregnancy
TOP
ectopic
29
Q

what features are seen in haemolytic disease of the newborn? is this extra/intra vascular?

A

jaundice
CCF
hepatosplenomegaly
kernicterus

extravascular

30
Q

Tx for haemolytic disease of the newborn?

A

phototherapy
FBCs
IVIgs

31
Q

what is a miscarriage?

A

loss of the fetus after a positive pregnancy test up until 23+6 wks

32
Q

risks factors for miscarriage?

A 
PCOS
DM
age
smoking
alcohol/drugs
obese
HT
antiphospholipid syndrome
infections
Hx
33
Q

features of miscarriage?

A

bleeding
cramps
passed products

34
Q

what are features of cervical shock? what causes it?

A 
cramps
N+V
sweating
hypotension
bradycardia

incomplete miscarriage sitting at the os

35
Q

what types of miscarriage exist? what is the os like?

A 
threatened (closed)
inevitable (open)
incomplete
complete (products in vagina)
early fetal demise
36
Q

Ix for miscarriage?

A

bHCG
US
speculum

37
Q

Tx for a miscarriage?

A 
conservative
medical (misoprostol)
MVA
surgery
anti D
38
Q

what is implantation bleeding?

A

bleeding before when period is due when a women is pregnant

39
Q

what is a subchorionic haematoma?

A

blood collects between chorion and uterine wall

40
Q

how many miscarriages until a patient is referred to rheum?

A

3

41
Q

what is an ectopic pregnancy?

A

implantation of a normal fetus outside the uterus

42
Q

risk factors for an ectopic pregnancy?

A 
Hx
surgery
IUD
STIs
smoking
43
Q

features of an ectopic pregnancy?

A 
pain (abdo/iliac fossa/left shoulder tip)
bleeding
collapse
pallor
peritonism
GI/urinary symptoms
44
Q

when does an ectopic pregnancy commonly occur in a cycle?

A

6-8wks after LMP

45
Q

commonest sites for an ectopic pregnancy?

A

ampulla
isthmus
ovary
peritoneum

46
Q

Ix for ectopic pregnancy?

A

FBC
G+S
bHCG
TVUS

47
Q

who gets conservative ectopic pregnancy management? what is done?

A 
<30mm
unruptured
asymptomatic
no heart beat
bHCG <1500 and declining

bHCG is monitored over 48hours (should fall)

48
Q

who gets medical ectopic pregnancy management? what is done?

A 
<35mm
unruptured
no pain 
no heart beat 
bHCG <3000

MTX

49
Q

who gets surgical ectopic pregnancy management?

A

> 35mm
pain/ruptured
can be a visible heart beat

salpingectomy/otomy

50
Q

what gets a miscarriage classed as a pregnancy of unknown viability?

A

gs <25mm
CRL <7mm

rescan in 7-10 days

51
Q

what is in liver that is teratogenic?

A

vit A

52
Q

what carries listeria risk?

A

pate

soft cheese

53
Q

what carries a toxoplasmosis risk?

A

under pasteurised milk

54
Q

booking bloods?

A 
HIV
syphilis 
hep B
sickle/thalassaemias
blood type + Abs

AB 4th Year O+G (17 decks)

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