Obs doc unknown bits Flashcards
how many fifths does there have the be for engagement to have occurred
need 2/5 to be able to say engagement has occurred
name 2 things that occur in the ampulla
fertilisation
ectopic pregnancies
what does blastocyst mean
the term used when the embryo has divided into 2 separate cell masses
what happens to BP during pregnancy and why does this occur
maternal BP drops during 2nd trimester due to expansion of uteroplacental circulation
is fetal distress an indication to induce labour. true/false?
FALSE - fetal distress is a contraindication to inducing labour
what are the 3 components of active management of the 3rd stage of labour
syntocinin
ergometrine - C/I’d in hypertension
controlled cord traction
define ‘engagement’
when the presenting part enters the pelvis
2/5 engagement
in the stations used to measure descent (-5 to +5), what anatomical landmark is 0
ischial spines
what is the acronym to remember cardinal movements of fetal decent
‘Don’t Forget I Enjoy Really Expensive Equipment’
what is 1st line to observe fetus in normal labour
doppler US!
in normal Labour, how often are fetal obs carried out
stage 1 -every 15 mins and at the start of every contraction
stage 2 -at the END of every contraction or every 5 mins
what is the most effective form of analgesia
epidural (L3-L4)
which analgesic slows the 2nd stage of labour and increases chance of malpresentation
epidural
how is a spinal different from an epidural
- spinal injected into subarachnoid space
2. spinal has a faster onset of action and doesn’t last as long
what is the analgesic of choice for C sections
SPINAL
what roots make up the pudendal nerve
S2-S4
at what point in pregnancy is VTE risk highest
puerperium
rupture of membranes before what week is classed as PROM
<37weeks
what is the main cause of PROM
lower genital tract infections
what is classed as failure to progress in the latent stage of the 1st stage
> 3-8 hrs to get 4cm dilation
how is primary arrest defined
<2cm dilation in 4 hours in active phase of stage 1
how is secondary arrest defined
poor progress of labour after reaching 7cm dilation
what does fetal distress indicate
fetal hypoxia
name 3 signs of fetal distress on CTG
bradycardia
loss of variability
late decelerations
what should be done if there is confirmed fetal distress
IV fluids and sit mum up stop syntoconin take fetal blood sample consider terbutaline (anti-contraction) plan for C section
what should a normal fetal blood sample be
pH >7.25
what is the management for a cord prolapse
terbutaline - anti-contractile
category 1 or 2 CS
what antibiotic is given in preterm prelabour rupture of membranes
erythromycin
how does steroid promote maturity of the lungs
stimulates surfactant production
what is placenta accreta
condition where the placenta embeds into the myometrium
what feels like a ‘doughy abdomen’ O/Ex
placenta accreta
what does the uterus feel like on palpitation in a uterine rupture
severe pain
what does an inverted uterus feel like on palpitation
it is not palpable and can be seen at vulva
it is an emergency- high risk of maternal shock and PPH
when is the anomaly scan done
18-20 weeks
what blood markers are HIGH in a fetus with downs syndrome
HIGH - `hCG, inhibin A
what blood markers are LOW in a fetus with downs syndrome
AFP, PAPP-A, estriol
what is trisomy 18
Edward’s syndrome
what growth deficiency is indicative of placental insufficiency
asymmetrical - normal sized head, small body - suggests not enough blood flow from placenta
describe what happens in a rhesus sensitising event
the mothers immune system produces a response against the fetal blood that contains antigens
the mother produces antibodies against the antigens
why do sensitising events only really affect future pregnancies after the event
initially, IgM is produced by the mother, which doesn’t cross the placenta so fetus isnt affected
But, the mother eventually produces IgG, which can cross the placenta and damage future pregnancies
how does the anti-D antibody injection work?
the anti D antibodies are given to mothers who don’t have the antigen
this is so that if a sensitising event were to occur, the anti D antibody given would breakdown the fetal antigens in maternal blood
the mother would NOT produce her Own antibodies, so would protect future pregnancies
what does a +ive indirect coombs mean
mother is sensitised
what artery is the standard artery used for doppler
umbilical artery
what can NSAIDs cause during pregnancy
premature closure of ductus arteriosus
what UTI antibiotic cannot be given in 1st trimester
trimethoprim
what should be used for VTE prophylaxis in pregnancy
LMWH
describe the course of hyperthyroidism in pregnancy
typically gets worse in 1st trimester
improves in 2nd and 3rd trimester
what is Sheehan’s syndrome
anterior pituitary necrosis due to massive hypovolemic shock caused by PPH
causes hypopituitarism
how can Sheehan’s syndrome present
failure to lactate
slowed mental function, weight gain and inability to stay warm
amenorrhoea or irregular periods
