Obs doc unknown bits

Question 1

how many fifths does there have the be for engagement to have occurred

Answer 1

need 2/5 to be able to say engagement has occurred

Question 2

name 2 things that occur in the ampulla

Answer 2

fertilisation

ectopic pregnancies

Question 3

what does blastocyst mean

Answer 3

the term used when the embryo has divided into 2 separate cell masses

Question 4

what happens to BP during pregnancy and why does this occur

Answer 4

maternal BP drops during 2nd trimester due to expansion of uteroplacental circulation

Question 5

is fetal distress an indication to induce labour. true/false?

Answer 5

FALSE - fetal distress is a contraindication to inducing labour

Question 6

what are the 3 components of active management of the 3rd stage of labour

Answer 6

syntocinin
ergometrine - C/I’d in hypertension
controlled cord traction

Question 7

define ‘engagement’

Answer 7

when the presenting part enters the pelvis

2/5 engagement

Question 8

in the stations used to measure descent (-5 to +5), what anatomical landmark is 0

Answer 8

ischial spines

Question 9

what is the acronym to remember cardinal movements of fetal decent

Answer 9

‘Don’t Forget I Enjoy Really Expensive Equipment’

Question 10

what is 1st line to observe fetus in normal labour

Answer 10

doppler US!

Question 11

in normal Labour, how often are fetal obs carried out

Answer 11

stage 1 -every 15 mins and at the start of every contraction

stage 2 -at the END of every contraction or every 5 mins

Question 12

what is the most effective form of analgesia

Answer 12

epidural (L3-L4)

Question 13

which analgesic slows the 2nd stage of labour and increases chance of malpresentation

Answer 13

epidural

Question 14

how is a spinal different from an epidural

Answer 14

1. spinal injected into subarachnoid space

2. spinal has a faster onset of action and doesn’t last as long

Question 15

what is the analgesic of choice for C sections

Answer 15

SPINAL

Question 16

what roots make up the pudendal nerve

Answer 16

S2-S4

Question 17

at what point in pregnancy is VTE risk highest

Answer 17

puerperium

Question 18

rupture of membranes before what week is classed as PROM

Answer 18

<37weeks

Question 19

what is the main cause of PROM

Answer 19

lower genital tract infections

Question 20

what is classed as failure to progress in the latent stage of the 1st stage

Answer 20

> 3-8 hrs to get 4cm dilation

Question 21

how is primary arrest defined

Answer 21

<2cm dilation in 4 hours in active phase of stage 1

Question 22

how is secondary arrest defined

Answer 22

poor progress of labour after reaching 7cm dilation

Question 23

what does fetal distress indicate

Answer 23

fetal hypoxia

Question 24

name 3 signs of fetal distress on CTG

Answer 24

bradycardia
loss of variability
late decelerations

Question 25

what should be done if there is confirmed fetal distress

Answer 25

``` IV fluids and sit mum up stop syntoconin take fetal blood sample consider terbutaline (anti-contraction) plan for C section ```

Question 26

what should a normal fetal blood sample be

Answer 26

pH >7.25

Question 27

what is the management for a cord prolapse

Answer 27

terbutaline - anti-contractile | category 1 or 2 CS

Question 28

what antibiotic is given in preterm prelabour rupture of membranes

Answer 28

erythromycin

Question 29

how does steroid promote maturity of the lungs

Answer 29

stimulates surfactant production

Question 30

what is placenta accreta

Answer 30

condition where the placenta embeds into the myometrium

Question 31

what feels like a 'doughy abdomen' O/Ex

Answer 31

placenta accreta

Question 32

what does the uterus feel like on palpitation in a uterine rupture

Answer 32

severe pain

Question 33

what does an inverted uterus feel like on palpitation

Answer 33

it is not palpable and can be seen at vulva it is an emergency- high risk of maternal shock and PPH

Question 34

when is the anomaly scan done

Answer 34

18-20 weeks

Question 35

what blood markers are HIGH in a fetus with downs syndrome

Answer 35

HIGH - `hCG, inhibin A

Question 36

what blood markers are LOW in a fetus with downs syndrome

Answer 36

AFP, PAPP-A, estriol

Question 37

what is trisomy 18

Answer 37

Edward's syndrome

Question 38

what growth deficiency is indicative of placental insufficiency

Answer 38

asymmetrical - normal sized head, small body - suggests not enough blood flow from placenta

Question 39

describe what happens in a rhesus sensitising event

Answer 39

the mothers immune system produces a response against the fetal blood that contains antigens the mother produces antibodies against the antigens

Question 40

why do sensitising events only really affect future pregnancies after the event

Answer 40

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

Question 41

how does the anti-D antibody injection work?

Answer 41

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

Question 42

what does a +ive indirect coombs mean

Answer 42

mother is sensitised

Question 43

what artery is the standard artery used for doppler

Answer 43

umbilical artery

Question 44

what can NSAIDs cause during pregnancy

Answer 44

premature closure of ductus arteriosus

Question 45

what UTI antibiotic cannot be given in 1st trimester

Answer 45

trimethoprim

Question 46

what should be used for VTE prophylaxis in pregnancy

Answer 46

LMWH

Question 47

describe the course of hyperthyroidism in pregnancy

Answer 47

typically gets worse in 1st trimester | improves in 2nd and 3rd trimester

Question 48

what is Sheehan's syndrome

Answer 48

anterior pituitary necrosis due to massive hypovolemic shock caused by PPH causes hypopituitarism

Question 49

how can Sheehan's syndrome present

Answer 49

failure to lactate slowed mental function, weight gain and inability to stay warm amenorrhoea or irregular periods