Obs/ gyne take home Flashcards
safe antihypertensives?
Pre-existing HTN: stop aRB/ ACEi. labetolol/ nifedipine (asthmatics) and hydralizine
Postnatal HTN management?
enalapril / nifedipine/ amlodipine (in black) then labetolol
Test to rule out pre-eclampsia in weeks 20-35?
Placental growth factor (blood test). low is likely to be eclampsia
Definition of gestational hypertension
<20weeks 140/90 or increased of 15/30 from booking date.
After 20W - pregnancy induced.
Definition of eclampsia?
20w+ with 140/90 HTN and feature of proteunura/ organ dysfunction or placental dysfunction.
Eclampsia prophylaxis?
75mg Aspirin from 12 weeks if 1x high RF (CKD/DM/HTN/autoimmune) or 2 x moderate RF (FH/ multip/ first pregnancy/ 40+, BMI 35+, 10yrs+last pregnancy)
HIV positive pregnant woman care?
No breast feeding
Vaginal delivery if < 50 viral load
Offer antiretrovirals to everyone
If C/S - give antiretroviral IV 4 hrs before
Induction of labour summary?
BISHOP score factors?
BISHOP - includes cervical dilation, effacement, consistency, position, fetal station.
<5 - unlikely to progress naturally
40-41 - do sweep
6 or less - vaginal E2 or misoprostol
6 or more can do amniotomy/ IV oxytocin infusion
Drugs to avoid breast feeding? (Avoid feeding chickens soup and let ami drive ben’s car)
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
Down’s syndrome screening including nuchal scan (timeline)
Week 11-13+6
Early scan to confirm dates, exclude multiple pregnancy
Week 10-13+6
continuous abdominal pain
shock disproportionate to the amount of blood loss, uterus spasm firm or ‘woody’
the fetus hard to feel and auscultate
Plancental abruption
What situations to give anti D
delivery of a Rh +ve infant, whether live or stillborn
any termination of pregnancy
miscarriage if gestation is > 12 weeks
ectopic pregnancy (if managed surgically, if managed medically with methotrexate anti-D is not required)
external cephalic version
antepartum haemorrhage
amniocentesis, chorionic villus sampling, fetal blood sampling
abdominal trauma
abdominal fullness, early satiety, 55+, increased urine urgency?
RF?
Protective?
Commone types?
Ovarian cancer sus - if CA125 35+, refer for USS.
RF: nulip, early menarche, late menses, BRCA1,2
protective: COCP, diagnostic lap,
Common: epithelial, serous cystadenoma
COCP protective against and RF for?
coc goes on cervix and breast
RF for breast ca and cervical ca
Protective against endometrial and ovarian
