Obsteric Problems Flashcards
Which concerning location of the placenta is more common following assisted conception?
Placenta praevia
Also associated with multi parity, multiple pregnancy, scars for surgery/ c-sections
What is fetal fibronectin?
A protien released from gestational sac. Postive results means increased likeliness of going into pre-term labour.
What problems for mother and baby can pre-eclampsia predispose?
Fetal- premAturity, growth retardation,
Mother - eclampsia, haemorrhage (placenta, intra abdominal, intra cerebral), cardiac fAilure, multi organ failure
What is the management for babies born to hep B positive mothers?
0.5ml HBIG within 12 hours of birth
Plus vaccination at 12hours, 1-2 months and 6months
What is the most common liver disease in the 3rd trimester of pregnancy?
Intrahepatic cholestasis of pregnancy (obstetric cholestasis)
- pruritis
- no rash
- raised bilirubin.
Rx - ursodeoxycholic acid
What are the risks of cocaine abuse during pregnancy?
Mother- placental abruption, hypertension/PET
Fetal- prematurity, neonatal abstinence syndrome
How is chest syndrome (sickle cell) treated in pregnancy?
Chest syndrome = chest pain, tachypnoea, cough, cxr infiltrates
Rx- as for pneumonia and a blood transfusion
What’s the first line antidepressant medicine in pregnancy?
SSRI eg sertraline
Avoid - paroxetine,
What is the advice for HIV + women and pregnancy?
Take HAART from 24weeks even if undetectable.
What is the advise about breast feeding in HIV+ women?
Avoid (it doubles transmission risk)
Cabergoline within 24hrs of birth to suppress lactation
If a women has a VTE during pregancncy , how long would you treat her for?
Lmwh for 6months and 6weeks post delivery
Consider switching to warfarin post delivery (safe to breast feed)
Stop lmwh during labour
If mother has measles 6 days before or after delivery, why do we give IG treatment to baby?
To stop neonatal subacute sclerosing panencephalitis
If at high risk of pre-eclampsia, what prophylaxis can be given?
75mg aspirin
from 12week to delivery
In pre-eclampsia when do you start anti-hypertensive treatment?
Bp > 150/100mmhg
If 150-159/100-109 admit to hospital until delivery and start antihypertensives
Severe >160/110, stabilise with antihypertensives, prophlactic magnesium sulphate, steroids if needed, deliver
What are the severe features of pre-eclampsia?
- > 160/110 bp on two occasions
- elevated liver enzymes (2x normal) and severe RUQ pain
- renal insuffinciency (creatinine >1.1)
- new onset cerebral or visual disturbances
- pulmonary odeama
- thrombocytopenia <100,000
