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T's O&G Y5 > Obstetric disease > Flashcards

Obstetric disease Flashcards

1
Q

What is gestational HTN

A

new HTN without proteinuria occurring after 20w gestation

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2
Q

what antihypertensives are used in preg

A 
1st = labetalol
2nd = nefedipine
3 = methyldopa
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3
Q

what is pre eclam

A

new HTN occurring with proteinuria after 20w gestation

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4
Q

what are the signs/sympto of pre eclam

A 
HTN + proteinuria
headache w/ visual disturbances
RUQ pain
hyperreflexia
liver involvement (inc transaminases)
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5
Q

what are the RFs for pre eclam

A 
DM
multiple preg
nulliparity
obesity
kidney D
HTN in prev preg
>40y
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6
Q

what should be offered to women at high risk of pre eclam

A

low dose aspirin (75mg) OD from 12w gestation

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7
Q

what is the medical management of antenatal eclampsia

A

antihypertensives (labetalol + nifedipine)
IV mg sulphate is severe
expedite delivery

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8
Q

what is the risk of recurrence of pre eclam

A

15%

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9
Q

what is HELLP syndro

A

obstetric comp of pre eclam
Haemolysis, elevated liver enz, low platelets
(distinguished by presence of jaundice)

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10
Q

what is the medical management of GDM

A

1st - diet and exercise
2nd - metformin
3rd - insulin

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11
Q

what are the RFs for GDM

A

age, FHx, obesity, multiple preg, asian

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12
Q

what are the risks of GDM

A

maternal - HTN disease, traumatic delivery, stillbirth

foetal - macrosomia, neonatal hypogly, congen abn

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13
Q

what is the key sympto of obstetric cholestasis

A

pruritus without rash (on hands and feet)

dec appt, malaise

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14
Q

how is a diagnosis of obstetic cholestasis made

A

diag of exclusion

  • USS liver/biliary tree
  • viral serology
  • AI screen
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15
Q

What monitorring is done in obstetric chol

A

Doppler/CTG - 2x per w

LFTs - 1 per w

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16
Q

what is the medical management of obs chol

A

offer induction of labour at 37w

ursodeoxycholic acid for pruritus

17
Q

what is the recurrence rate of obs chol

A

90%

18
Q

how does pre ecam cause FGR

A

cytotrophoblasts do not invade interstitial and endovasc tissue correctly -> hypoperfusion of placenta

19
Q

what is placental praevia

A

placenta lies directly over internal os (only applies after 16w)

NB - low lying P -> P lies <2cm from OS

20
Q

what are the RFs for PP

A

older mother
prev C sec
prev PP
smoking/drug use

21
Q

what are the complications of PP

A

maternal - shock, renal tubular nec, APH

foetal - hypoxia, SGA/FGR, premature

22
Q

when does FGR become SGA

A

SGA = <10th centile

23
Q

what is the presentation of PP

A

soft abdomen, painless bleeding

24
Q

how is PP diagnosed

A

USS

25
Q

how is a non symptomatic PP managed

A

explain risk of bleeding
explain that 90% of placentas will move away from os
rescan 1t 32w
avoid sex

26
Q

how does PA present

A

hard abdo
bleeding with pain
pain between contractions

27
Q

what are the RFs for PA

A

drug use - esp crack cocaine
FGR
polyhydramnios

28
Q

what is the management of PA

A

if mother stable and no ev of fetal distress - give steroids and admit, deliver at 37w

if unstable/fetal distress - expedite delivery

29
Q

what should be given to all PA/PP women depending of status

A

is Rh-neg, give anti D Ig within 72hr

30
Q

what is placental acreta

A

placental attaches too deeply into uterine wall

31
Q

what is placental increta

A

placenta attaches to uterine muscle

32
Q

what is placental percreta

A

placenta goes completely through uterine wall, sometimes invading nearby organs

33
Q

who should be screened for placental acreta/increta/percreta

A

women with anterior low lying placental/PP who have had prex C-sec

34
Q

what is a threatened miscarriage

A

bleeding during preg but cervical os is closed

35
Q

what is an inevitable miscarriage

A

bleeding during preg and cervical os is open

36
Q

what is an incomplete miscarriage

A

tissue left in cervical canal

T's O&G Y5 (5 decks)

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