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Year 3 - Repro and Sexual Health > Obstetric Emergencies > Flashcards

Obstetric Emergencies Flashcards

1
Q

What are the risk factors for amniotic fluid embolism?

A 
Mutli preg
Increasing age
IOL
Uterine rupture
PP
PA 
Eclampsia
Polyhydramnios
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2
Q

How does amniotic fluid embolism present?

A

Acute onset hypoxia, hypotension and confusion
Seizures
Shock
DIC

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3
Q

How is amniotic fluid embolism investigated?

A

FBC
ECG
CXR

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4
Q

How is amniotic fluid embolism managed??

A

ABCDE

Get senior help

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5
Q

What is shoulder dystocia?

A

One of the shoulders of the foetus gets stuck (usually on a bony prominence)

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6
Q

Which structure may shoulder dystocia result in damage of?

A

Brachial plexus

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7
Q

What are the pre-labour risk factors for shoulder dystocia?

A 
Prev event
Macrosomia
Diabetes
Maternal BMI >30
IOL
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8
Q

What are the intrapartum risk factors for shoulder dystocia?

A

Prolonged stage 1 or 2
Secondary arrest
Oxytocin
Operative delivery

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9
Q

What is the “turtle neck” sign in shoulder dystocia?

A

Foetal head retracts in towards the pelvis

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10
Q

How is shoulder dystocia managed?

A

Senior help
Stop pushing
Avoid downwards traction
Episiotomy

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11
Q

What examination is recommended after albour with shoulder dystocia?

A

PR

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12
Q

What is an umbilical cord prolapse?

A

When cord comes through the cervix before/with the infant

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13
Q

What is occult complete cord prolapse?

A

Descends alongside presenting part of foetus, but not in front of it

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14
Q

What is overt incomplete cord prolapse?

A

Cord comes out first and is beyond the presenting part of the feotus

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15
Q

By which two mechanisms does foetal hypoxia occur with cord prolapse?

A

Occlusion - presenting part presses on the cord and stops blood flow

Arterial vasospasm - exposure of umbilical cord to cold atmosphere causes vasospasm

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16
Q

What are the main risk factors for cord prolapse?

A 
Breech 
Unstable lie
Artificial rupture of membranes
Polyhydramnios
Prematurity
17
Q

How is umbilical cord prolapse managed?

A 
Senior help
Don't touch cord
Lift presenting part
C-section
Terbutaline
18
Q

Why is terbutaline given in cord prolapse?

A

Relaxes uterus and stops contractions

19
Q

What is eclampsia?

A

TC seizure in pre-eclamptic woman with absence of neuro or metabolic explanation

20
Q

What a high risk factor for eclampsia?

A 
Prev event
HTN
DM
CKD
Autoimmune
21
Q

What are mod risk factors for eclampsia?

A 
>40yrs
BMI>35
FHx
Nulliparity
Preg interval >10 years
Multi preg
22
Q

What may eclampsia cause in the foetus?

A 
IUGR
Premature delivery
Infant RDS
Foetal death
Placental abruption
23
Q

Why may USS be performed in eclampsia?

A

Rule out placenta abruption

24
Q

In which position should the patient be in in eclampsia?

A

Left lateral

25
Q

How are eclamptic seizures treated?

A

MgSO4

26
Q

Which anti-hypertensives can be used in pre-eclampsia and eclampsia?

A

Labetalol

Hydralazine

27
Q

What is the definitive treatment for eclampsia?

A

Deliver the baby

28
Q

What is uterine rupture?

A

Full-thickness disruption of the uterine muscle and overlying serosa

29
Q

What are the two types of uterine rupture?

A

Complete

Incomplete

30
Q

Describe an incomplete uterine rupture

A

Peritoneum over uterus in still intact

31
Q

Describe a complete uterine rupture

A

Peritoneum also torn - uterine contents can escape into peritoneal cavity

32
Q

What are the main risk factors for uterine rupture

A 
Anything that makes the uterus weaker
Prev C-sec or uterine surgery
IOL
obstruction
Multi preg
Multiparous
33
Q

How does uterine rupture present?

A

Severe continuous abdo pain between contractions

With/out vaginal bleeding

34
Q

What is the surgical management of uterine rupture?

A

C-sec

Uterine repair or removal

Year 3 - Repro and Sexual Health (23 decks)

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