Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obs and Gynae > Obstetric issues > Flashcards

Obstetric issues Flashcards

1
Q

Factors associated with increased risk of miscarriage

A 
Increased maternal age
Smoking, alcohol, drugs
High caffeine intake
Obesity
infections and food poisioning
Health conditions e.g. uncontrolled DM, severe HTN
Medicines e.g. ibuprofen
Unusual shape or structure of womb
Cervical incompetence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of labour

A

Regular and painful uterine contractions
Show- shedding of mucous plug
ROM
shortening and dilatation of cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stages of labour

A

Stag1: onset of true labour to when cervix fully dilated
Stage 2: from full dilatation to delivery of foetus
Stage 3: from delivery of fetus to when the placenta and membranes have completely been delivered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Monitoring in labour

A 
FHR every 15min or continuously by CTG
Contractions assessed every 30min
Pulse every 60min
BP and temp every 4h
VE offered every 4 hours to check progression
urine- ketones and protein every 4h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anaemia in pregnancy

A

Checked at booking at 28w.
oral iron therapy if:
booking- <11g/dl
28- <10.5g/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Amniotic fluid embolism

A

When foetal cells/amniotic fluid enters mothers bloodstream and stimulates reaction which results in chills, sweating, hypotension, cyanosis, tachycardia, MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications of IOL

A

Prolonged pregnancy- 40 +12
Prelabour premature ROM where labour doesn’t start
Diabetic mother >38w
Rhesus incompatibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Raised AFP

A

NTDs
Abdominal wall defects
Multiple pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Decreased AFP

A

Down’s syndrome
Trisomy 18
Maternal DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

RF for VTE in pregnancy

A 
Age >35
BMI >30
Parity >3
Smoker
Gross varicose veins
Current pre-eclampsia
Immobility
FHx of unprovoked VTE
Low risk thrombophilia
Multiple pregnancy
IVF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of VTE in pregnancy

A

4 or more RF- immediate treatment with LMWH continued to 6 weeks postnatal
3 RF- LMWH from 28w until 6w post natal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

VTE prophylaxis to avoid in pregnancy

A

DOACs

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RF for pre-eclampsia

A 
hypertensive disease in previous pregnancy
CKD
autoimmune disease
DM -T1/2
Chronic HTN
First pregnancy
>40y
pregnancy interval >10y
BMI >35
FHx of pre-eclampsia
Multiple pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Consequences of pre-eclampsia

A 
Fetal prematurity or IUGR
Eclampsia
Haemorrhage- abruption, intra-abdominal, intra-cerebral
Cardiac failure
Multi-organ failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Definition of pre-eclampsia

A

HTN >20w + proteinuria (>0.3g/24h)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of severe pre-eclampsia

A 
HTN typically >170/100 mmHg + proteinuria
Protein on dipstick 2/3+
headache
visual disturbance
papilloedema
RUQ/epigastric pain
Hyperreflexia
Platelet count <100 x106/l, abnormal liver enzymes or HELLP syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of pre-eclampsia

A

Oral labetalol
Nifedipine and hydralazine may also be used
Delivery of baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PPH: definition

A

blood loss >500ml
primary- within 24h
Secondary- 24h-12w (retained tissue or endometritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RF for PPH

A 
Previous PPH
prolonged labour
pre-eclampsia
increased maternal age
polyhydramnios
emergency C-section
placenta praevia, accreta
macrosomia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

4 causes of PPH

A

Tone- uterine atony
Tissue- retained products of conception
Thrombin- coagulopathy
Trauma- genital tract trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of PPH

A

ABC + two peripheral 14 gauge cannula
IV syntocin 10u or IV ergometrine 500 micrograms
IM carboprost
if medical fail- surgical options
intrauterine balloon tamponade, ligation of uterine arteries
last resort- hysterectomy

22
Q

Requirements for instrumental delivery

A 
FORCEPS
Fully dilated cervix
OA position preferably OP
Ruptured membranes
Cephalic presentation
Engaged presenting part i.e. head at or below ischial spines
Pain relief
Sphincter (bladder) empty
23
Q

Indications for forceps use

A

Fetal distress in second stage of labour
Maternal distress in 2nd stage
Failure to progress in 2nd stage
control of head in breech delivery

24
Q

Indications for CTG monitoring

A 
Suspected chorioamnionitis/sepsis/ T> 38
Severe HTN >160/100
Oxytocin use
Presence of significant meconium
Fresh vaginal bleeding that develops in labour
25
CTG interpretation
``` DR C BRA V A D O ```
26
Cause of bradycardia on CTG
<100 bpm increased fetal vagal tone maternal B-blocker use
27
Cause of tachycardia on CTG
``` >160 bpm Maternal pyrexia Chorioamnionitis Hypoxia Prematurity ```
28
Cause of loss of baseline on CTG
<5bpm Prematurity Hypoxia
29
Cause of early deceleration on CTG
Deceleration of HR which commences with onset of contraction and returns to normal on completion Usually innocuous and indicated head compression
30
Cause of late deceleration on CTG
deceleration of HR which lags onset of contraction and doesn't return to normal until after 30s following end of contraction Indicated fetal distress- asphyxia or placental insufficiency
31
Cause of variable decelerations on CTG
independent of contractions | may indicate cord compression
32
Eclampsia
development of seizures in association to pre-eclampsia.
33
Management of eclampsia
MgSO4 1V bolus 4g over 5-10 min followed by infusion of 1g/hour monitor urine output, reflexes, RR and oxygen sats continue for 24h after last seizure or delivery
34
Placenta praevia
Placenta lying wholly or partly in lower uterine segment Associated factors- multiparity, multiple pregnancy, previous LSCS clinical features- shock in proportion to visible loss, np pain, no tenderness Usually picked up on routine 20w abdo USS
35
Placenta accreta
Attachment of placenta to myometrium due to defective decidua basalis. Doesn't properly separate during labour- risk of PPH RF- placenta praevia, previous C-section
36
Physiological changes in pregnancy
CV- raised HR, CO, SV. lower BP Resp- O2 requirements increase Blood- blood volume increases, increased risk of thromboembolism, platelets fall, calcium requirements increase Urine- GFR increases, salt and water reabsorption increased Uterus size increases
37
Chorioamnionitis
Result of ascending bacterial infection of amniotic fluid/membranes/ placenta Medical emergency- life threatening to mother and foetus Prompt delivery of foetus and IV Abx considered mainstay of initial treatment
38
Hyperemesis gravidarum
Most common 8-12, can be up to 20. | Linked to raised beta hCG levels
39
Hyperemesis: diagnosis and associations
``` Diagnosis: 5% pre-pregnancy weight loss, dehydration, electrolyte imbalance Associations: Multiple pregnancies Trophoblastic disease Hyperthyroidism Nulliparity Obesity ```
40
Hyperemesis: management and complications
Management: Antihistamines- cyclizine Ondansetron and metoclopramide- 2nd line admission may be needed for IV hydration Complications- Wernicke's encephalopathy, Mallory-Weiss tear, central pontine myelinolysis, acute tubular necrosis, fetal- SGA, preterm
41
Possible sensitisation events
``` Delivery of Rh +ve infant TOP Miscarriage if gestation >12w Ectopic- surgical management ECV antepartum haemorrhage amniocentesis/chorionic villus sampling/ foetal blood sampling abdominal trauma ```
42
Threatened miscarriage
Painless vaginal bleeding <24w | Cervical os closed
43
Missed (delayed) miscarriage
Gestational sac which contains dead fetus <20w without symptoms of expulsion Light vaginal bleeding/discharge, disappearance of pregnancy symptoms
44
Inevitable miscarriage
Cervical os open | Heavy bleeding- clots and pain
45
Incomplete miscarriage
Not all products of conception have been expelled
46
Ectopic pregnancy: signs and symptoms
Lower abdominal pain- constant and unilateral vaginal bleeding- lighter and darker than normal (brown) recent amenorrhoea ruptured- peritoneal bleeding causes shoulder tip pain and pain on defecation and urination
47
Placental abruption
Shock out of keeping with visible loss constant pain tender, tense uterus distressed foetus
48
Symphysis pubis dysfunction
Pain of pubis symphysis with radiation to the groins and medial aspects of thigh may have waddling gait Due to increased ligament laxity in response to hormonal changes of pregnancy
49
Uterine rupture: signs and symptoms
Maternal shock, abdominal pain, vaginal bleeding
50
RF for perineal tears
``` Primigravida Large babies Precipitant labour Shoulder dystocia Forceps ```
51
RF for cord prolapse
``` Prematurity Multiparity Polyhydraminos Twin pregnancy Cephalopelvic disproportion Abnormal presentation e.g. Breech, transverse lie Placenta praevia Long umbilical cord High fetal station ```

Obs and Gynae (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions