Obstetric MCQs Flashcards
What acid-base change does pregnancy cause?
Compensated respiratory alkalosis
How much does blood volume increase above baseline in pregnancy?
30-50% (4.7L to 7.5L)
What is a side effect of spinal anaesthesia?
Hypotension
What is the typical thyroid status in pregnancy?
Mild hyperthyroidism in T1, euthyroid in T2 and T3
What happens to fibroids during pregnancy?
Red degeneration plus
Bleeding, placenta displacement, premature labour, miscarriage
Is round ligament pain worse on the left or right during pregnancy?
Right - uterus rotated to the right causing compression
What causes foetal tachycardia?
Foetal hypoxia
Chorioamnionitis
Maternal fever
Hyperthyroidism
Anaemia
What causes early decelerations?
Head compression (normal)
What is the order of features of herpes simplex virus?
Vesicles, ulcer, crust, resolution
What is the treatment for varicella pneumonia in a pregnant woman?
IV acyclovir
A pregnant woman is exposed to chicken pox in the first trimester - what is the next best step?
Check IgG status and give IV acyclovir
What are the risk factors associated with uterine atony?
Overdistension of the uterus (multiple gestations, macrosomia, polyhydramnios)
Prolonged labour
Augmentation of labour (oxytocin)
Grand multiparity
What is the delivery plan for unstable lie?
Contraindication to IOL, elective C-section
What are the indications for classical C-section incision?
Pre-term and poorly formed lower segment
Placenta praevia with large vessel over lower segment
Transverse lie with back inferior
Large fibroid
PROM
What is the classic skin incision for C-section?
Pfannenstiel incision
What are the complications of instrumental delivery?
Haematoma
Facial palsy
Subgalci and cephalohaematomas
What method of contraception least affects breast milk?
Progesterone
What contraceptive is contraindicated in breastfeeding?
COCP
How long is colostrum produced for?
3 days
How long does it take for breastmilk to be produced following pregnancy?
72 hours (day 3)
When does engorgement happen in a non-breastfeeding woman?
2-3 days
What is the presentation of breast engorgement?
Warm, tender and firm breasts with engorged veins and fever
What are the symptoms of a blocked duct in breastfeeding?
Low grade fever
Painful lump
Hot, tender breast
Erythema
How long does it take for a woman’s weight to return to normal following delivery?
6 months
(Lose 4.5kg follow birth of baby - most back to normal by 1 month but may take 9 months)
What are the top 3 causes of maternal death?
- VTE event
- Sepsis (peurperal)
- Haemorrhage
What is the cause of PV bleeding in a woman 15 days postpartum with a normal temperature?
Lochia (rule out PPH)
What is the order of features of herpes simplex virus?
Vesicles, ulcer, crust, resolution
