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AKT > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

SSRIs that can be used whilst breastfeeding

A

Sertraline

Paroxetine

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2
Q

Risk factors for gestational diabetes

A

BMI >30

Previous baby >4.5kg

Previous gestational DM

Diabetes in 1st-degree relative

South Asian, Afro-Caribbean, Middle Eastern

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3
Q

Screening for gestational diabetes - women with prior gestational diabetes

A

OGTT asap after booking + at 24-28 weeks

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4
Q

Screening for gestational diabetes - women without prior gestational DM

A

OGTT at 24-28 wks if any risk factors

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5
Q

Diagnosis of gestational diabetes: fasting glucose

A

Fasting glucose >= 5.6 mmol/L

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6
Q

Diagnosis of gestational diabetes: 2-hour glucose

A

2-hour glucose >= 7.8 mmol/L

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7
Q

If mother is HBsAg positive, anti-HBe positive, newborn should receive

A

Hep B vaccine

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8
Q

Mother had acute hepatitis B during pregnancy, newborn should receive

A

Hep B vaccine + Hep B immunoglobulin

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9
Q

Mother is HBsAg positive and baby weighs <1500g, newborn should received

A

Hep B vaccine + Hep B immunoglobulin

regardless of maternal anti-HBe status

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10
Q

Definition of pre-eclampsia

A

New BP >=140/90 after 20wks
+
Proteinuria/other organ involvement

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11
Q

Who should take high dose folic acid (5mg)

A 
Previous infant NTD
Antiepileptics
Diabetes
Coeliac
Sickle cell
Thalassaemia
BMI >30
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12
Q

Which group of pregnant women receive routine anti-D at 28 weeks

A

Rhesus negative mothers who are not sensitized

D antibody negative on booking

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13
Q

NHS advised supplements for all pregnant women

A

Folic acid 400mcg first 12 weeks

Vitamin D 10mcg throughout pregnancy

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14
Q

First-line treatment of mastitis (systemically well, no fissure)

A

12-24 hours of milk removal

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15
Q

2nd-line treatment of mastitis (or if systemically unwell, fissure)

A

Flucloxacillin PO 10-14 days

Continue breastfeeding/expressing

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16
Q

Booking visit at

A

8-12 weeks

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17
Q

Dating scan

A

11 - 14 weeks

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18
Q

Down’s syndrome screening including nuchal scan

A

11 - 13+6 weeks

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19
Q

Anomaly scan

A

18 - 20+6 weeks

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20
Q

Second screen for anaemia + atypical red cell alloantibodies

A

28 weeks

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21
Q

2nd dose anti-D given to Rhesus -ve women at

A

34 weeks

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22
Q

Antibiotics contraindicated if breastfeeding

A

Ciprofloxacin
Tetracyclines
Chloramphenicol
Sulphonamides

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23
Q

Antibiotics permitted in breastfeeding

A

Penicillins
Cephalosporins
Trimethoprim

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24
Q

Sodium valproate and breastfeeding

A

Allowed

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25
Q

Carbemazepine and breastfeeding

A

Safe

26
Q

Beta-blockers and breastfeeding

A

Allowed

27
Q

Warfarin and breastfeeding

A

Allowed

28
Q

Heparin and breastfeeding

A

Allowed

29
Q

Aspirin and breastfeeding

A

Avoid (risk of Reye’s)

30
Q

Prevention of pre-eclampsia in high risk groups

A

Aspirin 75mg OD from 12 weeks until delivery

31
Q

High risk factors for pre-eclampsia

A 
Prev HTN in pregnancy 
Chronic HTN
CKD
Diabetes
Antiphospholipid, SLE
32
Q

Gestational diabetes - fasting glucose >= 7 mmol/L at diagnosis

A

Start insulin

33
Q

Gestational diabetes - fasting glucose <7 mmol/L

A

Trial of diet + exercise for 1-2 weeks

34
Q

Gestational diabetes - glucose targets not met within 1-2 weeks of diet/exercise

A

Start metformin

35
Q

Gestational diabetes - glucose targets not met despite metformin

A

Add insulin

36
Q

Treatment of nipple candidiasis

A

Miconazole cream for mother

Nystatin suspension for baby

37
Q

Blood tests at booking appointment - haematology

A 
FBC
Blood group
Resus status
Red cell alloantibodies
Haemoglobinopathies
38
Q

Blood tests at booking appointment - infection screen

A

Hep B
Syphilis
HIV

39
Q

Alpha feto-protein is raised in

A

Neural tube defects
Abdominal wall defects
Multiple pregnancy

40
Q

Alpha feto-protein is decreased in

A

Down’s syndrome
Trisomy 18
Maternal diabetes

41
Q

ACEi/ARBs in pregnancy

A

Avoid (teratogenic)

42
Q

Sodium valproate in pregnancy is associated with

A

Neural tube defects

Neurodevelopmental delay

43
Q

Phenytoin in pregnancy is associated with

A

Cleft palate

44
Q

Which of the ‘older antiepileptics’ is considered the least teratogenic in pregnancy

A

Carbemazepine

45
Q

NICE Hb cut-off for oral iron in 1st trimester

A

< 110 g/L

46
Q

NICE Hb cut-off for oral iron in 2nd/3rd trimester

A

< 105 g/L

47
Q

NICE Hb cut-off for oral iron postpartum

A

< 100 g/L

48
Q

Moderate risk factors for pre-eclampsia

A 
First pregnancy
Multiple pregnancy
> 40y
Pregnancy interval >10y
BMI >=35
FH pre-eclampsia
49
Q

Use of SSRIs in first trimester is associated with

A

Congenital malformation (mainly cardiovascular)

50
Q

Use of SSRIs in second trimester is associated with

A

Pulmonary hypertension

51
Q

Use of SSRIs in third trimester is associated with

A

Neonatal withdrawal symptoms

52
Q

Digoxin and breastfeeding

A

Allowed

53
Q

Lithium and breastfeeding

A

Avoid

54
Q

Methotrexate and breastfeeding

A

Avoid

55
Q

Carbimazole and breastfeeding

A

Avoid

56
Q

Amiodarone and breastfeeding

A

Avoid

57
Q

Benzodiazepines and breastfeeding

A

Avoid

58
Q

Commonest cause of early-onset neonatal sepsis

A

Group B streptococcus

59
Q

Risk factors for GBS neonatal infection

A

Premature
PROM
Previous sibling GBS infection
Maternal pyrexia

60
Q

Women with GBS in previous pregnancies - offer

A

Intrapartum antibiotic prophylaxis
or
GBS test 35-37 weeks

61
Q

Women with previous baby with GBS infection

A

Offer intrapartum antibiotic prophylaxis

62
Q

Agent used in intrapartum antibiotic prophylaxis for GBS

A

Benzylpenicillin

AKT (28 decks)

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