Obstetrics

Question 1

Early miscarriage?

Answer 1

<12wks gestation

Question 2

Late miscarriage?

Answer 2

12-24wks gestation

Question 3

Missed miscarriage?

Answer 3

Fetus no longer alive - no symptoms occurred

Question 4

Threated miscarriage?

Answer 4

Vaginal bleed with closed cervix, but fetus still alive

Question 5

Inevitable miscarriage?

Answer 5

Vaginal bleed with open cervix

Question 6

Incomplete miscarriage?

Answer 6

Retained conception products remain in uterus after miscarriage

Question 7

Complete miscarriage?

Answer 7

Full miscarriage; no conception products left in uterus

Question 8

Anembryonic pregnancy?

Answer 8

Gestational sac present, but contains no embryo.

Question 9

Investigation of choice for dx a miscarriage?

Answer 9

Transvaginal ultrasound

Question 10

Rupture of membranes?

Answer 10

Amniotic sac ruptured

Question 11

Spontaneous rupture of membranes?

Answer 11

Spontaneous rupture of amniotic sac

Question 12

Prelabour rupture of membranes?

Answer 12

Rupture before onset of labor

Question 13

Preterm prelabour rupture of membranes?

Answer 13

Amniotic sac ruptured before onset of labor and before 37wks gestation (preterm)

Question 14

Prolonged rupture of membranes?

Answer 14

Amniotic sac ruptures >18 hours before delivery

Question 15

Prematurity?

Answer 15

Birth <37wks gestation

Question 16

WHO prematurity:
Extreme preterm?
Very preterm?
Moderate to late preterm?

Answer 16

Extreme: <28wks
Very: 28-32wks
Moderate to late: 32-37wks

Question 17

Rupture of membranes?

SROM?

Answer 17

Amniotic sac rupture

Spontaneous rupture of amniotic sac

Question 18

P-PROM?

Answer 18

Rupture of membranes prior to onset of labour in patient <37wks gestation

Question 19

P (prolonged) ROM?

Answer 19

Amniotic sac ruptures >18hrs before delivery

Question 20

P (prelabour) ROM?

Answer 20

Amniotic sac rupture before labour onset

Question 21

What are risk factors and think of two major risk factors for PROM?

Answer 21

2 major: smoking and short cervical length (<25mm)

Vaginal bleed during pregnancy, +ve amniotic fluid cultures, previous preterm delivery

Question 22

What x2 can be offered as prevention for PROM?

Answer 22

Vaginal progesterone

Cervical cleavage

Question 23

Who is cervical cleavage offered to for PROM?

Answer 23

<25mm cervical length on vaginal USS between 16-24 wks.
Cervical trauma
Previous premature birth

Question 24

Who is vaginal progesterone offered to for PROM?

Answer 24

<25mm cervical length on USS between 16-24wks.

Question 25

Dx for PROM? think x2

Answer 25

Vaginal speculum exam | IGFBP-1 in high conc. in amniotic fluid (alternative is PAMG-1)

Question 26

Examples of magnesium sulphate toxicity signs?

Answer 26

Tendon reflex absent (patella to test), reduced RR and BP.

Question 27

What can be given as a prophylaxis against chorioamnionitis?

Answer 27

Erythromycin 250mg qds for 10 day course.

Question 28

Why might IM betamethasone be given for PROM?

Answer 28

Helps to reduced rate of neonatal death, RDS and IV hemorrhage.

Question 29

Monozygotic? | Dizygotic?

Answer 29

Identical twins from single zygote | Non-identical from different zygotes

Question 30

Monoamniotic? | Diamniotic?

Answer 30

Single amniotic sac | Two separate amniotic sacs

Question 31

Monochorionic? | Dichorionic?

Answer 31

Single placenta | Two separate placentas

Question 32

What are the best outcomes in twin pregnancy?

Answer 32

Diamniotic and dichorionic (separate sacs and nutrient supplies)

Question 33

Multiple pregnancy: | If embryo splits are 3 days what is the resultant?

Answer 33

Two chorions, two amnions

Question 34

Multiple pregnancy: | If embryo splits at 4-7 days what is the resultant?

Answer 34

Single placenta, one chorion, two amnions

Question 35

Multiple pregnancy: | If embryo splits at 8-12 days what is the resultant?

Answer 35

Single placenta, one chorion, one amnion

Question 36

Multiple pregnancy: | If embryo splits at 13 days what is the resultant?

Answer 36

Conjoined (Siamese) twins - very rare