obstetrics Flashcards
complete hydatiform mole vs partial
chromosome?
fetal parts?
partial- 1 egg two sperms, 69 XXX, 69XXY, FETAL PARTS
complete- empty egg, 1 sperm, 46XX, 46XY, all genetic from father
indications for induction of labour?
methods for induction of labour
Postpartum haemorrhage (PPH) is defined ….?
causes of PP?
> 500mL
Postpartum haemorrhage (PPH) mx?
What advice should be given regarding the prevention of neural tube defects?
all women should take 400mcg of folic acid until the 12th week of pregnancy
HIGHER RISK (ie T1DM, BMI OVER 30): folic acid 5mg 3 months before conception to 12 weeks of pregnancy.
woman, pregnant, not had MMR vaccine
advice?
keep away from people who might have rubella and receive MMR post natal
Gestational diabetes screening test? weeks?
oral glucose tolerance test (OGTT) at 24- 28 weeks
dx: fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L
needs insulin
REMEMBER 5, 6, 7 ,8
if fasting <7 can be advised on diet, but repeat glucose in 1-2 weeks. if target not met then metformin, if still not met then add insulin
pregnant, under 20 weeks, HTN, tx?
labetalol
category 1 vs 2 c section time frame has to be done once decision is made?
30 vs 75 mins
baby blues vs postnatal depression vs puerperal psychosis
time frame, presentation?
pregnant mum 34 wks, has UTI, positive for Group B Streptococcus (GBS)
mx?
intrapartum iv abx
benzylpenicillin is the antibiotic of choice for GBS prophylaxis
pregnant lady has chicken pox or significant exposure, mx depending on weeks of pregnancy?
first check does she have immunity VZI IgG levels
over 20 weeks: acyclovir
under 20 weeks: Varicella-zoster immunoglobulin VZIG
Intrahepatic cholestasis of pregnancy
presentation?
mx?
check lfts also
Gestation week screening earliest:
Down syndrome screening (nucal)?
anomaly scan?
first dose of anti reusus if woman negative
breech management?
<36 turns on its own
36> external cephalic version
24-year-old primigravida
mother had seizure during her pregnancy
She has no past medical history
BP is 125/85
No abnormalities are detected on her urine dipstick.
BMI is 38 kg/m².
mx?
A woman at moderate or high risk of pre-eclampsia should take aspirin 75-150mg daily from 12 weeks gestation until the birth
r/f: first pregnancy, BMI >35 kg/m² and family history of eclampsia
Women who are at high risk of developing pre-eclampsia should take …?
aspirin 75mg od from 12 weeks until the birth of the baby.
What is the first line management for shoulder dystocia?
McRoberts manoeuvre (hyperflexion of the maternal legs) is the first management approach
Oligohydramnios is less then ..?ml
causes?
when to take aspirin if at risk for pre-eclampsia i.e previous hx or family hx, type 1 or 2 diabetes?
A woman at moderate or high risk of pre-eclampsia should take aspirin 75-150mg daily from 12 weeks gestation until the birth
screening tool for postnatal depression
Edinburgh scale
patient has pre eclampsia.. mx?
treat with labetalol
Delivery should not be offered to women before 34 weeks unless:
severe hypertension remains refractory to treatment
maternal or fetal indications develop as specified in the consultant plan
on methotrexate and wants to have a baby
advice?
Methotrexate: must be stopped at least 6 months before conception in both men and women
12 week scan shows high chance and and quad scan of downs, next step?
Non-invasive prenatal screening test (NIPT)- analyses DNA
2-day-old baby
rudimentary digits, limb hypoplasia and microcephaly.
what was he exposed to?
varicella zoster
pregnant mum, previously has gestational diabetes, when do you seen her?
OGGT asap after booking.
normally you do it at 24-28 wks
pregnant
how much vit d?
daily supplement 10micrograms of vitamin D
27wks preg, regular weak contractions
premature labour- cervix cm dilated
mx?
Admit and administer tocolytics and steroids
when to give anti D?
advise giving anti-D to non-sensitised Rh -ve mothers at 28 and 34 weeks
Eclampsia– having a seizure ?
mag sulphate
6-day-old baby is found to have congenital cataracts, sensorineural deafness and pulmonary artery stenosis
RUBELLA
ruby eyes, and ears
Anti-epileptics in pregnancy
Lamotrigine
UTI while breastfeeding?
Trimethoprim
HIV positive women can she breastfeed?
NO
Neonatal antiretroviral therapy sicne mum has HIV
zidovudine is usually administered orally to the neonate if maternal viral load is <50 copies/ml.
if viral load >50 then triple ART 4-6 weeks.
HIV mum, mode of delivery?
Down’s syndrome is suggested by
?HCG
?PAPP-A
?nuchal translucency
Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency
