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
Carbemazepine and breastfeeding
Safe
26
Beta-blockers and breastfeeding
Allowed
27
Warfarin and breastfeeding
Allowed
28
Heparin and breastfeeding
Allowed
29
Aspirin and breastfeeding
Avoid (risk of Reye's)
30
Prevention of pre-eclampsia in high risk groups
Aspirin 75mg OD from 12 weeks until delivery
31
High risk factors for pre-eclampsia
Prev HTN in pregnancy Chronic HTN CKD Diabetes Antiphospholipid, SLE
32
Gestational diabetes - fasting glucose >= 7 mmol/L at diagnosis
Start insulin
33
Gestational diabetes - fasting glucose <7 mmol/L
Trial of diet + exercise for 1-2 weeks
34
Gestational diabetes - glucose targets not met within 1-2 weeks of diet/exercise
Start metformin
35
Gestational diabetes - glucose targets not met despite metformin
Add insulin
36
Treatment of nipple candidiasis
Miconazole cream for mother Nystatin suspension for baby
37
Blood tests at booking appointment - haematology
FBC Blood group Resus status Red cell alloantibodies Haemoglobinopathies
38
Blood tests at booking appointment - infection screen
Hep B Syphilis HIV
39
Alpha feto-protein is raised in
Neural tube defects Abdominal wall defects Multiple pregnancy
40
Alpha feto-protein is decreased in
Down's syndrome Trisomy 18 Maternal diabetes
41
ACEi/ARBs in pregnancy
Avoid (teratogenic)
42
Sodium valproate in pregnancy is associated with
Neural tube defects Neurodevelopmental delay
43
Phenytoin in pregnancy is associated with
Cleft palate
44
Which of the 'older antiepileptics' is considered the least teratogenic in pregnancy
Carbemazepine
45
NICE Hb cut-off for oral iron in 1st trimester
< 110 g/L
46
NICE Hb cut-off for oral iron in 2nd/3rd trimester
< 105 g/L
47
NICE Hb cut-off for oral iron postpartum
< 100 g/L
48
Moderate risk factors for pre-eclampsia
First pregnancy Multiple pregnancy > 40y Pregnancy interval >10y BMI >=35 FH pre-eclampsia
49
Use of SSRIs in first trimester is associated with
Congenital malformation (mainly cardiovascular)
50
Use of SSRIs in second trimester is associated with
Pulmonary hypertension
51
Use of SSRIs in third trimester is associated with
Neonatal withdrawal symptoms
52
Digoxin and breastfeeding
Allowed
53
Lithium and breastfeeding
Avoid
54
Methotrexate and breastfeeding
Avoid
55
Carbimazole and breastfeeding
Avoid
56
Amiodarone and breastfeeding
Avoid
57
Benzodiazepines and breastfeeding
Avoid
58
Commonest cause of early-onset neonatal sepsis
Group B streptococcus
59
Risk factors for GBS neonatal infection
Premature PROM Previous sibling GBS infection Maternal pyrexia
60
Women with GBS in previous pregnancies - offer
Intrapartum antibiotic prophylaxis or GBS test 35-37 weeks
61
Women with previous baby with GBS infection
Offer intrapartum antibiotic prophylaxis
62
Agent used in intrapartum antibiotic prophylaxis for GBS
Benzylpenicillin