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Women’s Health > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

What is a molar pregnancy very commonly associated with?

A

Pre eclampsia
Hyperemesis gravidarum due to very high b hcg levels
Theca lutein cysts due to high beta hcg

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2
Q

When do we do the metastatic work up when the diagnosis of molar pregnancy has been made?

A

BEFORE suction evacuation

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3
Q

What is the number one investigation that assesses the chance of conversion of GTD to GTN?

A

Baseline hcg

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4
Q

What is primary vs secondary post partum hemorrhage?

A

Bleeding after delivery >500ml.
Primary: within the first 24h
Secondary: 24h to 12 weeks post pregnancy

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5
Q

Persistent uterine bleeding past 8 weeks of pregnancy. What should we do?

A

Urine hcg test to exclude GTN

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6
Q

In which cases do we have to give anti d antibodies?

A

After ectopic pregnancy, miscarriage or regular pregnancy

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7
Q

Primary s secondary pph?

A

Primary PPh: 500ml+ in the first 24h
Secondary pph: within 24h to 12weeks post partum

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8
Q

8+ weeks of bleeding post partum or any pregnancy event. What is the primary test that we should do?

A

HCG to exclude GTN

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9
Q

What are we most worried about in a case of septic miscarriage?

A

SEPTIC SHOCK!!! MUST MONITOR VITAL SIGNS

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10
Q

Most common cause of cervical incompetence?

A

Trauma

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11
Q

Management of a patient with eclampsia?

A

FIRST: ABCD. Ensure patent airway, make sure she’s oxygenated
SECOND: Check the bp, control it
THIRD: MgSO4 to prevent further seizures
FOURTH: Evaluate for delivery.

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12
Q

What finding massively increases the chances of getting pyelonephritis in pregnancy

A

Asymptotic bacteruria

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13
Q

,oat common cause of pyelonephritis and most common route of infection?

A

Blood borne, e coli

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14
Q

What should we do to women with recurrent uti after delivery?

A

Intra venous pyelography to exclude ureteric stones

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15
Q

Define Hyperemesis gravidarum

A

Protracted NVP + dehydration (ketonuria) + electrolyte imbalance + loss of more than 5% of pre pregnancy weight

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16
Q

Most important investigations in Hyperemesis gravidarum?

A

Urine analysis for ketone bodies, serum electrolytes for sodium and potassium

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17
Q

What do we do if vanishing twin occurs in 1st or 2nd trimester”

A

1st trimester: no treatment needed
2nd: increase chances of preterm birth, hemorrhaging and infection, must manage accordingly.

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18
Q

What warrants a continuous FTT during labor?

A

Use of oxytocin! Could cause fetal decelerations

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19
Q

If a pregnant woman with SLE has positive anti ro/ anti la antibodies, what should we a part of her prenatal management.

A

Continuous surveillance of fetal heart rate since these antibodies could cause congenital heart block.

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20
Q

WHAT SHOULD WE SUSPECT IN A PATIENT WITH PREECLAMPSIA/ HELLP BEFORE 20 WEEKS GESTATION?

A

APS

21
Q

Pregnancy complications associated with APS?

A

Preeclampsia.
Placental abruption.
Fetal growth restriction
Primary billiary cirrhosis, Bud Chiarri
Recurrent pregnancy loss

22
Q

How do we estimate fetal weight?

A

Fetal biometry (done by US): 4 things.
Bi parietal diameter, Head Circumference , Abdominal Circumference , Femur Length

23
Q

Which vaccines are totally contraindicated in pregnancy?

A

Live attenuated vaccines (MMR measles mumps rubella, BCG, varicella chicken pox!)

24
Q

What can be used as a screening test for SGA?

A

PAPPA
Uterine artery Doppler at 20-24 weeks.
Sympheseal fundal height starting 24weeks

25
Q

Diagnosis of SGA?

A
  1. US Biometry: AC or EFW (combination of BPD, HC, AC, FL)
  2. Doppler
  3. Oligohydraminous and AFI
26
Q

How will a SGA reflect on fetal biometry and amniotic fluid?

A

SGA: BRAIN SPARING
Normal HC, decreased AC (increased HC:AC ratio)
Decreased renal perfusion: oligohydraminous

27
Q

How can we prevent SGA in a woman with preeclampsia?

A

Low dose aspirin starting 16weeks

28
Q

Primary screening tool for SGA?

A

Umbilical artery Doppler

29
Q

What are possible complications of spontaneous rupture of membranes in a women with polyhydraminous?

A

Sudden uterine decompression: cord prolapse and placental abruption

30
Q

What condition is very commonly associated with placental abruption?

A

Pre eclampsia. MUST THINK OF PRE ECLAMPSIA WHEN U SEE AP

31
Q

What condition is commonly associated with placental abruption?

A

PRE ECLAMPSIA!! YOU MUSTTT THINK OF PRE ECLAMPSIA WHEN U FIND PLACENTAL ABRUPTIOM

32
Q

What do we call the uterus in the case of a concealed placental abruption?

A

Couvelaire’s uterus

33
Q

What is the most ACCURATE WAY to predict fetal gestational age in 1st trimester?

A

Crown rump length

34
Q

Commonest cause of hydrocephalus?

A

gene mutation.

35
Q

What is the most common risk factor for pre Labour rupture of membranes?

A

Ascending infection

36
Q

What is the most dangerous chorioamnionitis infection caused by and what could chorioamnionitis lead to?

A

GBS. sepsis ans septic shock, peurperal sepsis.

37
Q

What is the most serious infectious organism in chorioamnionitis and in what way is that infection acquired?

A

Ascending infection. GBS

38
Q

What are the two methods of management we could do for a woman presenting with polyhydraminous?

A

Most women don’t need any intervention to be done.
In severe cases, we reduce fluid volume by:
1. Amnioreduction
2. Prostaglandin synthetase inhibitors such as indomethacin (should not be used beyond 32 weeks to prevent PDA.) They reduce the kidney perfusion and hence reduce the amniotic fluid volume.

39
Q

What is the most likely organism to cause sepsis in the puerperium?

A

Group A strept (strept pyogenes). Associated with offensive serosanguinous vaginal discharge

40
Q

What is the key investigation in a woman with suspected sepsis?

A

Blood culture. Start empirical antibiotics until culture results appear.

41
Q

If we suspect shock in a patient with sepsis, how do we confirm it?

A

Serum lactate: more than or equal to 4 is indicative of tissue hypoperfusion.

42
Q

How do we differentiate the cephalhaematoma from caput succedaneum?

A

Palpable periosteal edges in cephalhematoma and spreading over 1 bone only.

43
Q

What do we do in a case of suspected uterine rupture?

A

Urgent laparotomy

44
Q

What finding is necessary to be able to diagnose neonatal sepsis?

A

Rising CRP titre
Also associated with neutropenia/neutrophila and thrombocytopenia

45
Q

How do we deliver an IUFD?

A

Induction of labour start by single dose of Mifepristone 200 mg then home*

• Admit 36-48 hours later for misoprostol induction of labour

46
Q

What antibiotic do we use for listeriosis?

A

Amoxicillin

47
Q

What is Poland syndrome?

A

Poland syndrome is a condition where amastia is associated with absent/partial pectoralis muscle and syndactyly.

48
Q

Most common risk factor for PROM?

A

Ascending infection

49
Q

What is the engaging diameter in breech?

A

Bi trochanteric diameter.

Women’s Health (5 decks)

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