Obstetrics Flashcards
What does term mean?
37-42 (usually)
When does a baby become post-term
40 weeks +
Quickening meaning?
Foetal movement
FM/RFM/DFM meaning
Foetal movement/ reduced/diminished
IUGR meaning?
Intrauterine growth restriction
What’s an ectropion
Columnar epithelium from the cervix meets squamous epithelium from the vaginal tissue
When is an ectropion normal?
Young person on contraception
What causes ectropions?
Hormones - oestrogen causes changes in tissue lining
When is an ectropion a problem?
An older lady who could maybe have an oestrogen secreating tumour
What is the transformation zone in relation to female reproductive system
Ectropion
Nabothian cyst meaning?
Lump filled with mucus on the surface of the cervix
What is a C-section
Surgical procedure either planned or emergency done to retrieve the baby if worrie of maternal or foetal health. Incision of the lower more fibrous part of the uterus
What is baseline bradycardia?
HR of <100
What is baseline tachycardia
Heart rate >160
What is loss of baseline variability
<5beats/min variability around the baseline
What is early deceleration
slowing of the heart rate which starts during a contraction and returns to normal after
What is late deceleration
Slowing of foetal heart rate after contraction occurs and doesnt return to normal after 30seconds
What is variable decelerations
Slowing of heart rate independent of contractions
How many categories of C section are there?
4
What is a cat 1 c section
Immediate threat to life of mother or baby
Delivery within 30 mins of decision needed
What is cat 2 section
Maternal/foetal compromise thats not immediately life threatening
Delivery within 75 mins
What is a cat 3 section
Delivery need but both stable
what’s a cat 4 section
Elective
When can you have an abortion
24 weeks onward
What date is the abortion act
1990
How to get abortion signed of?
2 medical practitioners
What medicine is given from abortion
Mifepristone followed 48hrs later by prostaglandins then pregnancy test in 2 weeks
What surgical options are there for termination
- MVA manual vacuum aspiration (misoprostol +/- mifepristone cervical priming)
- Dilation and evacuation (d+e - IUD inserted after evacuation)
What’s ECV
External cephalic Version
- breech/transverse to cephalic
When is ECV given
37 weeks
Is anti-d given for ECV in rhesus neg mothers
Yes
Foetal causes of breech/malpresentaitons (4 foetal)
- Premature (small)
- Microsomnia (thin)
- Polyhydramnios (water everywhere)
- Multiple pregnancy (more room)
How many stages of labour are there
4
What is latent first stage
Cervic 0-4cm
Painful contractions (intermittent or continuous)
what is active first stage
Cervix 4-10
Regular painful contractions
Usually 8 hours for nulliparous, 5 hours for multi
What is second stage
Expulsion of foetal from full cervical dilation
What is third stage delivery
Placental delivery
Role of oxytocin in pregnancy
Induces dilation caused from baby’s head pressure on cervical os
Types of SROM breaking (2)
Forewater (normal bubble at head that squeezes under pressure = gush)
Hindwtar (baby leg broke it = trickles down)
What does green SROM suggest
Meconium staning, foetal distress
What’s meconium
Baby poo
5 symptoms of late pregnancy
- Nesting behaviour
- Mucous plug goes
- Baby droop/ relief off lungs
- Bowel habits change (diarrhoea)
- Backache
What is PPH
Post partum haemorrhage
How is PPH defined
Blood loss of >500ml after vaginal delivery
What are the 4Ts in relation to PPH
- Tone
- Trauma
- Tissue
- Thrombin
When does PPH happen
24 hours
What tx is for PPH
Mechanical, medical and surgical
Mechanical method for pPH (3)
ABCDE
Warmed crystalloid
Compress the uterus and catheterise pt
medical methods of tx for PPH (4)
IV oxytocin
Egometrine slow iV
Carboprost
Misoprostol
Surgical PPH
Balloon tamponade
Ligation
Hysterectomy
When is the timeline for PPH
24hrs-6weeks
What is the incision known as for C-section
Pfannensteil incision
How many layers are there to go through before retrieving the baby
7
What are the 7 layers of the c-section
- Skin
- Subcutaneous fat
- Rectus fascia
- Rectus abdominus muscles
- Peritoneum
- Lower uterine segment entered
- Amniotic sac
BABY
How many layers of the peritoneum are there
- Parietal
- Visceral
What part of the peritoneum is cut through
- Parietal layer
What’s a feature of the peritoneum
Highly vascularised
Reasons for c-section?
- Breech
- Dysocia (prolonged and unprogressive brith)
- Placenta praevia
- Foetal distress (placenta separates, umbilical cord squeezed/pressed, strangling baby, inadequate blood flow)
- Multiple births
- HTN
- Uncontrolled
When is a c-section usually done?
After 39 week gestation
What is a Bakri Catheter
Balloon Tamponade