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PART 1 > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

What is the anatomical landmark against which foetal head position is assessed during labour?

A

Ischial spine

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2
Q

What is the risk of uterine rupture during VBAC?

A

0.2 - 0.8%
= 25 per 10,000 or 2 in 1,000

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3
Q

Incidence of anal sphincter injury in primips?

A

6%

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4
Q

Definition of anaemia in second / third trimester?

A

Hb <105

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5
Q

Definition of anaemia in first trimester?

A

Hb <110

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6
Q

What effect does active management of third stage of labour have on risk of PPH?

A

Reduce by 60%

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7
Q

Which 3 infectious diseases are routinely screened for in antenatal care?

A

Syphillis, Hep B, HIV

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8
Q

By what process is the cervix softened during labour?

A

Break down of type 1 collagen by interstitial collagenase

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9
Q

What is the incidence of PPH in the UK?

A

24%

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10
Q

Most common causative organism of peuperal sepsis?

A

Group A Strep

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11
Q

What is the effect of pregnancy on platelet count?

A

Reduces platelets

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12
Q

What is the earliest gestational age at which amniocentesis should be carried out?

A

15/40

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13
Q

When should we test for gestational diabetes?

A

If previous history of GD:
As soon as possible after booking and again at 24-28/40

If no history but risk factors for GD:
24-28/40

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14
Q

When should abx given in ELCS?

A

Prophylactic abx should be given in every case prior to incision

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15
Q

Which antibiotic does NICE recommend for UTI in pregnancy?

A
  1. Nitro
  2. Trimethoprim (given with folic acid in 1st trimester)
  3. Cefalexin
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16
Q

First line pharmacological management of PPH in LSCS

A

Syntocinon
5 units by slow IVI

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17
Q

What is the risk of foetal varicella syndrome in mothers who have chickenpox?

A

Week 1-12/40 = 0.4%

Week 12/20/40 = 2%

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18
Q

What abnormalities are associated with foetal varicella syndrome?

A

Hypoplasia of one limb
CNS abnormalities
Eye abnormalities
Cicatricial lesions (band like hair loss) in dermatomal distribution

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19
Q

Normal arterial pH range of cord blood

A

7.26 - 7.3

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20
Q

Cord gas threshold for adverse neurological outcomes

A

<7.1

(Normal 7.26 - 7.3)

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21
Q

Foetal mortality rate in listeria infection during pregnancy?

A

25%

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22
Q

Which interleuken is raised during pregnancy?

A

IL10
Felt to have increased survival advantage

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23
Q

Most common cause of maternal mortality in UK?

A

Cardiac disease

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24
Q

Which is the only immunoglobulin to cross the placenta

A

IgG

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25
Q

Management of group b strep in labour

A

No allergy: Ben pen

Pen allergy: cephalosporin (eg cefalexin)

Severe pen allergy: vancomycin

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26
Q

Cause of raised AFP in pregnancy

A

Spina bifida

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27
Q

How many days after fertilisation does implantation occur

A

8 days

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28
Q

Main hormone causing uterine involution after delivery

A

Oxytocin

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29
Q

Blood flow in ml/min through uterine artery at full term

A

750 ml / min (12% maternal cardiac output)

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30
Q

First immunoglobulin to be made by the neonate

A

IgM

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31
Q

Mortality rate of disseminated neonatal herpes (treated)

A

30% mortality rate
17% neurological sequelae in survivors

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32
Q

At what gestation does maternal IgG cross to the foetus

A

12/40

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33
Q

Which cytokine is reduced during pregnancy?

A

Th1

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34
Q

Definition of concerning variability on CTG

A

<5bpm for 30 - 50 minutes

35
Q

Main cause of acute fatty liver of pregnancy

A

Foetal deficiency of long chain 3 hydroxyl CoA dehydrogenase (LCHAD)

36
Q

Incidence of obstetric cholestasis

37
Q

Leading cause Down’s syndrome

A

Non disjunction maternal gamete

38
Q

Leading cause Down’s syndrome

A

Non disjunction maternal gamete

39
Q

At what gestation is amniotic fluid greatest volume

40
Q

Risk of miscarriage in 35-39 year olds

41
Q

Risk of miscarriage in over 45s

42
Q

Polyhydramnios radiological definition

A

Deepest pocket >8cm

Amniotic fluid index >25cm

43
Q

What is lowest gestational age at which CVS can be done

44
Q

Risk of foetal laceration during c section

45
Q

Risk of foetal laceration during c section

46
Q

Chance of successful VBAC

47
Q

Incidence of placenta accreta in UK

A

1.7 per 10,000

48
Q

What sutures should you use to repair anal mucosa

A

3.0 polyglactin
Interrupted sutures

49
Q

Which antibody is present in breast milk

A

IgA (A glass of milk pls)

50
Q

Treating gonorrhoea in pregnancy

A

Azithromycin / ceftriaxone / spectinomycin

51
Q

Oligohydramnios USS definition

A

<5cm or deepest amniotic fluid pocket <2cm

52
Q

Polyhydramnios USS definition

A

> 25cm or deepest amniotic fluid pocket >8cm

53
Q

At what gestation is a gestational sac visible on TVUS?

A

From 4+3/40

(On trans abdominal ultrasound this is 5+3/40)

54
Q

Definition of prolonged third stage of labour

A

Trick question! Depends if active or physiological management

Active = >30 min til placenta

Physiological = >60 min til placenta

55
Q

Mechanism of closure of ductus arteriosus

A

Decreased prostaglandin E2 (hence why women can’t have NSAIDs)
Increased arterial pO2
Increased bradykinin

56
Q

Which gestations get steroids prior to a c-section?

A

Less than 38+6

57
Q

Diagnosis of gestational diabetes

A

Fasting glucose >5.6

2 hour glucose >7.8

(5, 6, 7, 8 boot scooting baby)

58
Q

What % of pregnancies are affected by GDM

59
Q

How much blood do you need to lose in a PPH before RCOG recommend resuscitation protocol?

60
Q

Which nerve roots are affected in Erb-Duchenne palsy?

A

C5, C6
Usually after a shoulder dystocia

61
Q

First line treatment for GBS

A

IM ben pen 3g

Cephalosporin / vanc if allergic

62
Q

What % of foetuses have Turner’s syndrome, and of those, how many make it to term?

A

1% of all conceptions have Turner’s
Only 1% of that make it to term (99% miscarry)

63
Q

What is the additional risk of perinatal death in a VBAC?

A

2 in 10,000

64
Q

Most common infective cause of congenital hearing loss

65
Q

When should warfarin be restarted post natally?

A

After 5-7 days regardless of breast feeding (not found in breast milk)

The wait to restart is over concerns of PPH

66
Q

Normal range for variability on CTG

67
Q

Drug of choice to stimulate lactation

A

Domperidone

68
Q

Which clotting factors are reduced during pregnancy?

A

XI and XIII

69
Q

What % of patients with PROM will go into labour within 24 hours?

70
Q

At what cervical dilatation can FBS be done?

71
Q

Risk of ischaemic hypoxic encephalopathy in VBAC

A

8 / 10,000

72
Q

Low AFP = what?

A

Edward’s
Down’s

73
Q

High AFP = what?

A

Multiple pregnancy
GI tract abnormalities
Anencephaly
Neural tube defects

74
Q

Incidence of placenta accreta

A

1.7 in 10,000

75
Q

Yolk sac size upper limit of normal

A

6mm
Max size at 10/40

76
Q

At what gestation does foetus start making urine?

77
Q

What % of babies born with brachial plexus injury have permanent disability?

78
Q

Cardiac abnormalities in Turner’s

A

Coarctation of aorta
ASD
Bicuspid aortic valve

79
Q

How does urea cross placenta?

A

Passive diffusion
Baby –> Mother

80
Q

Which immunoglobulin is found in large quantities in breast milk?

81
Q

Most common malignancy of newborn

A

Neuroblastoma

82
Q

Bitrochanteric diameter in breech presentation

83
Q

Definition of anaemia in pregnancy

A

1st trimester: <110

2nd and 3rd: <105

PART 1 (12 decks)

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