Obstetrics Flashcards
Folic acid and pregnancy
Most woman 400micrograms daily is fine
However, if BMI > 30 or diabetic, sickle cell, coeliac, on antiepileptics or any link with neural tube defects then 5mg OD
Tool to screen for post natal depression
Edinburgh scale
Congenital rubella syndrom
Cataracts, Sensorineural deafness and pulmonary artery stenosis
Screening test for Gestational diabetes
OGTT
GDM targets
Pregnant women with GDM should be advised to maintain their CBGs below the following target levels:
fasting: 5.3mmol/L
AND
1 hour postprandial: 7.8 mmol/L or
2 hours postprandial: 6.4 mmol/L
HIV + and breast feeding
avoid
PROM Rx
Management
admission
regular observations to ensure chorioamnionitis is not developing
oral erythromycin should be given for 10 days
antenatal corticosteroids should be administered to reduce the risk of respiratory distress syndrome
delivery should be considered at 34 weeks of gestation - there is a trade-off between an increased risk of maternal chorioamnionitis with a decreased risk of respiratory distress syndrome as the pregnancy progresses
down syndrome
is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency
When is foetal anomaly scan
18-20 weeks
When is downs screening with nuchal?
11-13+6
Booking visit?
8-12
Gestational diabetes when to start insulin?
If fasting glucose is greater than 7
Pregnant women and chicken pox?
Pregnant women ≥ 20 weeks who develop chickenpox are generally treated with oral aciclovir if they present within 24 hours of the rash
When is usual OGTT
24 - 28 weeks
When to give vaginal prostaglandin?
If Bishop score < 6
BP cut off for pre-eclampsia admission
160/110
When to refer if unable to feel fatal movements?
24
As per RCOG and Green-top guidelines, when exposure to chickenpox has occurred, prophylaxis depends on the mother’s immunity status. Since there is doubt in this scenario, the correct option is to arrange an urgent blood test to check for varicella antibodies. If not immune, RCOG guidance suggests either varicella-zoster immunoglobulin (VZIG) or aciclovir can be given to a pregnant woman >20 weeks. If she was less than 20 weeks pregnant and not immune, only VZIG would be offered, not a choice between VZIG or aciclovir.
When can you do ECV?
36 weeks (nulliparous)
37 weeks (multiparous)_
BMI and folic acid?
If BMI >30, give 5mg daily until end of 12th week
Chloramphenicol and breast feeding?
Grey baby syndrom
