Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialities > Obstetrics 3 > Flashcards

Obstetrics 3 Flashcards

1
Q

How is intrauterine growth restriction measured?

A

Asymmetrical intrauterine fetal growth - measured in 2 weekly separations

Low amniotic fluid index score

Umbilical artery flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What features on CTG are seen on intrauterine growth restriction?

A

Absent accelerations

decreased baseline variability

shallow decelerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What needs to be monitored during/ after administration of MgS04- in eclampsia?

A

15mins:
- blood pressure
- respiratory rate

Hourly sp02

Patella reflexes

Temperature

Urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some of the immediate side effects the mother may expereince with administration of MgS04-?

A

Feeling of impeding doom

Facial flushing

Heat traveling up arm

Metallic taste

N&V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drug is given to reverse MgS04 toxicity?

A

Calcium gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which drug should not be used in the 3rd stage labour management for patients with pre-eclampsia?

A

Ergometrine

- i.e. syntometrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List 4 indications for a forceps delivery:

A

Fetal distress during 2nd stage of delivery

Maternal distress during 2nd stage of delivery

Failure to progress

Control of head during a breech delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should Anti-D immunoglobulin be given immediately?

A

Delivery of Rh + alive or still born

Any termination of pregnancy

Miscarriage >12 weeks

Surgical management of an ectopic

External cephalic rotation

Amniocentesis

*and in obstetric emergencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the AFP do in Down’s syndrome and neural tube defects?

A

High in Neural tube defects

Low in Down Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the major cause of cord prolapse?

A

Artificial rupture of membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When are twins delivered and why is there different monitoring processes for them?

A

DCDA: 37 weeks

MCMA: 36 weeks

*if the first is cephalic presenting then vaginal delivering may be possible.

Different monitoring is used to prevent confusion/ or the same twin being monitored twice.

  • CTG
  • Fetal scalp electrode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A cord sample is taken and the cord blood is low in oxygen but the pH is normal, why is this?

A

it is normal for the fetus to undergo times of hypoxia, especially during birth. it adapts. this is through:

  • increase O2 extraction (fetal Hb)
  • redistribution of blood
  • increased anaerobic metabolism (this is usually more severe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some of the risk factors and signs of a uterine rupture?

A

Risk factors:

  • previous C section
  • Vaginal birth after C section
  • previous uterine surgery
  • Multiparity
  • use of oxytocin
  • RTA

Signs:

  • abdominal pain not related to contractions
  • ceasing of uterine contractions
  • shoulder tip pain
  • pain over uterine scar
  • Shock
  • palpable fetus in the abdomen
  • fetal distress
  • loss of station and/or presenting part
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In uterus inversion how should it be managed?

A

Resuscitation
- 4 units cross matched

Manual or hydrostatic can be used.

Manual
- push uterus back up and hold with fist and hold it there to allow uterus to constrict around it

Hydrostatic
- inflating the uterus with fluid to compress it back into shape

Surgical:
- laparotomy to stitch the uterus back into position

**do not remove placenta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the major causes of secondary PPH and how should they women be managed?

A

secondary: 24hours - 12weeks.

Endometritis
Retained products of conception

  • High vaginal swap + Antibiotics + admit
  • US of uterus for retained products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the main postpartum care for women?

A

7 B’s

  • Breastfeeding
  • Bladder - urine retention (within 6 hours)
  • Bowel (constipation, iron tablets)
  • Bleeding (secondary PPH)
  • Bottom - pain from tears etc
  • Birth control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three main factors are associated with placental abruption?

A

Trauma
Multiparity
Increased maternal age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How should placental abruption be managed?

A
  • Senior obstetrician, midwife and anaesthetist
  • Blood products + Fluid
  • CTG monitoring of fetus and careful monitoring of mother
  • Anti - D prophylaxis (determined by Keilhauer test)
    +/- Steroids and magnesium sulphate
    +/- emergency C section

*active 3rd stage management as there is a high risk of PPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can be the complications of placental abruption?

A

Hypovolemic shock

Sheehan syndrome

AKI

DIC

Fetal:

  • intrauterine death
  • intrauterine hypoxia - cerebral palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What test is conducted to asses the dose of anti-D prophylaxis needed?

A

Keilhauer test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is used to assess the progress of the of labour?

A

Partogram

  • cervical dilation *recorded very 4 hours
  • Decent of fetal head
  • Maternal BP, HR
  • Fetal HR
  • contractions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How often are uterine contractions measured and what would 2/10 mean?

A

every 10 mins

Means 2 contractions every 10mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are definitions for the delay in 3rd stage?

A

30mins - active management

60mins - physiological management

24
Q

What are the main options for the management of failure to progress?

A

Artificial rupture of membrane (if membranes still intact)
Oxytocin infusion
Instrumental delivery
C- section

25
Q

What are the values for preterm babies?

A

<37 weeks preterm
32- 37 weeks - moderate to late preterm
28-32 weeks - very preterm
<28 weeks - Extreme preterm

26
Q

What prophylactic options are there for prevent preterm?

A

Progesterone pessary
- offered to those with a cervix <25mm length at 24 weeks

Cervical cerclage
- offered to those with a cervix <25mm length at 24 weeks

27
Q

What is the diagnostic investigation and management of pre-term labour?

A

Fetal fibronectin
- the glue between the cervix and chorion

Management:

  • CTG monitoring
  • Nifedipine (tocolytic)
  • Maternal steroids
  • Magnesium sulphate
  • Antibiotics

Delivery:
- Delayed cord clamping

28
Q

In PROM, PPROM and preterm labour when examining what is a very important point:

A

Sterile speculum examination

- prevent introducing infection tracking up causing Chorioamnionitis

29
Q

Which are more effective at achieving vaginal delivery within 24 hours, PG’s vaginally or Syntocinon?

A

Vaginal PG’s are more effective at achieving vaginal delivery within 24 hours

30
Q

What is the most common type of breech presentation?

A

Frank

- hips flexed and legs extended

31
Q

How does polyhydramonis and oligodramonis related to breech presentation?

A

Both can cause breech:
Poly = more room to move
Oligo = if it gets stuck its unable to turn

32
Q

What is are the complete contraindications to External cephalic version?

A

Rupture of the membranes

Placenta previa

Recent antepartum haemorrhage

Major uterine abnormalities
- uterine fibroids

33
Q

In order for an instrumental delivery what needs to be in place?

A

An empty bladder
Adequate analgesia
Ruptured membranes
Cervix fully dilated

34
Q

What type of delivery should be avoided in very-preterm babies and why?

A

Use of ventouse

- it can cause large haematomoas and head deformities

35
Q

Which STI testing is not routinely done at booking appointment?

A

Chlamydia testing

- may be done in <25 year olds

36
Q

When does obstetric cholestasis usually present?

A

> 30 weeks

*women who have cholestasis are usually recommended for delivery at 37

37
Q

Which has a higher risk of miscarriage CVS or Amniocentesis?

A

CVS

- it can be carried out at 10 weeks as opposed to 15 weeks but carriers a higher risk of miscarriage

38
Q

Why might polyhydramnios indicated rhesus isoimmunisation?

A

Fetal hydrops through destruction of the RBCs

39
Q

When is Anti D prophylactically given?

A

28 weeks and 34 weeks

40
Q

At the initial appointment what examination and investigations are usually undertaken?

A

Examination:

  • BP
  • HR
  • BMI
  • Urine sample

Investigations:

  • FBC (anaemia, thrombocytopenia)
  • Blood group - ABO, Rh
  • Rubella status
  • Hb Electrophoresis
  • Hepatitis B status
  • Syphilis screen
  • HIV status
41
Q

What are the benefits of skin to skin contact of the baby and the mother following birth?

A

Calms baby

Releases oxytocin in mother:

  • aids contraction of the uterus
  • Stimulates lactation
42
Q

If a pregnant women is >20 weeks pregnancy and exposed to chickenpox and develops the rash within 24 hours which drug should be administered?

A

Aciclovir

*note this is different from exposure to actually having it in which VZV immunoglobulin is of no use

She also needs to be seen by a specialist

43
Q

What is the dose of folic acid that should be administered for pregnant mothers on anti-epileptic medication and obese >30BMI?

A

5mg

44
Q

At which point would lochia require further investigation?

A

> 6 weeks

45
Q

What are the targets for gestational diabetes and what should be offered if not met?

A

Fasting: <5.3mmol.

1 hour after meal: <7.8mmol
or
2 hours after meal: <6.4mmol

If over a management of diet and exercise should be done, if this doesn’t correct in 1-2 weeks then:
- metformin

if still not adjusted after 1-2 weeks then:
- insulin

If >7mmol fasting at diagnosis then insulin

46
Q

If there is late deaccelerations on the CTG what would your next line of management be?

A

Fetal blood sampling

  • to assess for acidosis.
  • if <7.2 then induction is needed
47
Q

What is a syndrome which can occur with the thyroid following pregnancy?

A

Post-partum thyroiditis.
- initially hypothyroidism followed by hypothyroidism.

Treated with propranolol

48
Q

Which skin pathology in pregnancy can cause bullae and does not spare the umbilicus? name severe complications associated with it.

A

Pemphigoid Gestationis

complications:
- Premature delivery
- fetal restriction
- transient blistering of child

49
Q

What is the definitive management for a prolapsed cord?

A

After calling for help and placing the mother into appropriate positions (Modified Sims, all fours) the definitive management of:
- delivery.

C- section with tocolytic agents to stop contractions if cervix is closed

Assisted vaginal delivery if closed

50
Q

At what stage do you refer if no fetal movements have been observed?

A

24 weeks

51
Q

Name a diagnostic test that can be done to diagnose PPROM:

A

On speculum examination test for:

- Insulin like growth factor - Binding protein

52
Q

Define G+P

A

G is how many pregnancies <24 weeks
P is how many over 24 weeks regardless of outcomes.

**If a woman has 2 children, has had 2 miscarriages and she is currently pregnant at 33 weeks she is:

G5 P2

**if a woman is pregnant for first time at 33 weeks she is:
G1 P0

53
Q

What is the management for a miscarriage?

A

If stable and <12 weeks:
- conservative (let the POC pass themselves)

Medical:

  • Misoprostol *vaginally or orally
  • Analgesia + Antiemetics

*mifepristone is not routinely given in UK

Surgical:

  • manual vacuum aspiration (LA)
  • Electrical vacuum aspiration (GA)

*surgical is done is hemodynamical unstable or infection

**if surgery or >12 weeks anti-D should be given

54
Q

Small for gestational age can be broadly broken down into what? and what is one of these subheading further divided into and reflect on time scales relating to it:

A

In the <10% centile

  • Constitutionally small
  • IUGR

IGUR is further broken down into:
- Placental causes (pre-eclampsia, Maternal health)

  • Non placental causes (chromosomal abnormalities, inborn errors, fetal infections)

IGUR can also be thought of in terms of late and early onset.
Early tends to be symmetrically small and more related to non-placental causes

Late tends to be asymmetrical and more related to placental causes

55
Q

How is SGA monitored?

A

Serial growth scans

Umbilical artery doppler

Amniotic fluid index

Maternal assessment can also be carried out:

  • BP
  • Urine dip
  • Infection screen (TORCH)

Genetic testing may also be carried out

Specialities (63 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions