Obstetrics Flashcards
Stretch marks on abdomen
Striae gravidarum
Butterfly pigmentation of the face (mask of pregnancy)
Chloasma gravidarum
Glycosuria
Physiological in up to 50% of pregnancies
Nitrates positive during pregnancy
Start antibiotics (if only leukocytes are positive send for further urinalysis before starting treatment)
Hepatitis B positive mother
Vaccinate baby at birth and consider IM immunoglobulin
Major teratogenic drugs
ACEIs Retinoids Sodium valproate Methotrexate Trimethoprim
CTG
Cardiotocography - records fetal heartbeat and uterine contractions
FHR
Fetal heart rate
Bradycardia - less than 110 bpm
Tachycardia - more than 160 bpm
SFH
Symphysis fundal height
Stages of labour
Stage 1 - begins when the cervix begins to dilate and ends with full dilation to around 10 cm
—Latent phase - onset of painful contractions to around 3 cm dilation (contractions may be less intense and less frequent)
—Active phase - quicker rate of dilation and greater intensity of contractions
Stage 2 - full dilation to delivery of the fetus (strong contractions every 2-3 minutes)
Stage 3 - delivery of the placenta
Normal position of the fetal head during descent
Occiput Transverse Position
9.5 cm fetal head diameter enabled by flexion of the head
Occipitobregmatic - lowest posterior point of occipital bone to anterior fontanel
Biparietal fetal head diameter
9.5 cm
Fetal station
Relationship between the presenting part of the fetus and the ischial spines
Maternal pyrexia
- 0 degrees Celcius once
37. 5 degrees Celcius twice, 2 hours apart
Normal time for spontaneous onset of labour
Any time after 37 weeks
Abnormal labour timescales
Before 37 weeks gestation (pre-term)
After 42 weeks gestation (post-mature)
Position that often leads to a prolonged labour
Occipitoposterior
Malpresentations
- Brow presentation (rare)
- Face presentation (1 in 500 deliveries)
- Shoulder presentation (very rare, transverse lie)
- Compound presentation (when a hand or foot is present along with the presenting part)
- Breech presentation
Horizontal incision made along the suprapubic crease in a lower segment caesarean section
Pfannenstiel incision
Two types of C-section
Classical and lower segment
Two types of vaginal assisted delivery
Forceps and ventouse
Most common drugs used with an epidural
Bupivucaine (local anaesthetic)
Fentanyl (opiate)
Define attitude
The relationship of fetal head to spine (e.g. flexed, neutral, extended)
EDD
40 weeks from first day of LMP
ARM
Artificial rupture of the membranes
Most common position of the uterus
Anteverted and anteflexed
PIH
Preganacy induced hypertension
Common site of headache for pre-eclampsia
Frontal
Pre-eclampsia core symptoms
Headache
Epigastric pain
Visual disturbance
Swelling
Dr C Br A Va D O
Define risk Contractions Baseline rate Accelerations Variability Decelerations Overall
CTG accelerations
Defined as an increase in FHR of >15 bpm for >15 seconds
Other name for obstetric cholestasis
Intrahepatic cholestasis of pregnancy
Lower-segment caesarean section scar
Pfannenstiel scar
Combined test for Down’s syndrome screening
10-13 weeks
- US fetal neck (nuchal translucency)
- PAPP-A
- Beta hCG
Test to measure the degree of transfer of fetal haemoglobin to a mothers bloodstream, usually in Rh-negative mothers
Kleihauer test (or KB test)
Gestation prior to which steroids must be given pre-delivery to reduce the risk of neonatal respiratory distress syndrome
34 weeks
Quadruple test for Down’s syndrome screening
16-19 weeks Unconjugated oestradiol hCG AFP Inhibin A
Injury to the upper nerves of the brachial plexus (C5-C6), often caused by shoulder dystocia and causing a pronated forearm in the ‘waiter’s tip’ position
Erb’s palsy
Injury to the lower roots of the brachial plexus (C8-T1), causing a ‘claw hand’ and supinated forearm
Klumpke’s palsy
