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Yr 4C > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

fecundity

A

the capacity to conceive (measured as the monthly probability of conception - normal is 20% for fertile women)

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2
Q

asthenozoospermia

A

abnormal sperm motility

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3
Q

teratospermia

A

abnormal sperm morphology

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4
Q

Naegele’s rule

A

Due date = LMP + 280 days (9mnths + 7ds)

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5
Q

Severe nausea & vomiting during pregnancy (–> LOW & dehydration)

A

Hyperemesis gravidarum

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6
Q

Zygosity

A

number of fertilised eggs

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7
Q

chorionicity

A

number of placentae

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8
Q

amnionicity

A

number of amniotic cavities

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9
Q

One fertilised egg, separates <3 days

A

dichorionic diamniotic pregnancy (DCDA)

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10
Q

One fertilised egg, separates in days 4-8

A

monochorionic diamniotic pregnancy (MCDA)

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11
Q

One fertilised egg, separates in days 7-12

A

monochorionic monoamniotic pregnancy (MCMA)

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12
Q

One fertilised egg, separates >12 days

A

conjoined twins

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13
Q

Monochorionic twins, 1 twin hyperperfused 1 twin hypoperfused, 1 twin polyhydramnios 1 twin oligohydramnios

A

Twin-to-twin transfusion syndrome (TTTS)

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14
Q

Miscarriage

A

Spontaneous loss of intrauterine pregnancy <20wks gestation

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15
Q

Recurrent miscarriage

A

3+ consecutive pregnancies lost

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16
Q

pelvic pain (unilateral –> generalised), shoulder tip pain, delayed period, abnormal bleeding, tender adnexal mass, shock, peritonism

A

Ectopic pregnancy

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17
Q

Implantation of the fertilised ovum in tissue other than the

endometrium of the uterine cavity

A

ectopic pregnancy

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18
Q

Most common site of ectopic pregnancy

A

fallopian tube (97%)

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19
Q

Infant - cicatricial skin lesions, limb hypoplasia, microcephaly, ophthalmic lesions

A

congenital varicella syndrome (CVS)

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20
Q

Flu-like illness + unpasteurised milk, soft cheeses, pre-prepared salads, uncooked seafood, processed meats

A

Listeria monocytogenes

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21
Q

Infection of the amniotic fluid, placenta, membranes and/or decidua

A

Chorioamnionitis

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22
Q

Pre-eclampsia

A

de novo hypertension arising >20 weeks gestation, returning to normal within 3 months postpartum, plus evidence of dysfunction in at least one other organ (placental disorder)

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23
Q

Eclampsia

A

pre-eclampsia + convulsions

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24
Q

Gestational HTN

A

de novo hypertension arising >20 weeks gestation without any other feature of preeclampsia, returning to normal within 3 months postpartum

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25
Q

In pregnancy - headaches, visual scintillations, epigastric/RUQ pain, oliguria, lower abdominal pain, bleeding (placental abruption), reduced foetal movements

A

Pre-eclampsia (+ convulsions = eclampsia)

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26
Q

Carbohydrate intolerance of variable severity with onset or first recognition during pregnancy

A

Gestational DM

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27
Q 
Pruritus in the absence of a skin rash with
abnormal LFTs (in pregnancy)
A

Cholestasis of pregnancy

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28
Q

The three Ps of delivery

A

Passenger (foetus), Passage (pelvis), Power (uterine contractions)

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29
Q

Foetal lie

A

relationship of the long axis of the foetus to the long axis of the mother. 1. longitudinal (cephalic = head first, breech = bottom/foot first) 2. transverse 3. oblique

30
Q

Macrosomia

A

Large for gestational age = estimated foetal weight >90th percentile (birth weight >4500g)

31
Q

Small for gestational age (SGA)

A

Estimated foetal weight (EFW) or abdominal circumference <10th percentile

32
Q

Severe SGA

A

EFW or abdominal circumference <3rd percentile

33
Q

SGA + problems (erratic growth, haemodynamic compromise, risk of poor outcomes)

A

Foetal growth restriction (FGR)

34
Q

Foetal position

A

the relationship of the denominator (occiput) to the maternal pelvis

35
Q

Foetal presentation

A

the part of the foetus that will present first (cephalic/vertex, shoulder, breech (foot/bottom))

36
Q

Frank breech

A

hips flexed, knees extended

37
Q

Complete breech

A

hips flexed, knees flexed, feet not below level of foetal buttocks

38
Q

Footling breech

A

one or both feet presenting below level of the foetal buttocks

39
Q

Stages of labour

A

1st (regular painful contractions –> full cervical dilation), 2nd (full cervical dilation –> delivery of infant), 3rd (delivery of infant –> delivery of placenta & membranes)

40
Q

Episiotomy

A

An incision through the perineum made to enlarge the

diameter of the vulval outlet and assist childbirth

41
Q

Perineal trauma

A

First-degree tear = injury to vaginal or perineal skin only
Second-degree tear = + injury to perineal muscles.
Third-degree tear = + involvement of anal sphincter muscles.
– 3a = <50% of external anal sphincter torn.
– 3b = >50% of external anal sphincter torn.
– 3c = internal anal sphincter also torn.
Fourth-degree tear = + injury to the rectal mucosa

42
Q

Stillbirth

A

birthweight of >400g or a gestation of >20 weeks

43
Q

Neonatal death

A

death <28 days after birth

44
Q

Infant death

A

death >28 days after birth

45
Q

Postpartum haemorrhage (primary)

A

> 500ml of blood loss within 24 hours after vaginal delivery

46
Q

Placental abruption

A

bleeding causes premature separation of the placenta from the wall of the uterus

47
Q

Shoulder dystocia

A

the foetal shoulders become impact in the maternal pelvis after delivery of the foetal head

48
Q

Cord prolapse

A

descent of the umbilical cord alongside or beyond the presenting part in the presence of ruptured membranes

49
Q

Antepartum haemorrhage

A

Bleeding from the genital tract after 20 weeks gestation

50
Q

In pregnancy - PV bleeding, continuous abdominal pain, tenderness on palpation, “woody’ uterus

A

Placental abruption

51
Q

Placenta praevia

A

Implantation of the placenta in the lower segment of the uterus

52
Q

Placenta accreta

A

placenta is morbidly adherent to the uterine wall

53
Q

Placenta increta

A

placenta invades into the myometrium

54
Q

Placenta percreta

A

placenta invades through the myometrium and the serosa of the uterus and may invade other body organs

55
Q

Vasa praevia

A

Foetal blood vessels run in the amniotic membranes below the presenting part of the foetus in front of the cervix, with no placenta or umbilical cord present

56
Q

In pregnancy - vaginal bleeding, acute foetal bradycardia, foetal vessels palpable over the membranes

A

vasa praevia

57
Q

“Turtle necking” of foetal head during delivery

A

shoulder dystocia

58
Q

Acute maternal collapse + foetal squames in maternal lungs

A

Amniotic fluid embolism

59
Q

Secondary postpartum haemorrhage

A

excessive vaginal bleeding from 24 hours to 6 weeks after birth

60
Q

During labour - abdominal pain, vaginal bleeding, +/- haematuria, contractions cease, decelerations on CTG, previous Caesarean delivery

A

Uterine rupture

61
Q

Uterine inversion

A

The uterine fundus descends either through the uterine cavity, through the cervix, or beyond the introitus. Caused by traction on the umbilical cord before the placenta has separated

62
Q

Preterm birth

A

Delivery <37wks gestation

63
Q

Preterm Pre-Labour Rupture of Membranes

A

Spontaneous rupture of membranes prior to 37 weeks gestation and before the onset of labour

64
Q

Term Pre-Labour Rupture of Membranes

A

Spontaneous rupture of membranes at or after 37 weeks gestation and before the onset of labour

65
Q

Trimesters

A

1st trimester: 0-12wks
2nd trimester: 13-27wks
3rd trimesters: 28wks-birth

66
Q

What is bHCG produced by?

A

Syncytiotrophoblast cells of the outer layer of the chorionic villi

67
Q

What is the function of bHCG?

A

To maintain the corpus luteum & stimulate its secretion of progesterone (structurally similar to LH)

68
Q

Causes of recurrent second trimester miscarriages

A

Septate/bicornuate uterus (due to incomplete fusion of paramesonephric ducts), cervical incompetence, antiphospholipid syndrome/SLE

69
Q

Causes of polyhydramnios

A

Maternal DM, foetal anencephaly, duodenal atresia (commonly assoc w Down’s foetus –> “double bubble” appearance on USS)

70
Q

PAPP-A

A

pregnancy associated plasma protein A (decreased in Down’s foetus)

71
Q

Sheehan syndrome

A

perinatal pituitary necrosis cause by hypovolemia (ie due to blood loss - PPH, placental abruption)

Yr 4C (6 decks)

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