Brainscape's Knowledge GenomeTM

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


See full index

Finals Revision > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

When can the combined test (blood & NT) be done for Downs Syndrome?

A

11 to 13+6 weeks

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

When is a booking visit usually done?

A

8 to 12 weeks

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

When can solely blood tests be done for Downs syndrome?

A

15 to 20 weeks

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

When is an anomaly scan done?

A

18 to 20+6 weeks

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

When is anti-D prophylaxis given?

A

28 weeks (+/- 34 weeks)

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

What investigations should be carried out at the booking visit?

A

Bloods (FBC, ABO, Rhesus, syphilis, HIV, HepB&C)
Urinalysis (MSSU for culture and sensitivities)
USS ( confirm viability, no of fetuses, gestation)

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

Is HCG increased or decreased in babies with downs syndrome?

A

Increased

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

Is PAPP-A increased or decreased in babies with downs syndrome?

A

Decreased

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

Is AFP increased or decreased in babies with downs syndrome?

A

Decreased

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

In what circumstances would AFP be raised in pregnancy?

A

Multiple pregnancy, placental abruption, anencephaly, spina bifida

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

What level of risk from the initial downs syndrome testing warrants invasive testing?

A

Risk of 1 in 150 or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the two invasive tests for Downs syndrome?

A

Chorionic Villous sampling

Amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is chorionic villous sampling carried out?

A

11-13 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is amniocentesis carried out?

A

15+ weeks

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

What is the risk of miscarriage in chorionic villous sampling?

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the risk of miscarriage with amniocentesis?

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should Anti-D be given acutely?

A

Within 72 hours of a sensitising event (e.g. CVS, amniocentesis, ectopic, miscarriage, termination)

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

How is Anti-D administered?

A

IM injection into deltoid muscle

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

What maternal factors can cause poor growth of the fetus?

A

Age (>35, <16), low socioeconomic status, parity (0 or >5), interpregnancy interval (<6 months, >120 months), medical conditions (e.g. SLE, asthma, pre-eclampsia etc), previous SGA, drug abuse, ART, maternal infection (TORCH, malaria, TB, UTIs, BV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What fetal factors can cause poor growth?

A 
Chromosomal anomalies (trisomies 13, 18, 21)
Major congenital anomalies
Congenital infections
Multiple pregnancy
Genetic syndromes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What placental factors can cause poor growth?

A 
Placental dysfunction (e.g. pre-eclampsia)
Placental abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is symmetrical IUGR?

A

Global growth restriction

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

What are the causes of symmetrical IUGR?

A

Aneuploidy, infection, maternal substance abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an asymmetrical IUGR?

A

Reduced abdominal circumference (normal head circumference, biparietal diameter and femur length)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the causes of an asymmetrical IUGR?

A

Placental insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the main features of IUGR?

A

Decreased fundal height
Reduced liqor
Reduced fetal movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What investigations should be done to assess growth of fetuses?

A

CTG
Biophysical assessment (looking at fetal movement, breathing, tone and liqor)
Doppler USS of umbilical artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does absent or reversed end diastolic flow on doppler USS of the umbilical artery indicate?

A

It indicates placental resistance which means there is a problem. The placenta is usually a low resistance, high flow organ.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the causes of large for dates?

A 
Constitutionally large
Polyhydramnios
Multiple pregnancy
Diabetes
Beckwith-Widemann syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the causes of polyhydramnios?

A

Twins, fetal anomaly, maternal diabetes, idiopathic, hydrops fetalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Hydrops fetalis?

A

Abnormal accumulation of fluid in 2 or more fetal compartments. Caused by rhesus disease, infection, congenital anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are some symptoms of polyhydramnios for the mother?

A

Discomfort, breathlessness, heartburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some potential complications of polyhydramnios?

A

Cord prolapse, placental abruption, preterm labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is polyhydramnios managed?

A

Expectant management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which type of twins are at the most risk of complications?

A

Monochorionic monozygotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the signs/symptoms of multiple pregnancy?

A

Exaggerated pregnancy symptoms, high AFP, large for dates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is twin to twin transfusion syndrome?

A

Placental anastamoses result in blood being moved disproportionately from one twin to another. Donor twin becomes dehydrated and has reduced growth. Recipient twin becomes fluid overloaded.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What twin type is at risk of TTS?

A

Monochorionic twins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Can twins be delivered normally?

A

Yes as long as one is cephalic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What dose of folic acid should pre-existing diabetic patients take?

A

5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

In pregnant pre-existing diabetics, what drugs should be stopped/ continued?

A

All should be stopped except metformin and insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are complications of pre-existing diabetes and pregnancy?

A 
Hypoglycaemia unawareness
Pre term labour
Stillbirth
Polyhydramnios
Macrosomia or IUGR
Congenital anomalies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

When should diabetics be offered induction of labour?

A

From 38 weeks to prevent macrosomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are complications for large for dates babies?

A

Risk of birth injuries e.g. shoulder dystocia
Prone to immaturity of suckling and swallowing
Hypoglycaemia
Hypocalcaemia
Polycythaemia (increased risk of jaundice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

By what week of pregnancy is the placenta functional?

A

Week 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What vessel transports oxygen rich fetal blood?

A

Umbilical vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What vessel transports oxygen low maternal blood?

A

Uterine vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What 3 things mean fetal oxygen carrying capacity is good?

A

Fetal Hb can carry more oxygen
Fetus’ have more Hb
The Bohr Effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What happens to cardiac output in pregnancy?

A

Increases (can cause ECG changes, murmurs etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What happens to stroke volume in pregnancy?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What happens to blood pressure in pregnancy?

A

Decreases in 2nd trimester and then steadily starts to increase until term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What happens to respiratory rate in pregnancy?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What happens to both tidal volume and minute volume in pregnancy?

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Do oxygen requirements in pregnancy increase or decrease?

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What happens to plasma volume in pregnancy?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What happens to RBC count in pregnancy?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What happens to Hb in pregnancy?

A

Decreases by dilution (due to increased RBC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What happens to platelets in pregnancy?

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What happens to GFR in pregnancy?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

When does HCG peak?

A

10 weeks then declines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What oestrogen is an indicator of fetal vitality?

A

Estriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

When is the anabolic phase of pregnancy?

A

1-20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When is the catabolic phase of pregnancy?

A

21-40 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What hormone causes growth of the ductile system in the breast?

A

Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What hormone causes the development of the lobular alveolar complex in the breast?

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What hormone stimulates milk production?

A

Prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What hormone is released following a suckling stimulus?

A

Oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is pre-existing HTN of pregnancy defined as?

A

Hypertension occurring before pregnancy/before 20 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How should women with pre-existing HTN be managed?

A

Switch patient to labetalol from ACEi/ARB
Do urine dip
Start aspirin 75mg from 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is pregnancy induced hypertension?

A

Hypertension occurring after 20 weeks with NO proteinuria or symptoms of pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is pre-eclampsia?

A

Pregnancy induced hypertension, proteinuria (>0.3g/l) +/- oedema

72
Q

What is thought to be the underlying mechanism behind pre-eclampsia?

A

Abnormal trophoblastic invasion leading to abnormal placental perfusion and placental ischaemia. This causes release of anti-angiogenic substances into the circulation, causing the presentation of PET

73
Q

What are risk factors for pre-eclampsia?

A

Age >40, BMI >30, personal history, family history, nulliparity, multiple pregnancy, pre-existing renal disease/hypertension/diabetes/SLE

74
Q

What are symptoms of pre-eclcampsia?

A

Headache, visual disturbance, epigastric/RUQ pain, N&V, rapidly progressive oedema

75
Q

What are some signs of pre-eclampsia?

A 
Increased BP
Proteinuria
Oedema
Abdominal tenderness
Disorientation
Intra-uterine death/SGA
Hyperreflexia/clonus
76
Q

What is eclampsia?

A

Tonic-clonic seizure with features of pre-eclampsia

77
Q

How is eclampsia treated?

A

BP control (IV Labetalol/Hydralazine)
Neuroprotection - IV Magnesium Sulphate 4g over 5 mins
Deliver baby

78
Q

How should fluids be managed in eclampsia?

A

The patient should be run DRY - 80ml/hr as the main cause of maternal death is pulmonary oedema

79
Q

What is HELLP syndrome?

A

Haemolysis
Elevated Liver enzymes
Low Platelets

80
Q

When should women with hypertension be admitted?

A

BP >170/110 or >140/90 with ++proteinuria
Significant symptoms
Significant proteinuria
Fetal compromise

81
Q

What blood pressure in pregnancy is an indication to initiate treatment?

A

> 150/100 regardless of aetiology

82
Q

What medications are used to treat blood pressure in pregnancy?

A

Labetalol, nifedipine, methyldopa, hydralazine

83
Q

What is the only cure for pre-eclampsia?

A

Delivery of the baby

84
Q

How is blood pressure treated post partum?

A

Slow reduction of medications based on blood pressure readings

85
Q

How soon after delivery should methyldopa be stopped and why?

A

By day 2 as it poses a risk of depression

86
Q

What is antepartum haemorrhage?

A

Bleeding after 24 weeks and before delivery of the baby

87
Q

What are the main causes of APH?

A 
Placenta praevia
Placental abruption
Placenta accreta
Uterine rupture
Vasa praevia
Local causes (ectropion, polyp, cancer etc)
88
Q

What is a minor APH defined as?

A

<50mls of blood that has settled

89
Q

What is a major APH defined as?

A

50-1000mls of blood with no clinical signs of shock

90
Q

What is a massive APH defined as?

A

> 1000mls of blood and/or significant shock

91
Q

What is placenta praevia?

A

Placenta is partially or totally implanted in the lower uterine segment

92
Q

What is the difference between a minor and major placenta praevia?

A

Minor does not cover the os, major does

93
Q

What are risk factors for placenta praevia?

A

Previous c-section, previous placenta praevia, asian ethnicity, smoking, previous TOP, age >40, multiparity, multiple pregnancy, ART

94
Q

How does placenta praevia present?

A

Painless bleeding, unusually unprovoked but can be triggered by sex. Uterus soft, non-tender. CTG normal. No fetal distress.

95
Q

How does placenta praevia affect delivery?

A

If within 2cm of os - c-section

If over 2cm from os - vaginal delivery

96
Q

What is placental abruption?

A

Premature separation of the uterus from the placenta.

Vasospam leads to arteriole rupture, blood then escapes into the myometrium which causes tonic contraction of the uterus leading to disrupted circulation and in turn hypoxia.

97
Q

What are risk factors for placental abruption?

A

Pre-eclampsia, hypertension, trauma, smoking, cocaine, renal disease, diabetes, polyhydramnios, multiple pregnancy, previous abruption

98
Q

How does a placental abruption present?

A 
Severe, continous abdominal pain
Bleeding (may be concealed)
Pre-term labour
Maternal collapse
'Woody hard abdomen and tense uterus' 
CTG - IUD/irritable
99
Q

How does placental abruption affect delivery?

A

Urgent delivery needed by c-section or ARM and induction

100
Q

What is placenta accreta?

A

When the placenta invades the uterine wall

101
Q

How is placenta accreta diagnosed?

A

MRI scan

102
Q

What are placenta increta and placenta percreta?

A

Increta - invasion of myometrium

Percreta - invasion of serosa/bladder/bowel

103
Q

What are some risk factors for placenta accreta?

A

Previous c-section, placenta praevia

104
Q

How is placenta accreta managed?

A

Insert prophylactic internal iliac balloon
May need caesarean hysterectomy
Expect >3L blood loss

105
Q

What is uterine rupture?

A

Full thickness opening of the uterus

106
Q

What are risk factors for uterine rupture?

A

Previous c-section, uterine surgery, multiparity, syntocinon use, obstructed labour

107
Q

How does uterine rupture present?

A

Shoulder tip pain, severe abdominal pain, maternal collapse, PV bleed, loss of contractions, peritonism, fetal distress

108
Q

What is vasa praevia?

A

Fetal vessels lie in the fetal membranes across the os

109
Q

What are risk factors for vasa praevia?

A

Placental anomalies (e.g. bilobed placenta, succeturiate lobe), placenta praevia, multiple pregnancy, ART

110
Q

How is vasa praevia diagnosed?

A

USS with colour doppler

111
Q

How does vasa praevia present?

A

Sudden PV bleed, painless
Fetal bradycardia, IUD
Fetal Hb may be found in PV bleed

112
Q

How is delivery affected in vasa praevia?

A

Must do c-section

113
Q

How are all APHs generally managed?

A

Admit to hospital
IV access via 2 large bore cannulae
FBC, LFTs, U&Es, Kleinhauer test
Crossmatch 4-6 litres of blood
Give IV fluids/transfuse if blood available
Anti-D if Rh-ve
FOR FETUS - CTG monitoring, administer steroids and MgSO4 for lung development and neuroprotection

114
Q

What is post-partum haemorrhage?

A

Loss of blood following delivery of baby

115
Q

What is a minor PPH defined as?

A

500-1000ml blood loss

116
Q

What is a major PPH defined as?

A

> 1000ml blood loss

117
Q

What are some antenatal risk factors for PPH?

A

Previous PPH or retained placenta, BMI >35, APH, multiparity, maternal age >35, fibroids, large placental site, overdistended uterus

118
Q

What are some labour risk factors for PPH?

A

Prolonged labour
Induction/oxytocin use
Operative delivery/c-section

119
Q

What are the causes of PPH?

A

The 4 T’s - Tone, trauma, tissue, thrombin
TONE - uterine atony, vessels don’t get clamped. May occur due to prolonged labour/overdistension
TRAUMA - vaginal/vulval lacerations
TISSUE - retained placental
THROMBIN - haemophilia, von willebrands etc

120
Q

How is PPH prevented?

A

Use of uterotonics - syntocinon

121
Q

What is given if a woman has no risk factors for PPH and has a vaginal delivery?

A

Syntocinon 10iu IM injection

122
Q

What is given if a woman has no risk factors for PPH and had a c-section?

A

Syntocinon 5iu by slow IV infusion

123
Q

What is given if a woman has risk factors for PPH?

A

Syntometrine (CI in hypertension)

124
Q

How is the bleeding managed in a minor PPH?

A

Uterine massage - expel any clots
5 units syntocinon IV stat
40 units syntocinon in 500ml Hartmanns - 125ml/hr

125
Q

How is the bleeding managed medically in a major PPH?

A

Confirm delivery of placenta and membranes complete
500mcg ergometrine IV
Prompt repair of vaginal/perineal trauma
Carboprost 250mcg IM every 15 mins (max 8 doses)
Misoprostol 800mcg sublingual./PR
Tranexaminc acid 1g IV
Packs, balloons, tissue sealants, arterial emboliztion

126
Q

How can a major PPH be managed surgically?

A

Undersuturing, B-Lynch sutures, uterine/internal iliac artery ligation, hysterectomy

127
Q

What fluid should be given in PPH?

A

Up to 2L of warmed crystalloid (e.g. saline, hartmanns) given asap
Up to 1.5L of warmed colloids until blood arives
Can do intra-operative cell salvage

128
Q

What is the first stage of labour?

A

Cervical dilatation

129
Q

What is the latent phase of the first stage of labour?

A

Up to 4cm cervical dilatation. Mild irregular uterine contractions, cervix softens and shortens

130
Q

What is the active phase of the first stage of labour?

A

4-10cm cervical dilatation. Contractions become increasingly rhythmic and strong.

131
Q

What is the second stage of labour?

A

From complete cervical dilatation to delivery of the baby

132
Q

How long should the second stage of labour last in nulliparous women?

A

Up to 2 hours or 3 hours if given regional anaesthesia

133
Q

How long should the second stage of labour last in multiparous women?

A

Up to 1 hour or 2 hours if given regional anaesthesia

134
Q

What is the third stage of labour?

A

After delivery of the baby until expulsion of the placenta and fetal membranes

135
Q

What are braxton-hicks contractions?

A

Tightening of the uterus muscles to prepare the body for birth. Felt from 2nd/3rd trimester onwards. Do not increase in frequency/intensity. Relatively painless, resolve on ambulation

136
Q

What are labour contractions?

A

Tightening of the top of the uterus, pushing the baby down into the birth canal. Described as a wave.

137
Q

What hormone initiates and sustains contractions?

A

Oxytocin

138
Q

What is the lie of the fetus?

A

Relation of the longitudinal axis of the fetus to the longitudinal axis of the mother

139
Q

What is the normal lie of a fetus?

A

Longitudinal

140
Q

What is vertex?

A

The baby being head down in the uterus

141
Q

What is fetal presentation?

A

The leading part of the fetus which occupies the lower pole of the uterus (e.g. cephalic, breech)

142
Q

What is fetal position?

A

Relation of the denominator of the presenting part to the quadrants of the maternal pelvis

143
Q

What is normal position for delivery?

A

Occipito-anterior

144
Q

What is station?

A

The location of the presenting part of the fetus in the birth canal (from -5 to+5) above and below the ischial spines

145
Q

What is it called when the head of the baby reaches the vulval ring and perineum stretches over its head?

A

Crowning

146
Q

Which shoulder is delivered first?

A

Anterior shoulder

147
Q

What signs indicate separation of the placenta from the uterus?

A

Uterus contracts, hardens and rises
Umbilical cord lengthens
Gush of blood

148
Q

What are the analgesia options for labour?

A 
Paracetamol/co-codamol
Entonox
Diamorphine
Epidural
Remifentanyl
Combined spinal epidrual
149
Q

With regard to puerperium, how long does it take for the funal height to reach the umbilicus?

A

2 weeks

150
Q

In what conditions is there increased nuchal translucency?

A

Downs syndrome
Congenital heart defects
Abdominal wall defects

151
Q

When and how much folic acid should be taken?

A

400mcg from trying to concieve until 12 weeks

152
Q

24 hours after delivery. Pain, vaginal bleeding, heavy offensive lochia, boggy poorly contracted uterus

A

Retained products

153
Q

What diabetic medication is safe in breast feeding?

A

Metformin

154
Q

When should methotrexate be stopped before trying to concieve?

A

For at least 3 months

155
Q

What scale is used to measure post natal depression?

A

Edinburgh Scale

156
Q

What is the criteria for hyperemesis gravidarum?

A

Dehydration
Electrolyte imbalance
5% pre-pregnancy weight loss

157
Q

What is the first line treatment for hyperemesis?

A

Antihistamines used first like (e.g. cyclizine, prochloperazine)
Metoclopramide and ondansetron second line

158
Q

What is hyperemesis associated with?

A

Multiple pregnancy, trophoblastic disease, hyperthyroidism, nulliparity, obesity

159
Q

What is fetal fibronectin?

A

Protein released from gestational sac. High level correlates with increased chance of premature labour

160
Q

What are indications for instrumental labour?

A

Fetal or maternal distress in 2nd stage

Failure to progress

161
Q

What are requirements for instrumental delivery?

A 
Fully dilated cervix
OA or OP position
Ruptured membranes
Cephalic presentation
Engaged presenting part
Pain relief
Sphincter (bladder) empty
162
Q

How should a non-immune pregnant woman who has been in contact with someone with chicken pox be managed?

A

Single dose varicella zoster immunoglobulin

163
Q

What are indications for induction of labour?

A

Prolonged pregnancy
PPROM
Diabetic mothers >38 weeks
Rhesus incompatibility

164
Q

What are the methods of inducing labour?

A

Membrane sweep
Intravaginal prostaglandins
Breaking waters
Oxytocin

165
Q

How does obstetric cholestasis present?

A

Widespread itch worse on palms and soles of feet

166
Q

What risk does obstetric cholestasis cause?

A

Preterm birth

167
Q

How is obstetic cholestasis managed?

A

Induction at 37 weeks
Urseodoxycholic acid
Vitamin K

168
Q

What Bishops score indicates that labour is unlikely to start without induction?

A

Less than 5

169
Q

What Bishops score indicates that labour is likely to start spontaneously?

A

Over 9

170
Q

Which vitamin in high levels is teratogenic?

A

A

171
Q

What is the management of a breech baby before 36 weeks gestation?

A

Nothing - most babies turn around before this stage

172
Q

When should external cephalic version be performed?

A

From 36 weeks for nulliparous women

From 37 weeks if multiparous

173
Q

What is McRoberts manouevre for?

A

Shoulder dystocia

174
Q

How is the McRoberts manouevre done?

A

Patient lies supine with hips fully flexed and abducted. Suprapubic pressure is applied

175
Q

What is the antibiotic treatment for PPROM?

A

Oral erythromycin (10days)

176
Q

What treatment is used for prevention of pre-eclampsia in at risk women?

A

Aspirin

Finals Revision (22 decks)

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