Obstetrics Flashcards
A pregnant lady with pain in her supra pubic area that radiates to the upper thighs which is worse on walking is likely to be suffering from which common condition?
Symphysis pubis dysfunction
Can be seen with a waddling gait
Tx is supportive
What does HELLP syndrome stand for?
Haemolysis
Elevated liver enzymes
Low platelets
What is the main risk factor for uterine rupture in pregnant women?
Previous C section
What is the most effective infusion to prevent convulsions in those with pre eclampsia?
Magnesium sulphate
What drug is a synthetic prostaglandin that can be used to induce labour?
Misoprostol
Bishops scored is used for what?
Used to assess the favourability of the cervix for labour, or whether induction will be required
How does blood pressure change during each trimester of pregnancy?
Diastolic BP falls in trimester 1 and 2 due to fall in peripheral vascular resistance due to increased progesterone (CO increases in response to this)
Rises again by trimester 3
Systolic BP is unchanged
At approximately which gestation do mothers feel the foetus moving?
Approximately 16 weeks for parous women, and 20 weeks in first time mums
When should the fundus be palpable at the xiphisternum?
Approximately 38 weeks gestation
When should the fundus be palpable at the umbilicus?
20 weeks gestation
Where should the fundus be palpable at 12-14 weeks gestation?
Pubic symphysis
How does an increase in progesterone during pregnancy affect the gastrointestinal tract?
Smooth muscle relaxation reduces gastric motility so constipation
Can also causes relaxation of the gallbladder leading to biliary stasis and gallstones and possibly cholecystitis
What are the blood sugar readings to diagnose gestational diabetes in a pregnant women?
> 5.6mmol/L random fasting glucose
>7.8 mmol/L 2 hour plasma glucose
When can chorionic villus sampling and amniocentesis be offered?
CVS from 10 weeks
Amniotic fluid sampling from 15 weeks
Can warfarin be taken during pregnancy and breast feeding?
Not during pregnancy due to teratogenicity
Can be taken during breast feeding as it doesn’t pass into the milk
What are some differentials for abdominal pain in a pregnant lady?
Appendicitis, cholecystitis, HELLP syndrome, ectopic, miscarriage, ovarian torsion, MSK, fibroid, gastroenteritis, UTI/ pyelonephritis, Labour
When can external cephalon version be offered for women with babies presenting breech?
From 36 weeks in nulliparous women
From 37 weeks in parous women
Gestational hypertension occurs after what gestation?
20 weeks
Pregnant women with hypertension before 20 weeks are likely to have pre existing hypertension
At which scan is the estimated delivery date confirmed?
12 week scan
What is Naegele’s rule?
Estimation of EDD by using:
First day of LMP + 1yr7days - 3 months
What syndromes does the combined test screen for?
Trisomy 21 (down’s) Trisomy 18 (Edwards) Trisomy 13 (pateu’s)
When is the combined screening test performed?
By the end of the first trimester, between 11 weeks and 13weeks 6 days
What does the combined test use?
Nuchal translucency, PAPP A, beta-hCG, woman’s age
What does the quadruple blood test screen for?
Trisomy 21 only