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Mnemonics / quick learn > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Eclampsia red flags + Emergency Mx?

A

Headache, epigastric pain, breathlessness, visual disturbance
Periorbital oedema, Hyperreflexia, clonus

give maternal steroids up to 36wks
O2 + mag sulfate (control fits) + labetalol

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2
Q

Possible sensitisation events for Rhesus

A 
TOP, ERPC after miscarriage
ECV
Blunt abdo trauma
Amniocentesis or CVS
Intrauterine death
Delivery
Antepartum haemorrhage
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3
Q

Mx of IUGR (high risk woman)

A

Screen for pre-eclampsia
Minimise risks + treat maternal illness
Serial scans: Liquor volume, fetal growth, umbilical artery flow

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4
Q

Primary PPH causes? (4Ts)!!

A

Tone - atonic (most common cause)
Tissue - retained placenta w/ long 3rd stage (>30mins)
Trauma - vaginal/cervical tear
Thrombin - assoc. pre-eclampsia / DIC

> 500ml - minor
1000ml - major
1500ml - massive

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5
Q

Special test for Rhesus -ve ladies - esp if large ante/post-partum haemorhage?

A

Kleihauer test - looks for fetal blood cells in maternal circulation

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6
Q

Causes of polyhydramnias?

A

DITCH
Diabetes - causes fetal polyuria = ^AM
Idiopathic/infection (parvovirus/CMV)
Twins - (+TTTS)
Congen abnormalties (e.g. fetal duodenal atresia-swallow difficulty)
Heart failure (due to VSD/Down’s) - causes fetal polyuria (due to ^BNP)= ^AF

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7
Q

Risks of polyhydramnios? (6 Ps)

A 
Placental abruption 
Pretty unusual lie
Premature labour 
Prolapse cord
Post partum haemorrhage
Perinatal mortality
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8
Q

4 main indications for induction? (4 Ps)

A

Post dates
Pre-labour rupture of membranes
Pre-Eclampsia
Plus Diabetes

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9
Q

Diabetes risks in pregnancy?

A 
SMASH
Shoulder dystocia 
Macrosomia 
Amniotic fluid excess - polyhydramnios 
Stillbirth 
Hypertension + neonatal hypoglycaemia

+Miscarriages + congenital malformations = if preceding diabetes

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10
Q

Gestational diabetes levels?

A

5, 6, 7, 8
Fasting >5.6
2hours post glucose >7.8

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11
Q

When to give Aspirin 75mg as prophylaxis for pre-eclampsia?

A 
ECLAMPT
Existing hypertension
CKD
Lupus
Anti-phospholipid
Maternal diabetes - pre-existing
Previous hypertension in pregnancy
Twins

(+nulliparity + obesity + Fam Hx)

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12
Q

Complications of pre-eclampsia? Fetal + Maternal

A

FIP (fetal) SHAME (maternal)
Fetal growth restriction
Intrauterine death
Premature delivery

Stroke 
HELLP
Abruption of placenta 
Multi-organ failure (+DIC +/- death)
Eclampsia
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13
Q

Failure to progress in labour - 3 causes?

A

3 Ps
Power
-Inneffective uterine contraction - induction
-Hyperactive uterine contraction - terbutalline

Passenger

  • big baby? bid head? (head swelling during delivery - caput)
  • Presentation? -breech/brow/face/shoulder
  • Position? - Normal = OT@inlet + OA@outlet

Passage
-Small pelvis?

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14
Q

General Obs risk factors

A 
Nulliparous
Obese
Twins
Fam Hx
Personal Hx
Old (40yrs+)
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15
Q

When deliver monoamniotic Monochorionic?

A

32 weeks!

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16
Q

Types of Small for gestational age - which is IUGR?

A

SWAN
Starved small (IUGR) - pre-eclampsia, drug/alcohol abuse
Wrong small - i.e. wrong dates
Abnormal small - congentital/chromosomal things
Normal small - genetic (growth velocity ok)

17
Q

Complications of prematurity

What reduces risk of these? Drug!

A

Heads, hearts, lungs, and guts (lungs and guts) x2
..and Retinitis drives me nuts

Resp distress
Interventricular haemorrhage
necrotising enterocolitis
(retinitis)
congenital heart abnormalities - patent ductus!

Maternal steroids!!! - IM dexa

18
Q

High risk factors for IUGR?

A 
SHITS (common) CRAP (rare)
Smoking 
Hypertension & pre-eclampsia
IUGR previous
Twins
Previous stillbirth

Cocaine use
Renal disease
Antiphospholipid
PAPPA levels low

19
Q

Shoulder dystocia maneouveurs?

A

McRoberts
Suprapubic pressure
Episiotomy (to allow for complicated)

Woodscrew (deliver posterior arm + rotate shoulder)
Break clavicle
Zavanelli

20
Q

CST. What? When? What’s covered?

What if missed? What’s covered in that?

A

Down syndrome scan
11-14 weeks
Nuchal translucency on USS, hCG, PAPP-A

Quadruple test (14-20weeks - late bookers)
hCG, AFP, Inhibin A, unconjugated oestriol
21
Q

When is Anti-D prophylaxis routinely?

A

28 + 34 weeks

22
Q

OGTT when routinely?

A

24-28 weeks

23
Q

What’s attempted before induction?

A

Membrane sweep

24
Q

3 stages of induction? whats given/done

A

Cervical ripening - Vaginal prostaglanding E2
Amniotomy - rupture of membranes
Cervical dilatation - oxytocin to generate contractions

25
Q

Bishops score to indicate induction?

A

<5

26
Q

Pre-term pre rupture of membranes what do you give?

A

steroids - lung dev!!

erythromycin delivery @ 34weeks

27
Q

Hyperememsis gravidarum dx? Mx?

A

5% pre-preg weight loss, dehydration, electrolyte imbalance

1st anti-histamine - cyclizine
2nd ondansetron / metoclopramide

Mnemonics / quick learn (7 decks)

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