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Obstetrics and gynaecology > Obstetrics and Gynaecology > Flashcards

Obstetrics and Gynaecology Flashcards

1
Q

Image page 4 of osce book. Cervix.

State 3 differential diagnoses

A

Cervical carcinoma
Cervical polyp
Endometrial polyp/pedunculated fibroid

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2
Q

What symptoms would a woman with this cervix present with?

A

Post coital bleeding
Intermenstrual bleeding
menorrhagia

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3
Q

Name three appropriate investigations.

Cervix page 4

A 
Cervical smear
Endometrial biopsy
Hysteroscopy
Biopsy of lesion
TVS
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4
Q

What corrective procedure should this lady have?

A

Removal of biopsy

Excision biopsy of lesion

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5
Q

The baby in the photographs 2 days old. What treatment is he receiving?

A

Phototherapy

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6
Q

Name the condition being treated.

A

Jaundice (raised serum bilirubin)

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7
Q

In this case the cause is physiological. Describe the mechanisms of jaundice. Specify 3 points.

A 
Raised neonatal PCV
Immature liver
Poor conjugation
Dehydration
Raised unconjugated bilirubin
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8
Q

How is conjugated bilirubin transported in the serum?

A

Bound to albumin

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9
Q

Describe two clinical features of Lee icterus other than jaundice

A

Poor feeding
Drowsiness
Opisthotonos
Convulsions

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10
Q

Name two potential long-term sequeale of kernicterus

A

Residual brain damage
Choreoathetosis
Mental retardation

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11
Q

Residual brain damage
Choreoathetosis
Mental retardation

A

The placenta

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12
Q

How much blood is found in the placenta, relative to how much is found in the fetus?

A

20-50 times more blood in the placental circulation

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13
Q

What term is used to describe how, in the fetus, both ventricles pump to the systemic circulation ?

A

Circulation in parallel

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14
Q

What is the fetal circulation termed a ‘circulation in parallel’?

A

Because both ventricles eject blood to the aorta and systemic circulation

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15
Q

What is the term used to describe post-natal (and adult) circulation where one ventricle is pulmonary and one is systemic?

A

Circulation in series

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16
Q

What does a ‘circulation in series’ describe?

A

It describes how in postnatal/adult circulation has two circulations - one to the pulmonary circulation, one to the systemic circulation

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17
Q

What type of diabetes is gestational diabetes?

A

Type IV

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18
Q

List 5 scenarios in which the mother would be deemed sick enough to warrant a termination in Ireland

A
  1. Pre-eclampsia at 19 weeks or serious deteriorating pre-eclampsia <br></br>
  2. Eclampsia <br></br>
  3. HELLP, slipping into renal and liver failure <br></br>
  4. Congenital heart disease in the mother - pregnancy can tip a woman into deterioration <br></br>
  5. Malignant disease, in the 1st trimester in particular
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19
Q

What are the 4 clauses that allow abortion in the UK abortion act?

A
  1. Risk to life of mother <br></br>
  2. Risk to health of mother <br></br>
  3. If there is a significant risk of foetal abnormality
    Lethal
    Serious handicap <br></br>
  4. Termination if there is a risk to the psychological wellbeing of the mother
    covers ‘social’ termination where a mother doesn’t want to be pregnany
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20
Q

Up until how many weeks is termination allowed in the UK?

A

24 weeks

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21
Q

Define abortion.

A

Termination of pregnancy before 24 weeks or <500g whether spontaneous or induced

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22
Q

Define a threatened abortion

A

Vaginal bleeding in early pregnancy, cervix closed

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23
Q

Define an inevitable abortion

A

Vaginal bleeding, cervix open, pregnancy not yet expelled but certain to be so

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24
Q

Define incomplete abortion

A

Placental tissues retained after abortion

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25
Q

Define complete abortion

A

No tissues left in uterus after abortion

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26
Q

Define missed abortion

A

Situation in which the fetus had died but is not yet expelled from the uterus

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27
Q

Define septic abortion

A

Abortion complicated by infection

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28
Q

Define recurrent (habitual) abortion

A

Three or more consecutive abortions

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29
Q

Define abruptio placentae

A

Premature detachment or a normally positioned placenta

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30
Q

Define fetal acidosis

A

Fetal blood pH is 7.2 or less

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31
Q

Define adenomyosis

A

ectopic endometrium (endometriosis) in the muscle of the uterus (myometrium)

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32
Q

What are afterpains?

A

Uterine contractions due to the release of oxytocin from the posterior lobe of the pituitary gland especially during suckling. Function to involute the uterus. <br></br>More intense in multiparae

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33
Q

What is alpha-fetoprotein?

A

A protein found in fetal serum that transfers to amniotic fluid and maternal blood in increased amounts when there is a fetal defect such as spin bifida or Downs syndrome

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34
Q

What is amniotic fluid?

A

Fluid surrounding the fetus composed mainly of fetal urine in late pregnancy

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35
Q

what is an amniotic fluid embolism?

A

when amniotic fluid gets into the maternal venous circulation. Foetal squames, hair and vernix become impacted in the pulmonary arterioles and thromboplastic substances cause intravascular coagulation

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36
Q

What is an amniotomy?

A

• Creating a hole in the membranes (amnion and chorion) to induce or accelerate labour. (artificial rupture of membranes)

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37
Q

Define antepartum haemorrhage

A

• Bleeding from the genital tract after 24 weeks of pregnancy

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38
Q

Define anencephaly

A

• Absence of the brain. The cerebellum and basal ganglia are sometimes present

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39
Q

What is the APGAR score?

A

• A numerical scoring system usually applied at 1 and 5 minutes after birth to evaluate the condition of the baby, based on heart rate, respiration, muscle tone, reflexes and colour

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40
Q

What is Arias-Stella reaction?

A

• Histological pattern of endometrium seen with ectopic pregnancy

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41
Q

What is Ashermans syndrome?

A

• Amenorrhoea due to adhesions in the uterine cavity, following septic abortion, or over zealous currettage

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42
Q

What is fetal asphyxia?

A

• Hypoxia leading to foetal or neonatal acidosis

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43
Q

Define asymptomatic bacteriuria

A

• Bacteria in a concentration of 105 of more per ml or urine without symptoms. This is present in about 8% of pregnant women who are at increase risk of clinical urinary tract infection during pregnancy

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44
Q

What is azoospermia?

A

• The absence of spermatozoa in semen

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45
Q

What is Bandl’s ring

A

• The grove between upper and lower uterine segments. It is situated at the level of the pubic symphysis at the onset of labour

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46
Q

What are Bartholin’s glands?

A

• Paravaginal glands susceptible to cystic enlargement and abscess formation

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47
Q

What is a biophysical profile?

A

• Method of assessing fetal well-being by ultrasound inspection of fetal behaviour and amniotic fluid volume with or without cardiotocography

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48
Q

What is a Bishop score?

A

• Method of recording the examination of the cervix to determine the ease with which labour may be induced

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49
Q

What is a blighted ovum?

A

• An embryonic pregnancy (ie) one in which arrest of development occurred at such as early stage that an embryo cannot be seen on ultrasound examination of pathological inspection. The majority of pregnancies which abort during the first trimester are of this type

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50
Q

Define fetal bradycardia

A

FHR <110

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51
Q

What are Braxton-Hicks contractions?

A

• Painless contractions of uterus before labour

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52
Q

What is the bregma?

A

• The large diamond-shaped anterior fontanelle

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53
Q

What is bromocriptine?

A

• Dopamine agonist used to treat hyperprolactinaemia and occasionally to suppress lactation

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54
Q

What part of a babies head is the brow?

A

• The part of the fetal head between the root of the nose and the anterior fontanelle

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55
Q

What is a kaput seccundum?

A

Oedema from obstructed venous return in the fetal scalp caused by pressure of the head against the rim of the cervix or birth canal

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56
Q

What is a cephalhaematoma?

A

A collection of blood beneath the periosteum of a skull bone. Limited to that bone by periosteal attachments

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57
Q

Define cephalo-pelvic disproportion?

A

Pelvis of inadequate dimensions to accommodate fetal head. It leads to mechanical obstruction and failure to progress during first or second stage of labour

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58
Q

What is cervical intraepithelial neoplasia (CIN)?

A

Potentially premalignant state of cervix associated with colposcopic abnormality

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59
Q

Define cholasma

A

Brown discolouration of the face during pregnancy

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60
Q

What is a chocolate cyst?

A

Cyst of the ovary containing blood and therefore brown in colour. Often (but not exclusively) associated with endometriosis

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61
Q

Define choriocarcinoma

A

• Malignant tumour of the placenta which usually follows hydatiform mole

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62
Q

What is the chorion?

A

• The outer fetal membrane

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63
Q

What is chorioinc gonadotrophin?

A

• Hormone produced by the placenta. Used for diagnositic purposes - as a pregnancy and as biochemical tumour marker in cases of choriocarcinoma, and also for therapy - to induce ovulation, as an LH substitute

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64
Q

What are the chorionic villi?

A

• Branching tentacles of the placenta which are the sites for metabolic exchange between maternal and fetal circulations during pregnancy. Chorionic villi may be sampled during early pregnancy to provide rapid diagnosis of chromosomal and other abnormalities (CVS)

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65
Q

Define climacteric

A

• Phase of time around the end of reproductive life in the female. The opposite to puberty

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66
Q

What is clomiphene?

A

• A drug which stimulates gonadotrophin release to induce ovulation

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67
Q

What is colostrum?

A

• Thin fluid secreted by the breasts during the first days after delivery and before production of milk proper. Rich in immunoglobulins

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68
Q

What is colporrhaphy?

A

• Suturing of the vagina to repair prolapse

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69
Q

What is colposcopy?

A

• Inspection of the cervix through a magnifying lens, usually indicated by an abnormal cervical smear

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70
Q

What are condylomata acuminata?

A

• Genital warts of viral origin found on the vulva or around the anus

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71
Q

What is cord presentation?

A

• The cord is alongside or below the pressing part with the membranes intact

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72
Q

What is cord prolapse?

A

• Serious complication in which the unbilical cord is below the foetus and is extruded into the vagina. If the membranes are still intact, it is called ‘cord presentation’

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73
Q

What is the corpus lutuem and what does it secrete?

A

• Structure in the ovary which forms after ovulation. Secretes progesterone (and oestrogen)

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74
Q

What are cotyledons?

A

• The lobes of the placenta

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75
Q

What is couvelaire uterus?

A

• Bruised uterus found after sever placental abruption. Bruising occurs because of extravasation of blood into the myometrium

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76
Q

What is cryptomenorrhoea?

A

• “Hidden menstruation”. Usually happens because a membrane above the hymen obstructs outflow, causing primary amenorrhoea.

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77
Q

What is curettage?

A

• Surgical removal of the endometrium by scraping with a curette

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78
Q

What is cypterone acetate?

A

• Anti-androgenic drug used to treat hirsutism

79
Q

Define cystocoele

A

• Prolapse of bladder, producing a bulge of the anterior vaginal wall

80
Q

Define eclapmsia

A

• A condition, unique to pregnancy, typified by convulsions, hypertension, proteinuria and oedema, with a significant risk of maternal (and fetal) death

81
Q

What is danazol?

A

• Used to treat several gynaecological disorders especially endometriosis

82
Q

Define decidua

A

• The endometrium during pregnancy

83
Q

What is a dermoid cyst?

A

• Common (in younger women) usually benign teratoma of the ovary. May contain sebum, hair and teeth

84
Q

What is dextro in relation to the utreus?

A

• Rotation of the uterus - the pregnant uterus usually is rotated towards the right side, due to the presence of the rectum and sigmoid colon on the left side.

85
Q

What is a disgerminoma?

A

• Germ cell tumour of the ovary

86
Q

Define dysfunctional menstrual bleeding?

A

• Abnormal menstruation in the absence of demonstrable pathology. common problem

87
Q

Define dysmenorrhoea?

A

• Painful menstruation. May be primary (spasmodic) or secondary

88
Q

Define dyspareunia?

A

• Painful sexual intercourse, may be superficial or deep

89
Q

Define dystocia

A

• Slow or difficult labour

90
Q

Define shoulder dystocia

A

• A desperate emergency in which the fetal shoulder fail to enter the pelvis after the head has already been delivered

91
Q

Define ectopic pregnancy

A

• Implantation of pregnancy outside the uterine cavity, most often in the fallopian tubes

92
Q

Define endometriosis

A

• Endometrial tissue found outside the uterine cavity. Generally applied to disease completely outside of the uterus (esp. pelvic peritoneum and ovaries)

93
Q

Define endometrium

A

• The mucous membrane lining the uterus which responds to ovarian hormones during the menstrual cycle

94
Q

Define engagment

A

• The fetal head is engaged when its maximum diameters (suboccipitobregmatic and biparietal, when the head is well flexed) have passed through the pelvic inlet

95
Q

Define episiotomy

A

• Incision of the perineum to facilitate childbirth, especially in primigravidae

96
Q

What is ergometrine?

A

• Valuable drug which causes sustained tetanic contraction of the uterus after delivery

97
Q

What is the EDD?

A

Estimated date of delivery

98
Q

Define the fetal face

A

• The area of the fetal head below the root of the nose and the orbital ridges

99
Q

What is ferning?

A

• During the late proliferative (highly oestrogenic) phase of the menstrual cycle cervical mucus forms a palm-leaf pattern when it dries on a slide. also produced by amniotic fluid after rupture of the membranes

100
Q

Define fetal grow retardation

A

• Birth-weight below the tenth percentile according to gestational age for infants born in the community concerned

101
Q

What is a follicular cyst?

A

• Small cyst which develops from a graafian follicle. Usually <5cm and unilocular

102
Q

What is a fontanelle?

A

• Space at the junction of 3 or more skull bones covered only by a membrane and skin

103
Q

What is the fourchette?

A

• The fold of skin formed by merging of the labia minora and labia majora posteriorly

104
Q

What is funic-souffle?

A

• The sound of blood passing through the umbilical cord, synchronous with the fetal heart beat

105
Q

What is GIFT?

A

• Gamete intra-fallopian transfer. A new form of assisted reproduction in which egg and semen are deposited in the patients fallopian tube via the laparoscope

106
Q

Define gonadal dysgenesis?

A

• Abnormal development of the gonads

107
Q

Define grand multipara?

A

• Para 5 or more. A patient likely to have powerful uterine contractions - hence the risk of uterine rupture if there is obstructed labour

108
Q

Define gravid and primigravida

A

• Means pregnant. A primigravida is a woman pregnant for the first time

109
Q

Define gravidity

A

• The number of pregnancies. Includes the current one, if the woman is pregnant

110
Q

Define haematocolpos

A

• Distension of the vagina with blood due to imperforate membrane (see cryptomenorrhea)

111
Q

What is HELLP syndrome?

A

• Variant of pre-eclampsia typified by haemolysis (H), elevated liver (EL) enzymes and low platelets (LP)

112
Q

What is herpes gestationis?

A

• Skin disease of pregnancy. Nothing to do with herpes virus

113
Q

WHat is a hodge pessary?

A

• Angled pessary used to maintain the uterus in a position of anteversion

114
Q

What is hyaline membrane disease?

A

• Cause of respiratory distress in the preterm neonate due to lack of surfactant in the alveoli of the lung

115
Q

What is a hydatiform mole?

A

• Pregnancy characterised by trophoblastic proliferation. May be partial (with fetus) or complete (no fetus)

116
Q

Define hydrops fetalis

A

• Accumulation of fluid in the body cavities and subcutaneous tissues of the fetus. Causes include Rhesus disease and other forms of fetal congestive cardiac failure, fetal infections and metabolic diseases

117
Q

What is hyperemesis gravidarum?

A

• Excessive vomiting in early pregnancy

118
Q

What is a hysterectomy?

A

• Surgical removal of the uterus (either vaginal or abdominal)

119
Q

What is a hysterosalpingogram?

A

• X-ray examination to outline the cavity of the uterus and lumina of the fallopian tubes by the injection of radio-opaque dye through the cervix

120
Q

What is a hysteroscopy?

A

• Inspection of the uterine cavity through a fibre-optic endoscope

121
Q

Define labour

A

• The process by which the products of conception are expelled from the uterus via the birth canal after the 28th week of gestation

122
Q

What is lactation?

A

• Production of milk. May be physiological after pregnancy or pathological (galactorrhoea)

123
Q

What is a leiomyosarcoma?

A

• Malignant tumour of the uterus which may rarely arise in fibroids (3/1000)

124
Q

What is leucorrhoea?

A

• Colourless (white), non-itchy, non-offensive vaginal discharge

125
Q

What is lightening?

A

• Usually occurs after 36 weeks and is commoner in nulliparas. The presenting part enters the pelvis and thus reduces the pressure on the diaphragm and the mother notices that it is easier to breath. It is not synonymous with engagement

126
Q

What is the line nigra?

A

• Brown or black line or pigment in the midline of the abdominal wall during pregnancy

127
Q

What is lochia?

A

• The discharge from the uterus during the puerperium. It is initially red (lochia rubra) then yellow (serosa) and finally white (alba)

128
Q

What is the definition of low birth weight?

A

• Birthweight less than 2.5kg. Babies either preterm (two thirds) or small-for-dates (one third)

129
Q

What is the lower uterine segment?

A

• Lower portion of uterus lying below the loose uterovesical fold of peritoneum. Develops during the third trimester

130
Q

Define a maternal death, the different type and the rate in Ireland

A 
• Death occuring during pregnancy, childbirth, or in the first 6 weeks following births or abortion from any cause related to or aggrevated by the pregnancy or its management (late deaths: 6 weeks to 1 year UK)
  Reported as rate/100,000
Direct obstetric death
Indirect obstetric death
Fortuitous obstetric death
  Unrelated to pregnancy
131
Q

What is meconium?

A

• Greenish-black fetal faeces composed of cellular debris, bile, lanugo and vernix caseosa

132
Q

What is menarche?

A

• Onset of menstruation at the completion of female puberty

133
Q

Define menopause

A

• Final cessation of menstruation

134
Q

What is menorrhagia?

A

• Excessive menstrual loss

135
Q

What is mentropathic haemorrhagica?

A

• Chaotic pattern of amenorrhoea followed by heavy menstrual loss, associated with anovulation

136
Q

What is moulding?

A

• Alteration in shape and diameters of the fetal head during labour. the fontanelles and sutures permit the force of contractions to compress the head against he bony pelvis and adapt its shape to that of the birth canal

137
Q

Define multigravida

A

• A woman who is pregnant for the second or subsequent time

138
Q

Define Naegles rule

A

• Method of calculating the estimated date of delivery (EDD) by adding 7 days and 9 months to the last menstrual period (LMP)

139
Q

Define neonatal death

A

• A liveborn infant who dies within 28 days of birth. Early NND = within first week

140
Q

Define a nullipara

A

• A woman who has never given birth or reached 28 (24??) weeks in a previous pregnancy

141
Q

What is oligohydramnios?

A

• Diminished volume of amniotic fluid. May be due to fetal growth retardation, fetal renal tract abnormality or ruptured membranes

142
Q

Define oligomenorrhagia

A

• Infrequent menstruation

143
Q

What is the operculum?

A

• The plug of mucus that occludes the cervical canal during pregnancy

144
Q

What is oxytocin?

A

• Hormone secreted from the posterior pituitary and from within the uterus which stimulates rhythmic uterine activity during pregnancy and milk release during lactation

145
Q

What is the parametric?

A

• Connective tissue lying within the leaves of the broad ligament and to the side of the uterus

146
Q

Define parity

A

• The number of previous viable pregnancies (ie >24 weeks or 500g). A woman who as had two successful pregnancies and a singe miscarriage would be described as para 2+1

147
Q

What is a partogram?

A

• Graphical representation of progress during labour by plotting cervical dilation against time

148
Q

Define perinatal mortality rate

A

• The number of stillbirths (babies born dead >500g or after 24 weeks) plus early neonatal deaths

149
Q

What is a pessary?

A

• 1. Instrument placed in the vagina either to support uterovaginal proplapse (ring pessary) or to correct uterine retroversion (Hodge pessary) 2. tablet containing a drug used for intravaginal therapy

150
Q

What is phototherapy?

A

• Use of light energy (wavelength 450mu) to convert the unconjugated bilirubin molecule in the jaundiced infants skin to a form which can be excreted without conjugation in the liver

151
Q

Define placenta praeviae

A

• Placenta implanted wholly or partly on the lower uterine segment

152
Q

Define polycystic ovarian syndrome

A

• Condition in which enlarged ovaries contain multiple cysts and may be associated with oligomenorrhoea, infertility, hirsutism, obesity and elevated serum LH

153
Q

What is polyhydramnios?

A

• Excessive amount of amniotic fluid. Produced a tense uterus and fetal parts difficult to palpate and a fluid thrill. May be due to a fetal malformations, diabetes, multiple pregnancy, rhesus disease etc

154
Q

Define postpartum haemorrhage

A
  • Excessive bleeding (>500 ml) from the genital tract after delivery
    • Primary PPH
      • Occurs within 24 hr
    • Secondary PPH
      • Occurs after 24 hr
    • Atonic PPH
      • Due to failure of the uterus to contract
155
Q

Define pre-eclampsia

A

• Pregnancy-induced condition of hypertension, proteinuria and oedema

156
Q

Define premenstural syndrome

A

• Complex of symptoms clearly related to the menstrual cycle, usually worse late in the cycle

157
Q

Define preterm

A

• Before 37 completed weeks of pregnancy. Preterm delivery is the most important cause of perinatal mortality

158
Q

What is procidentia?

A

• Complete prolapse of the uterus so that it is entirely outside the introitus of the vagina. “third degree prolapse”

159
Q

Define progestagen

A

• Any substance that has an action similar to that of progesterone

160
Q

Define prolapse

A

• Protrusion of the uterus, bladder (cystocele), rectum (rectocele) or pouch of Douglas (entrocele) into the vagina

161
Q

What is the function of a pudendal nerve block?

A

• Local anesthetic technique to facilitate forceps delivery and episiotomy

162
Q

Define puerpium

A

• The 6 weeks following delivery when the mother’s body is returning to its non pregnant state

163
Q

Define pyometra

A

• collection of pus in the uterine cavity

164
Q

Define pyosalpinx

A

• Collection of pus in the lumen of the fallopian tube

165
Q

Define retained placenta

A

• Placenta still in utero 1 hr after birth of the baby

166
Q

Define retroversion of the uterus. How common is it?

A

• The uterine fundus lies in the retovaginal pouch of Doughlas instead of anteriorly on the bladder. Occurs in 10-15% of women and usually asymptomatic

167
Q

What is ritodrine?

A

• A beta-sympathomimetic drug (as salbutamol) sometimes used in attempts to suppress preterm labour

168
Q

What is a salpingectomy?

A

• Surgical removal of the fallopian tube (eg for ectopic pregnancy)

169
Q

What is salpingitis?

A

• Infection of the fallopian tube(s)

170
Q

What is salpingostomy?

A

• An operation to open blocked fallopian tubes

171
Q

What is serous cystadenocarcinoma?

A

• The most common malignant ovarian tumour

172
Q

what is Sheehan’s syndrome?

A

• Pituitary failure due to infarction of the gland as a consequence of hypovolaemic shock from severe post partum haemorrhage

173
Q

Define a “show”

A

• A discharge of mucus and blood at he onset of labour when the cervix dilates and the operculum (cervical mucus plug) falls out

174
Q

What is the sinciput?

A

• That part of the fetal head in front of the anterior fontanelle. It is subdivided into the brow and the face

175
Q

Define small for dates baby

A

• Babies with birth weights-for-gestational age below an arbitrary percentile value (eg) 5th or 10th. Often the term used as if synonymous with ‘growth retarded’ but also constitutionally small babies

176
Q

Define still birth

A

• Child which shows no sign of life when expelled from the mother after 24 weeks or 500g

177
Q

Define stress incontinence

A

• Involuntary leakage of urine on raising intra-abdominal pressure (eg) by coughing due to weakness of bladder neck and proximal urethra

178
Q

What is supine hypotension?

A

• State of hypotension induced by pressure of gravid uterus on inferior vena cava worsened by epidural anaesthesia and relieved by lying on the side

179
Q

What is syntocinon?

A

• A synthetic oxytocin

180
Q

What is syntometrine?

A

• Preparation that combines ergometrine and oxytocin. Standard drug for active management of the third stage of labour

181
Q

Define term

A

• From 37 to 42 completed weeks gestation (259-293). Neither preterm delivery (<37 weeks) nor prolongued pregnancy (>42 weeks)

182
Q

What is testicular feminisation?

A

• Tissue insensitivity to androgens in genetically make individual resulting in female phenotype

183
Q

What is a third degree tear?

A

• A perineal laceration passing through the anal sphincter and laying open the anal canal

184
Q

What is trophoblast?

A

• Ectodermal tissue of the placenta consisting of cytrophoblast and syncytiotrophoblast

185
Q

Define unstable lie?

A

• Varying fetal presentation. This becomes of clinical significance after 36 weeks because of the imminence of labour and the possibility of spontaneous rupture of membranes (with the risk of cord collapse)

186
Q

What is vasa praevia?

A

• Blood vessels in the membranes below the fetal head which may rupture and exsanguinate the fetus

187
Q

What is the vertex?

A

• Area on the top of the fetal head bounded by anterior and posterior fontanelles and the parietal eminences

188
Q

What is a vesico-vaginal fistula

A

• Connection between the bladder nad vagina which causes urinary incontinence. Most commonly due to surgery or cancer or radiotherapy in the ‘developed’ world and to obstructed labour in the ‘developing’ world

189
Q

What kind of swab do you need to do to diagnose GBS carriage>

A

High vaginal swab

190
Q

What is the size of the normal uterus?

A

Pear sized

191
Q

What could be the cause of tender adnexa?

A

Endometriosis <br></br>
Adhesions <br></br>
Infection

192
Q

What are ectropium?

A

Patches of endocervical tissue that has everted out of the cervix - benign

193
Q

Define amenorrhorea

A

No periods in 6 months ore more

Obstetrics and gynaecology (3 decks)

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