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4th year medicine > Obstetrics - Antepartum > Flashcards

Obstetrics - Antepartum Flashcards

1
Q

Combined screening test for Down’s - when and what markers does it measure

A 
11-14 weeks
PAPPA
Beta HCG
AFP
uE3
Inhibin A
Nucchal transulcency USS
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2
Q

Triple/quadruple screening test for Down’s - when and what markers does it measure

A

15-20 weeks
AFP
uE3
hCG

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3
Q

Anomaly scan

A

18-21 weeks

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4
Q

Booking visit with midwife

A

10 weeks

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5
Q

Appointments for nullip

A

x10

10, 16, 25, 28, 31, 34, 36, 38, 40,41 weeks

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6
Q

Appointments for multip

A

x7

10, 16, 28, 34, 36, 38, 41

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7
Q

Anti-D given

A

28 weeks, 34 weeks

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8
Q

Diagnostic testing for Down’s

A

10-15 weeks, CVS

After 15 weeks, amniocentesis

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9
Q

Booking appointment - infectious disease screening (4)

A

Rubella - if non-immune, avoid all infectious contacts and wait until after this pregnancy until being immunised
Hep B - if positive, newborn immunisation
HIV - antenatal ART, elective CS, no breast feeding
Syphilis - maternal ABx

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10
Q

Booking appointment - other bloods (3)

A

FBC
ABO
Rh

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11
Q

When to test for gestational diabetes

A

If risk factors, OGTT at 24-28wks

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12
Q

Common antenatal problems (6)

A 
Constipaion
Reflux
Haemorrhoaids
Varicose veins
Oedema
Nausea/vomiting
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13
Q

Respiratory changes in pregnancy (3)

A

Increased tidal volume
Reduced residual volume
Compensated respiratory alkalosis

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14
Q

Cardiovascular changes in pregnancy (3)

A

Increased blood volume
Increased CO
Decreased BP

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15
Q

GI changes in pregnancy (5)

A 
Nausea
Altered appetite
Reflux (delayed emptying)
Gallstone predisposition
Liver signs (difficulty metabolising progesterone and oestrogen)
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16
Q

Genitourinary changes in pregnancy (4)

A

Increased GFR
Increased sodium
Reduced bladder capacity
Mild hydronephrosis

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17
Q

Haematological changes in pregnancy (2)

A

Increased fibrinogen, F VII, VIII, IX, X

Decreased protein S, antithrombin III

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18
Q

Endocrine changes in pregnancy (2)

A

Reduced calcium

Increased aldosterone and cortisol

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19
Q

MSK changes in pregnancy (1)

A

Exaggerated lumbar lordosis (leads to lower back strain)

20
Q

Dermatological changes in pregnancy (2)

A

Hyperpigmentation of umbilicus, areolae, midline (linea nigra)
Liver skin signs

21
Q

High risk pregnancies (5)

A 
Problems in current pregnancy:
Problems in labour
Pre-existing conditions
Problems in previous pregnancy
Social
22
Q

High risk pregnancy: problems in current pregnancy (5)

A 
IUGR
Multiple pregnancy
Hypertension
Diabetes
Thromboembolism
23
Q

High risk pregnancy: problems in labour (3)

A

Meconium/bloody liquor
Pathological CTG
Lack of progress

24
Q

High risk pregnancy: pre-existing conditions (5)

A 
Diabetes
Hypertension
VTE
Obesity
Mental illness
25
Q

High risk pregnancy: problems in previous pregnancy (6)

A 
Pre-eclampsia
Previous CS
Recurrent miscarriage
Preterm, stillbirth
Gestational diabetes
Tears
26
Q

High risk pregnancy: social (5)

A 
Teenage 
Domestic violence
Low SEC
Alcohol, drugs
Maternal age >40
27
Q

HELLP

A

Haemolysis
Elevated Liver enzymes
Low Platelets

28
Q

Presentation of HELLP

A

RUQ/epigastric pain
N&V
Headaches

29
Q

Antiphospholipid syndrome in pregnancy - treatment

A

Aspirin

LMWH

30
Q

Screening for gestational diabetes

A

Previous gestational diabetes - OGTT at 16-18 weeks

Risk factors - OGTT at 24-28 weeks

31
Q

Management gestational diabetes

A

Change in diet and exercise (works in 80%)

Metformin or insulin if complications or poor control

32
Q

Management pre-existing diabetes

A

Stop all oral hypoglycaemics apart from metformin, start insulin

33
Q

Causes of increased nuchal translucency

A

Down’s syndrome
Congenital heart defects
Abdominal wall defects

34
Q

Causes of hyperechogenic bowel

A

CF
Down’s syndrome
CMV

35
Q

Vomiting in pregnancy - treatment

A

Antihistamines e.g. promethazine

36
Q

CTG: causes of early decelerations (3)

A

Head compression,
Cord compression
Foetal hypoxia

37
Q

CTG: causes of variable decelerations (1)

A

Cord compression

38
Q

CTG: causes of late decelerations (1)

A

Foetal hypoxia

39
Q

CTG: causes of reduced variability (4)

A

Baby sleeping
Depressants e.g. opiates
Thumb sucking
Maternal dehydration

40
Q

CTG: normal foetal heart rate

A

110-150

41
Q

CTG: causes of foetal tachycardia (5)

A 
Foetal hypoxia
Chorioamnionitis (does mother have fever?)
Hyperthyroidism
Foetal/maternal anaemia
Foetal tachyarrhythmia
42
Q

CTG: causes of foetal bradycardia (7)

A 
Post-date presentation
OP or transverse presentation
Prolonged:
   Prolonged cord compression
   Cord prolapse
   Epidural/spinal
   Rapid foetal descent
   Maternal seizures
43
Q

CTG: management early decelerations

A

Physiological - no management required

44
Q

CTG: management variable decelerations

A

Change maternal position

Shouldering is reassuring

45
Q

CTG: management late decelerations

A

Foetal blood sample for pH

If acidotic, emergency LSCS

46
Q

CTG management prolonged decelerations

A

Foetal blood sample for pH

If acidotic, emergency LSCS

47
Q

CTG: management sinusoidal pattern

A

(Smooth, regular, wavy)

Immediate C section

4th year medicine (22 decks)

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