OG EMQ Flashcards
After the head delivers throigh the vulva , it immediately aligns with fetal shoulder
restitution
Occiput escapes from underneath the symphysis pubis which acts as a fulcrum
Extension
Postpartum Cervical tears vs. vaginal tears
Cervical - common cause of traumatic postpartum haemorrhage
Vaginal tears - common after rotational forceps delivery
adnexal mass antepatrum - increase risk of ovarian tortion after birth why?
increase laxity of the tissues
abdo pain followed by collapse and non palpable uterus suggest
uteine inversion
30 minutes of pushing with fetal head in left pcciptoposterior position with head below the ischial spines what to do next
ventous delivery
persistent late deceleraition is an inidciation for
fetal blood sampling
poor trace obtained by external CTG monitors what do you do?
Do a fetal scalp electrodes
when to repeat fetal blood sampling
if the ph 7.2-7.25 - repeat blood sampling in 30 minutes
post delivery with SOB, ground glass appearance soon C-Xray and impaired coagulation profile
amniotic fluid embolism RF - induction of labour hypotonic uterine contractions increasing age uterine trauma
14 weeks gestation with SUDDEN occipital headache and projectile bo,citing poor to arrival , GCS of 3 DX of
Subarachnoid heamorrage
zavanelli’s technique - when to do
when true shoulder dystocia under GA
Ture shoulder dystocia - delivery of head shoulder dystocia is Dx with fetal shoulders above the pelvic brim
examination under GA in postpartum haemorrhage when?
When there has been instrumental deliveries - want to put out dramatic pospartum haemorrhage
intrauterine death + PPH think
DIC
in a DM what tocolytic do u use
you can’t use beta agonist so you use oxytocin antagonist - Atosiban
third degree perineal tear
repaired by either end to end technique or overlapping technique
continuous loose non locking polydixanone sutures to vagina mucosa perineal mucle and subcutanous layer
distrubtion in anal spincter and rectal mucosa … how to fix
RECTAL mucosa should be repaired first then spinchter
1cm buttonhole defect invovling rectal mucosa in the upper vagina how to repair?
defunctioning colostomy - better healing
reversed in 6-12 weeks
External cephalic version should be offered?
after 37 (notes say 36) with uncomplicated breech postion
Hx 2 previous miscarriages , greyish discharge and positive pregnancy test - what to do?
Treat Bacterial vaginosis
standard test for recurrent miscarriage
- parental karyotype
- thrombophilia screen
- pelvic ultrasound
treatment for 14 weeks pregnant with cervical dilation of 2cm with coning of memebranes
Cervical cerclage
TOP at 9 weeks… what treatment
MEDICAL treatment :
mifepristone
THEN prostaglandin (GEMEPROST) 48 hours later
5 moths pregnant how would u do TOP
mifepristone followed by prostaglandin 48 hours
- 2nd trimester
Dose 200mg of mifipristone
