Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obstetrics > Outcomes for Pregnancy > Flashcards

Outcomes for Pregnancy Flashcards

1
Q

What are monozygotic multiple pregnancy

A

Identicle twins from a single zygote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are dizygotic multiple pregnancy

A

Non-identicle twins from two different zygotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does monoamniotic mean

A

Embryo in a single amniotic sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does diamniotic mean

A

Embryo in two separate amniotic sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does monochorionic mean

A

Embryo share a single placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does dichorionic mean

A

Embryo have two separate placentas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sign of diachorionic diamniotic twins on US

A

Lambda sign or twin peak sign - triangular appearance where the membrane meets chorion and partially blends which indicates separate placentas (membrane between twins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sign of monochorionic diamniotic twins on US

A

T sign - membrane abruptly meets the chorion indicating single placenta (membrane between twins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sign of monochorionic monoamniotic twins on US

A

There is no membranes separating the twins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications of twins

A

Anaemia, polyhydramnios, HTN, malpresentation, spontaneous preterm birth, instrumental delivery or C section, PPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk to the fetus and neonates of multiple births

A

Miscarriage, stillbirth, fetal growth restriction, prematurity, twin-twin transfusion syndrome
twin anaemia polycythaemia sequence, congenital abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antenatal care for multiple pregnancy

A

Monitoring for anaemia, additional US scans, planned birth offered, corticosteroids given before delivery to help mature lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Delivery options for twins

A

Monoamniotic twins - elective C section between 32-33+6 weeks.
Diamniotic twins - vaginal if first presentation is cephalic - C section may be required for second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What classifies as small for gestational age

A

Below 10th centile, two measurements on US are used to measure it - estimated fetal weight and fetal abdominal circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of small for gestational age

A

Constitutionally small or fetal growth restriction - divided into placenta mediated growth restrictoin and non-placental mediated growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of placental mediated growth restriction

A

Idiopathic, pre-eclampsia, maternal smoking, maternal alcohol, anaemia, malnutrition, infection, maternal health conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of non-placental mediated growth restriction

A

Genetic abnormalities, structural abnormalities, fetal infection, errors of metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs of fetal growth restriction

A

SGA, reduced amniotic fluid volume, fetal movements, abnormal doppled studies, abnormal CTGs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Short term complications of fetal growth restriction

A

Fetal death or stillbirth, birth asphyxia, neonatal hypothermia, neonatal hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Long term complications of fetal growth restriction

A

CVD, HTN, T2DM, obesity, mood, behavioural problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk factors for SGA

A

Previous SGA baby, obesity, smoking, diabetes, HTN, pre-eclampsia, mother >35, multiple pregnancy, low pregnancy associated plasma protein A, antepartum haemorrhage, antiphospholipid syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Monitoring for SGA babies or those with risk factors

A

Serial growth scans with umbilical artery doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Monitoring for mothers with high risk factors for SGA

A

Serial US measuring - estimated growth weight and abdominal circumference to determine growth velocity, amniotic fluid volume and umbilical arterial pulsatility index (measure flow through umbilical artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What classifies as large for gestational age

A

Weight is more than 4.5kg at birth or estimated fetal weight is above 90th centile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Causes of LGA
Constitutional, maternal diabetes, previous macrosomia, maternal obesity or rapid weight gain, overdue, male baby
26
Risks of LGA babies
Shoulder dystocia, failure to progress, perineal tears, instrumental delivery or caesarean, PPH, uterine rupture, birth injury, neonatal hypoglycaemia, obesity in childhood and later life, T2DM
27
Management of LGA
US to exclude polyhydramnios and estimate fetal weight, OGTT
28
Causes of stillbirth
Unplained (50%), pre-eclampsia, placental abruption, vasa praevia, cord prolapse or wrapped around fetal neck, obstetric cholestasis, diabetes, thyroid disease, infections, genetic abnormalities or congenital malformations
29
Definition of stillbirth
Birth of a dead fetus after 24 weeks gestation - it is result of intrauterine fetal death
30
Factors increasing risk of stillbirth
Fetal growth restriction, smoking, alcohol, increased maternal age, maternal obesity, twins, sleeping on back as opposed to side
31
Diagnosis of stillbirth
US to visualise fetal heart beat, passive fetal movements possible after IUFD and a repeat scan is offered
32
Management of stillbirth
Vaginal birth unless reasons for C section, choice of induction of labour or expectant management - mifepristone and vaginal or oral misoprostol, and dopamine agonists to suppress lactation after birth
33
How is medical abortion carried out
Two treatments of mifepristone and misoprostol 1-2 days later.
34
How is surgical abortion carried out
Involves cervical priming with misoprostol, mifepristone or osmotic dilators. Then dilation and suction of contents of uterus usually up to 14 weeks. Or dilation and evacuation using forcepts between 14-24 weeks
35
Management after abortion
Urine pregnancy test at 3 weeks to confirm completion
36
Complications of abortion
Vaginal bleeding and cramps intermittently, failure, damage to cervix, uterus or other structures
37
Legal requirements of abortion before 24 weeks
Can be performed before 24 weeks if continuing pregnancy involves greater risk to the physical or mental health of the women or existing children of the family
38
Legal requirements of abortion at any gestation
Can be performed at any time during pregnancy if continuing the pregnancy is likely to risk life of women, prevent permanent injury to physical or mental health of the woman, or substantial risk child would suffer
39
What is a hydatidiform mole
Type of tumour which grows like a pregnancy inside the uterus. Also called molar pregnancy. There are two types
40
What is a complete molar pregnancy
When two sperm fertilise an ovum which has no genetic material. These then combine material and cells divide to form tumour, where no fetal material will form
41
What is a partial molar pregnancy
When two sperm fertilise a normal ovum at the same time so the cell has 3 sets of genetic chromosomes. Cell mulitplies into tumour and some fetal material may form
42
Indications of a molar pregnancy rather than a normal pregnancy
More severe morning sickness, vaginal bleeding, increased enlargement of uterus, abnormally high hCG, thyrotoxicosis - hCG can mimic TSH
43
What will an US scan show of a molar pregnancy
Snowstorm appearance.
44
Diagnosis of molar pregnancy
Provisional diagnosis made by US and confirmed with histology of mole after evacuation
45
Management of molar pregnancy
Evacuation of uterus to remove mole, patients referred to gestational trophoblastic disease centre. Levels of hCG monitored until returned to normal. Occasionally mole may metastasise
46
Risk factors for ectopic pregnancy
Previous ectopic, previous PID, previous surgery to fallopian tubes, intrauterine devices, older age, smoking
47
Features of ectopic pregnancy
Missed period Constant lower abdominal pain in iliac fossa Vaginal bleeding Lower abdominal or pelvic tenderness Cervical motion tenderness Dizziness/syncope (blood loss) Shoulder tip pain (peritonitis)
48
US findings of ectopic pregnancy
Gestational sac containing yolk sac or fetal pole may be seen in fallopian tube, empty uterus and fluid in uterus, non-specific mass seen
49
What is pregnancy of unknown location
When a woman has a positive pregnancy test but there is no evidence of pregnancy on US scan
50
What is used to help monitor pregnancy of unknown location
Serum hCG tracked over time, it is repeated after 24 hours to measure change from baseline
51
What happens to levels of hCG in ectopic or miscarriage
There is a rise of less than 63% after 48 hours
52
Management of ectopic pregnancy
Expectant, medical or surgical management
53
Criteria for expectant management of ectopic pregnancy
Unruptured, adnexal mass <35mm, no visivle heartbeat, no pain, hCG <1500IU/L
54
Criteria for medical management of ectopic pregnancy
hCG level must be <5000IU/, confirmed absence of intrauterine pregnancy on US
55
How is medical management of ectopic carried out
Methotrexate given as IM injection and patient advised not to get pregnant in following 3 months
56
Criteria for surgical management of ectopic pregnancy
Most require surgical - Pain, adnexal mass >35mm, hCG levels >5000,visible heart beat
57
How is surgical management of ectopic pregnancy carried out
Lap salpingectomy first line and lap salpingotomy in women at increased risk of fertility due to damage to other tube, reduced risk of removal of ectopic. Anti-rhesus D prophylaxis given if necessary
58
S/E of methotrexate for ectopic treatment
Vaginal bleeding, nausea and vomiting, abdominal pain, stomatitis
59
What classifies as a miscarriage
spontaneous termination of pregnancy - with early being before 12 weeks and late between 12-24 weeks
60
What is a threatened misscariage
Vaginal bleeding with a closed cervix and fetus which is alive
61
What is an inevitable misscariage
Vaginal bleeding with an open cervix
62
What is an anembryonic misscariage
Gestational sac is present present but contains no embryo
63
What is an incomplete misscariage
Retained products of conception which remain in uterus after miscarriage
64
Features which sonographer uses to determine miscarriage
Mean gestation sac diameter, fetal pole, crown rump length and fetal heartbeat
65
Management if miscarriage is less than 6 weeks in gestation
Presenting with bleeding they can be managed expectantly providing they have no pain or complications or risk factors. Repeat pregnancy test after 7-10 days to confirm
66
Management if miscarriage is more than 6 weeks in gestation
Expectant management, medical management or surgical management
67
Risks of having an incomplete miscarriage
Risk of infection
68
Management of incomplete miscarriage
Medical management with misoprostol or surgical management by evacuation of retained products
69
What defines recurrent miscarriages
Three or more consecutive misscariages
70
When are investigations for miscarriages initiated
Three or more first trimester, one or more in second trimester
71
Causes of miscarriage
Idiopathic Antiphospholipid syndrome Hereditary thrombophilias Uterine abnormalities Genetic factors ni parents Chronic histiocytic intervillositis Other chronic diseases - diabetes, thyroid, SLE

Obstetrics (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions