Passmed Flashcards
gestational diabetes
diagnostic thresholds
fasting glucose?
2 hour glucose?
> 5.6 mmol/l
7.8
if a pregnant woman takes an ACE inhibitor or angiotensin II receptor blocker (ARB) for pre-existing hypertension
what should you do?
this should be stopped immediately
refer to specialist and give another hypertensive labetalol
pyrexia >38?
prophylaxis of GBS
benzylpenicillin IV 3g
delayed third stage of labour causes?
uterine atony
retained placental tissue (which can happen due to placenta accreta)
why does placenta accreta cause PPH?
retained placenta is a cause of PPH right
in accreta the placenta is ATTACHED to myometrium = unable to deliver placenta
definitive management would thus be hysterectomy
what causes group B strep?
streptococcus agalacticae
gram negative diplococci
that is an obligate aerobe treated with ceftriaxoner?
Neisseria gonorrhoea
rubella in pregnancy?
disccus with local health protection unit
what happens to blood pressure during pregnancy?
falls in first trimester
then rises
the fall is due to the drop in systemic vascular resistance
the rise is due to the increase in Cardiac output
invasive tests
which is offered at 15
amniocentesis is preferred
CVS is done between 11 and 13 weeks: can be done upto 14 weeks and 6 days
when is the early scan for dates?
10-13 weeks
when is the first scan for anaemia and RBc anomalies?
booking scan which should be between 8-12 weeks
Diabetic with pprom at 25 weeks but stable how to manage?
admit
observe
adminster steroid 2 doses
but monitor glucose BM
as steroids can cause hyperglyacemia ?
perineal tears
injury to perineal muscle but not sphincter?
second degree
injury to vaginal mucosa and perineal skin not extending to muscles is a second degree perineal tear.
T/F
false
first degree as injury to skin but not underlying muscles
what is a third degree tear?
injury to muscle and anal sphincter complex but not to rectal mucosa
do first degree tears require repair?
no
monitoring BM - pregnat patient
daily fast
pre meal
1 hour post
bedtime
third stage of labour active management
10IU oxytocin IM
then ergometrine combination
then oxcytocin infusion
anatomy of c section
superficial fascia
deep fascia
anterior rectus sheath
rectus abdominis (tear here)
transversalis fascia
extraperitoneal
peritoneum
uterus
pre eclampsia risk
age 40>
nulliparity
BMI 31
vascular disease
renal disease
multiple
fhx
previous hx
what is defective that lets placenta attach to myometrium?
decidua basalis
DVT management
treat with LMWH
routine measure anti-XA
pregnant and smoking - how to stop?
nicotine replacement therapy
which women are screen for GDM with an OGTT
history of macrosomic baby
BMI >30
previous GDM
Fhx of diabetes
ethnicity - south asian
rhesus sensitisation in Rh negative mother with anterpartum haemorrhage
one dose of anti-D immunoglobulin followed by kleihauer test
when should anti-d always be given
RH negative
infant is rhesus +
termination of pregnancy
miscarriage >12 weeks
ectopic
when is lochia normal to?
upto 6 weeks
what are the 3 stages of lochia ?
rubra - red 4 days
serosa - yellow 2/3 weeks
alba - white 1-2 weeks