Passmed Flashcards
What is the Group B streptococcus management in pregnancy?
Symptomatic: Treatment Abx at time + IV benzylpenicillin after the start of labour and 4 hrly until delivery
Asymptomatic: intrapartum prophylaxis
What are the risks for Group B strep in pregnancy?
Prematurity
prolonged rupture of the membranes
previous sibling GBS infection
maternal pyrexia
What is the first line medical management of uterine atony?
- IV syntocinon (oxytocin) 10 units
- IV ergometrine 500 microg
- IM carboprost
What is the sequence management of PPH?
- bimanual uterine compression to manually stimulate contraction
- intravenous oxytocin and/or ergometrine
- intramuscular carboprost
- intramyometrial carboprost
- rectal misoprostol
- surgical intervention such as balloon tamponade
What things do you do in monitoring labour?
FHR monitored every 15min (or continuously via CTG)
Contractions assessed every 30min
Maternal pulse rate assessed every 60min
Maternal BP and temp should be checked every 4 hours
VE should be offered every 4 hours to check progression of labour
Maternal urine should be checked for ketones and protein every 4 hours
What is involved in active management in third stage of labour?
- uterotonic drugs (IU oxytocin IM after the delivery of the anterior shoulder
- Deferred clamping and cutting of cord, over 1 minute after delivery but less then 5 minutes
Controlled cord traction after signs of placental separation
What is the triad for diagnosing hyperemesis gravidarum?
- Dehydration
- Electrolyte imbalance
- 5% pre-pregnancy weight loss
What is the management of hyperemesis gravidarum?
- Antihistamines (promethazine)
- Ondansetron and metoclopramide
- ginger and P6
- Admission may be needed for IV hydration
What is the management of premature labour?
Admission and administration of tocolytics and steroids (in case delivery is required to help baby’s lung mature)
