Physio + ANC, early pregnancy, infections & PP psychiatry

Question 1

Definition of threatned miscarriage

Answer 1

Any bleeding from the genital tract before 24w of pregnancy in the context of a closed internal cervical os and viable pregnancy

Question 2

Misconceptions regarding recurrent miscarriage

Answer 2

Unexplained aetiology accounts for 50% of recurrent miscarriages
There is no definitive ass w/ arcuate uterus and recurrent miscarriage
Women w/ syphilis has a high incidence of recurrent miscarriage in the late T2 and stillbirth

Question 3

Why is methotrexate effective in treating ectopic pregnancy?

Answer 3

Because the highly proliferating trophoblastic cells are very sensitive to the action of the drug

Question 4

ANC Mx of a varicella infected mother

Answer 4

Caution in using acyclovir if <20w
VZIG can be given up to 10d of contact if no signs develop
Delaying delivery by at least 7d is beneficial (allows more Abs to cross)

Question 5

ANC Mx of HSV

Answer 5

C-section should be considered if primary HSV infection occurs w/i 6w of delivery; it isn’t recommended in recurrent infections
C-section isn’t needed in women w/ active infection and 4 hours of ruptured membranes

Question 6

WHO class IV category acc. to CVS risk

Answer 6

Pregnancy is contraindicated in:

Pulmonary HTN of any cause
Severe systemic ventricular dysfunction (LVEF <30%)
Previous peripartum cardiomyopathy w/ any residual ventricular dysfunction

Question 7

US evidence of a non-viable pregnancy

Answer 7

Empty gestation sac w/ a mean diameter of 28mm]
No FHB
Irregular shaped gestation sac

Question 8

Mx of post-term pregnancy where induced labour is refused

Answer 8

Assess fetal wellbeing w/ at least CTG twice weekly with an assessment of the deepest vertical pool of liquor on US

Question 9

Intrapartum ABx prophylaxis of GBS

Answer 9

Benzyl penicillin

If allergic; clindamycin