Pick'n'Mix 3A (1) Flashcards
Management of PROM
Admit for 48hr Rule out choriorioamnionitis Take a swab with a steriles speculum Give steroids Erythromycin 500mg ODS
Outline the different types of hysterectomy
Total: hysterectomy, tubes, ovaries and cervix
Vaginal: hysterectomy, tubes, ovaries and cervix and top part of the vagina
Treatments for
i) Stress incontinence
ii) Overactive bladder
i) Stress incontinence Conservative Pelvic floor exercise Duloxatine ( lots of side effects) Surgery
ii) Overactive bladder
Reduce caffeine intake
Anticholinergics
Botox
Define HELLP syndrome
Haemolysis
Elevated liver enzymes
Low platelets
What does the combined test consist of
PAPPA
bHCG
Nuchael translucency
What are diabetic pregnancies at increase risk of
Miscarriage
Shoulder dystocia
Infection
Cord prolapse
What are the contraindications for synotometrin
HTN
Asthma
Active heart disease
What is a csytourethalcycle
Urethrocyle and a cystocyle
Descent of a proportion of tissue can lead to ulceration
List the risk of an ectopic
Prev ectopic Contraception Tubal surgery Other surgeries in the abdominal cavity Pelvic inflammatory disease Infertility
Define secondary infertility
Achieved at least one pregnancy ( regardless of the outcome)
Signs of red degeneration
Syphsis- fundal height greater than expected
Complication of a fibroid
Occurs usually in the middle trimester
Outline the pathology of Erb’s palsy
Occurs due to trama to the upper trunk C5,C6 of the brachial plexus
Occurs during obstructed labour
Muscles supplied by C5 and C6
- musclocutaneous
- radial
- axillary
Outline the criteria for normal sperm
Volume 2-3mL Count > 15,000,000 Progressive motility > 50% Morphology > 15% Progression> 25%
Outline the different types of rupture of membranes
SROM: Spontaneous rupture of membranes
AROM: Artificial rupture of membranes
PROM: Rupture of membranes prior to the onset of labour in >37weeks
PPROM: PROM prior to 37 weeks
Outline the care for an epileptic pregnant lady
- ANC
- Intra
- PNC
ANC
- Consultant led
- Pre conceptual care
- Folic acid 5mg
- Monotherapy if possible
- Vitamin K in the last few weeks
- Regular anomaly scans
Intra
- Vaginal delivery ( if possible)
- Lower seizure threshold during labour and postpartum
- If status epilepticcus give benzos
PNC
- Baby vit K
- Implement strategies to prevent dropping the baby
Causes/Risk of miscarriage
Multiple pregnancy Infections Cytotoxic drugs Cervical incompetence Anatomical anomaly Rising age of the mother Radiation Implementation Anti-phospolipid syndrome Genetic abnormalities Endocrine
Risk factors for placenta caret
Previous c-sections
Ashermann’s syndrome
Pelvic inflammatory disease
Post maturity pregnancy
Bishop’s score <6: vaginal PGE2
Reassess after 6hrs
Bishops’s score <7 administer further prostaglandins and reassess
Indications to induce FOETAL - >10 days post due date - Foetal growth restriction - GDM - Haemolytic disease of the newborn - Foetal abnormalities
MATERNAL
- Pre-eclampsia
- Worsening medical condition
- Malignancy
Mechanism of action of the copper coil
Inflammatory reaction in the endometrial cavity
Thicken cervical mucus
Inhibits sperm motility ( golgi apparatus)
Reduces the likelihood of implantation
Contraindications for receiving the coil
Pregnancy or 48hrs-4 weeks post part Undiagnosed irregular vaginal bleeding STI <3mnths ago Distorted uterine cavity Gynae cancer Copper allergy
Define maternal mortality ratio
Number of maternal deaths per live births per 1,000
Define infant mortality rate
Number of deaths amongst infants at 1 yr of age
Define neonatal mortality rate
Number of deaths amongst infants under 28 days over 1,000 live births
Define the still birth rate
Number of the foetus delivered after 24 weeks + who at that time did not breathe or show signs of life per 1,000 per total births
