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Obs & Gynae 01.15 > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What level does the baby head move to in the propulsive phase

A

Pelvic floor - ischial spines

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2
Q

What happens in the expulsive phase

A

Baby pushed out

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3
Q

Cervix is “fully dilated” at what size?

A

10cm

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4
Q

What is effacement of the cervix

A

Cervical canal draws into uterine body - and dilation of external os.

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5
Q

On a partogram, if the Liquor is “C” what does this mean

A

The amniotic fluid is clear so does not show contamination by meconium from the baby (a sign of foetal distress)

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6
Q

What is meconium

A

Foetus poo

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7
Q

The “lie” of the baby can be in 3 ways

A 
Longitudinal
Transverse (across the abdomen)
Oblique (diag across abdomen)
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8
Q

What is cephalic and breech presentation

A

Breech - feet first

Cephalic - normal head first

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9
Q

What is moulding

A

Overlap of skull bones

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10
Q

What is the definition of “engaged” for the baby

A

2/5 or less palpable per abdomen

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11
Q

What is “caput”

A

Scalp oedema

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12
Q

This drug is used to induce labour - causes rythmical contractions (Avoid if NOT first preg – chance of uterine rupture)

A

Oxytocin / Syntocinon

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13
Q

This drug causes prolonged tetanic contractions / spasm – for post partum haemorrhage (Contraindication = high BP)

A

Ergometrine

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14
Q

This drug is a combination of ergometrine and oxytocin – used in 3rd stage to speed placental expul.

A

Synometrine

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15
Q

What does DOA in relation to the baby position mean

A

Direct occipito anterior “face to arse” - normal position prior to final expulsion

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16
Q

What does DOP mean in relation to baby position

A

Direct occipito posterior - “face to pubes” more difficult delivery as diameter of skull is wider through the pelvis

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17
Q

This complication of pregnancy presents with hypertension, proteinurea +/- oedema. There is deranged renal functio and CNS/PNS effects

A

Pre-Eclampsia

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18
Q

What is the consequence of uncontrolled gestational diabetes on baby

A

Baby produces insulin in response to raised glucose - Insulin is a growth factor - can cause macrosomia (big baby)

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19
Q

Preg woman complains of sore hot calf and SOB - problem?

A

DVT /PE - increased risk of thromboembolism

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20
Q

The ovary produces what 3 hormones

A

Oestrogen
Progesterone
Testosterone

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21
Q

What is contained within the medulla of the ovary (the deep tissue)

A

Lymphatics and blood vessels

22
Q

Where are follicles produced in the ovary

A

Cortex - contain follicles each containing oocyte (Graffian follicle)

23
Q

What is the stroma of the ovary

A

Soft tissue on surface - forms Tunica Albuginea

24
Q

What is the function of a bartholin’s gland

A

Lubrication of vagina

25
Q

What is another name for the recto-uterine pouch

A

Pouch of douglas

26
Q

What is the “quadruple test” for Downs syndrome and when would it happen - what will the levels of the 4 things be?

A

approx 15/16 weeks

  1. AFP - Alpha fetoprotein (HIGH)
  2. HE3 - Oestrodial (LOW)
  3. bHCG - Human chorionic gonadotropin (HIGH)
  4. Inhibin A (LOW)
27
Q

What is the threshold for LOW / HIGH risk of Down’s as a number

A

1/150

28
Q

What can be carried out to confirm if a baby is carrying Down’s

A

Amniocentesis

29
Q

What is the risk of miscarriage in amniocentesis

A

1%

30
Q

At what stage of pregnancy is pre-eclampsia most common

A

3rd trimester

31
Q

Key 3 features of pre-eclampsia

A

HTN
Proteinurea
Oedema

32
Q

HELLP is associated with pre-eclampsia what 3 key things are it referring to

A

Haemolysis
Elevated liver enzymes
Low platelets

33
Q

What liver enzyme is raised during normal pregnancy

A

Alk Phosphatase

34
Q

Bp 140 - 159mmhg and proteinurea - mild, mod or severe pre-eclampsia?

A

Mild

35
Q

BP >160mmHg, and proteinurea is mod pre-eclampsia.

Severe is this plus one of a number of other features (6+)

A 
Visual disturb
Clonus
Headaches
Epigastric pain
Papilloedema
HELLP - Liver tenderness, ALT >70, platelets
36
Q

What is the underlying cause of pre-eclampsia (ie what is happening in terms of cytotrophoblast attachment to endometrium etc)

A

Poor attachment - reduced development of spiral artery formation in endometrium - small diam and low NO = high BP

37
Q

Scans are usually performed at 12 and 18-20 weeks - why

A

1st - routine

2nd - Anomaly scan

38
Q

What is placenta previa - what are the 2 main types

A

Obstruction of the cervical os by placenta establishing in “wrong place” - Types: 1. Minor (partial obstruction of os) 2. Major - total obstruction of os

39
Q

What is placental abruption - 2 main types

A

Bleed of placenta - hidden (bleeding behind placenta) and obvious (from uterus)

40
Q

Sign of placental abruption on examination of abodomen

A

Hard woody uterus

41
Q

Assisted contraception, previous terminations, defective endometrium are all risk factors for what

A

Placenta previa

42
Q

Pre-eclampsia, multi-parity, blunt trauma are all risk factors for what

A

Placental abruption

43
Q

How might oxytocin help in management of post partum haemorrhage

A

It stimulates contractions - uterus contracts so helps stem bleeding

44
Q

What is given in sever pre-eclampsia if delivery is due to occur

A

Magnesium sulfate - is also protective to neonatal brain development

45
Q

Why must magnesium sulfate be given slowly

A

To avoid cardio pulmonary arrest in mother

46
Q

What is the only “cure” for pre-eclampsia or eclampsia

A

Delivery of baby

47
Q

What is the name for the classic c-section incision

A

Pfannenstiel

48
Q

Twins are described in relation to whether they have their own placenta / amniotic sac. What does the following mean:
Monoamniotic monochorionic

A

Both in one amniotic sac - sharing one placenta

49
Q

What is the issue with monochorionicity

A

Complications from only having 1 placenta - miscarriage, developmental problems, various issues to mother also

50
Q

Twins are described in relation to whether they have their own placenta / amniotic sac. What are di-zygotic (non-identical) twins always?

A

Diamniotic and dichorionic - they each have their own amniot. and placenta

Obs & Gynae 01.15 (4 decks)

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