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Pregnancy Flashcards

1
Q

values for anaemia in pregnancy

A

1st trimester - Hb less than 110
2nd/3rd trimester - Hb less than 105
Postpartum - Hb less than 100

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2
Q

sudden extreme abdo pain in 3rd trimester, cold to touch

A

placental abruption

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3
Q

Single most significant RF for pre eclampsia

A

having had it before

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4
Q

tx for eclampsia

A
  • Magnesium sulphate - 4g over 5 mins then 1g hourly until 24 hrs seizure free
  • c section
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5
Q

does oestrogen increase or decrease excitability

A

increase

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6
Q

is oxytocin released from anterior or posterior pituitary

A

posterior

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7
Q

Increase or decrease of oestrogen and progesterone at birth

A

sudden drop

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8
Q

what hormone does the suckling stimulus promote release of

A

oxytocin

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9
Q

why are ACEI/ARBs not used in pregnancy

A

can cause renal hypoplasia in foetus

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10
Q

valproate causes ?

A

neural tube defects

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11
Q

phenytoin causes ?

A

cleft lip/palate

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12
Q

how much folic acid is given in epilepsy

A

5 mg daily

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13
Q

drug treatment for N & V

A

cyclizine

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14
Q

warfarin causes ?

A

limb and facial defects

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15
Q

lithium causes ?

A

CV defects

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16
Q

antibiotic for UTI in third trimester

A

trimethoprim

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17
Q

most common cause of PPH

A

uterine atony

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18
Q

primary PPH is defined as blood loss more than ?

A

500 ml

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19
Q

what causes secondary PPH

A

retained placenta

endometriosis

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20
Q

what vitamin is teratogenic in high doses

A

vitamin A

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21
Q

what is HELLP syndrome

A

haemolysis
elevated liver enzymes
low platelets

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22
Q

symptoms of pre eclampsia

A 
severe headache
vomiting
problems with vision
severe pain just below the ribs
sudden swelling of the face, hands or feet
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23
Q

Drug treatment in women with risk of pre eclampsia (i.e. CKD, hypertensive disease in previous pregnancy, diabetes, first pregnancy, > 40 yrs old, multiple pregnancy, autoimmune disease etc…)

A

anti platelet - aspirin 75mg daily from 12 weeks until birth of baby

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24
Q

blood pressure in pregnancy tends to fall and then rise again at how many weeks?

A

20 - 24

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25
HTN in pregnancy is defined as ?
systolic > 140 | diastolic > 90
26
in which conditions should 5mg folic acid be given rather than 400 mcg
diabetes, taking epileptic drugs, coeliac disease, thalassaemia trait, obesity
27
a single prolonged deceleration on CTG lasting ? mins or longer is abnormal
3 mins
28
loss of baseline variability is < ? beats per min
5
29
variable decelerations may indicate ?
cord compression
30
puerperal pyrexia
temp > 38 in the first 14 days following delivery | admit for IV abx
31
when is anti D required - in a surgical management of ectopic pregnancy or - in a medical management with MTX of ectopic pregnancy
anti D is required in surgical management but not if medical mx
32
what drug is given if there are 2 or more RF's for VTE in pregnancy? when is it given?
LMWH | at delivery and up to 7 days post partum
33
is it safe to be on warfarin during delivery
risk of haemorrhage
34
amiodarone can cause neonatal .. ?
hypothyroid
35
valproate can cause .. ?
neural tube defects
36
phenytoin can cause .. ?
cleft lip / palate
37
how many weeks is anti D given if rh -ve?
28 and 34
38
amniocentesis can be done after ? weeks
15 weeks
39
chorionic villus sampling can be done after ? weeks
12
40
dating scan
11 - 12 weeks
41
anomaly scan
20 weeks
42
changes of the cervix in labour
shortens and softens | full dilatation = 10 cm
43
after how long is the placenta removed surgically?
after 1 hr
44
normal foetal position for delivery
longitudinal lie, cephalic presentation, occipito-anterior
45
how much blood loss is acceptable during pregnancy
< 500 ml
46
what hormone are true labour contractions due to
oxytocin
47
normal weight of baby (kgs)
2.5 - 4 kg
48
which is physiological: early or late decelerations
early
49
what are variable decelerations usually due to
cord compression
50
ctg - normal variability
10 - 25 bpm
51
does an epidural impair uterine activity?
no
52
what is an abnormal foetal scalp pH
< 7.2 | >> deliver!
53
what are tocolytic drugs? give an example
they suppress pre term labour | e.g terbutaline
54
snow storm appearance
molar pregnancy
55
presentation of molar pregnancy
hyperemesis varied bleeding passage of grape like tissue SOB
56
chorionic haematoma tx
most resolve on own! reassure and keep an eye (if large can be source of infection and miscarriage)
57
light brownish limited bleed about 10 days post ovulation
implantation bleeding
58
choriocarcinoma malignancy of which type of cells? where does it usually metastasise to? commonly co-exsists with what?
malignancy of trophoblastic cells of the placenta commonly metastasises to the lungs commonly co-exists with molar pregnancy (especially complete mole)
59
how many chromosomes in partial mole
69
60
management of ectopic pregnancy is anti d needed if rh -ve?
IM MTX if stable and bHCG < 1500 (teratogenic >> advise contraception for 3-6 m) - anti D not needed surgical if severe pain, bHCG > 1500 etc - GIVE ANTI D
61
in a viable pregnancy, how should bHCG change?
should double every 48 hrs
62
how is placenta previa dx? | what should you not do?
U/S | dont do vaginal exam until you exclude it
63
which steroid is preferred for promoting foetal surfactant production
betamethasone
64
what is placenta accreta
placenta invades myometrium > severe bleeding, PPH c-section at 37 weeks
65
management of PPH if unresponsive? if > 1500 ml?
uterine massage IV syntocin if not responsive > Ergometrine (avoid in heart disease), repair trauma, senior help, PGF2 alpha (carboprost) if > 1500 ml > packs, balloons, factor VIIa, embolisation
66
PPHN what is it? mx?
sats 10-20% lower in foot than hand ventilate, nitric oxide (vasodilator), sedation, inotropes, ECLS (taking blood out of baby to oxygenate it)

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