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Repro > Pregnancy > Flashcards

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
Q

HTN in pregnancy is defined as ?

A

systolic > 140

diastolic > 90

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26
Q

in which conditions should 5mg folic acid be given rather than 400 mcg

A

diabetes, taking epileptic drugs, coeliac disease, thalassaemia trait, obesity

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27
Q

a single prolonged deceleration on CTG lasting ? mins or longer is abnormal

A

3 mins

28
Q

loss of baseline variability is < ? beats per min

A

5

29
Q

variable decelerations may indicate ?

A

cord compression

30
Q

puerperal pyrexia

A

temp > 38 in the first 14 days following delivery

admit for IV abx

31
Q

when is anti D required
- in a surgical management of ectopic pregnancy
or
- in a medical management with MTX of ectopic pregnancy

A

anti D is required in surgical management but not if medical mx

32
Q

what drug is given if there are 2 or more RF’s for VTE in pregnancy? when is it given?

A

LMWH

at delivery and up to 7 days post partum

33
Q

is it safe to be on warfarin during delivery

A

risk of haemorrhage

34
Q

amiodarone can cause neonatal .. ?

A

hypothyroid

35
Q

valproate can cause .. ?

A

neural tube defects

36
Q

phenytoin can cause .. ?

A

cleft lip / palate

37
Q

how many weeks is anti D given if rh -ve?

A

28 and 34

38
Q

amniocentesis can be done after ? weeks

A

15 weeks

39
Q

chorionic villus sampling can be done after ? weeks

A

12

40
Q

dating scan

A

11 - 12 weeks

41
Q

anomaly scan

A

20 weeks

42
Q

changes of the cervix in labour

A

shortens and softens

full dilatation = 10 cm

43
Q

after how long is the placenta removed surgically?

A

after 1 hr

44
Q

normal foetal position for delivery

A

longitudinal lie, cephalic presentation, occipito-anterior

45
Q

how much blood loss is acceptable during pregnancy

A

< 500 ml

46
Q

what hormone are true labour contractions due to

A

oxytocin

47
Q

normal weight of baby (kgs)

A

2.5 - 4 kg

48
Q

which is physiological: early or late decelerations

A

early

49
Q

what are variable decelerations usually due to

A

cord compression

50
Q

ctg - normal variability

A

10 - 25 bpm

51
Q

does an epidural impair uterine activity?

A

no

52
Q

what is an abnormal foetal scalp pH

A

< 7.2

|&raquo_space; deliver!

53
Q

what are tocolytic drugs? give an example

A

they suppress pre term labour

e.g terbutaline

54
Q

snow storm appearance

A

molar pregnancy

55
Q

presentation of molar pregnancy

A

hyperemesis
varied bleeding
passage of grape like tissue
SOB

56
Q

chorionic haematoma tx

A

most resolve on own!
reassure and keep an eye
(if large can be source of infection and miscarriage)

57
Q

light brownish limited bleed about 10 days post ovulation

A

implantation bleeding

58
Q

choriocarcinoma
malignancy of which type of cells?
where does it usually metastasise to?
commonly co-exsists with what?

A

malignancy of trophoblastic cells of the placenta
commonly metastasises to the lungs
commonly co-exists with molar pregnancy (especially complete mole)

59
Q

how many chromosomes in partial mole

A

69

60
Q

management of ectopic pregnancy

is anti d needed if rh -ve?

A

IM MTX if stable and bHCG < 1500 (teratogenic&raquo_space; advise contraception for 3-6 m) - anti D not needed

surgical if severe pain, bHCG > 1500 etc - GIVE ANTI D

61
Q

in a viable pregnancy, how should bHCG change?

A

should double every 48 hrs

62
Q

how is placenta previa dx?

what should you not do?

A

U/S

dont do vaginal exam until you exclude it

63
Q

which steroid is preferred for promoting foetal surfactant production

A

betamethasone

64
Q

what is placenta accreta

A

placenta invades myometrium > severe bleeding, PPH

c-section at 37 weeks

65
Q

management of PPH

if unresponsive?

if > 1500 ml?

A

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
Q

PPHN
what is it?
mx?

A

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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