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pregnancy > pregnancy > Flashcards

pregnancy Flashcards

1
Q

what is the rate of spontaneous twins and triplets ?

A

twins - 1/80

triplets - 1/10,000

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2
Q

what day and stage will an embryo splitting result in dichorionic/diamniotic twins ?

A

morula at day 1-3

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3
Q

cleavage at what day and stage will result in monochorionic/diamniotic twins

A

blastocyst day 4-8

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4
Q

what day and stage will result in monochorionic/monoamniotic twins?

A

implanted blastocyst day 8-13

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5
Q

the splitting of the egg at what stage will result in conjoined twins ?

A

formed embryonic disc - day 13-15

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6
Q

on what days does implantation most commonly occur

A

day 8-9

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7
Q

what kind of twins are the highest risk of twin-twin transfusion syndrome? how often are they scanned?

A

monozygotic and monochorionic twins are scanned every 2 weeks

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8
Q

what signs/symptoms of multiple pregnancies ?

A

high afp, high hcg , large for dates uterus , hyperemesis gravidarum

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9
Q

what is twin- twin transfusion syndrome ?

A

disproportionate blood flow to one twin in monochorionic pregnancies anastomosis in blood supply may cause blood from one to flow to the other. the one losing blood will affect growth cause decreased urine output, anaemia and oligohydramnios. the one gaining blood will have increased urine output and polyhydramnios, polycythaemia and eventually heart failure

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10
Q

treatment of twin-twin transfusion syndrome? and when is it carried out? what is potential consequence

A

fetoscopic ablation before 26 weeks, can lead to TAPS twin anaemia polycythaemia syndrome

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11
Q

when should you deliver DCDA twins, MCMA twins and MCDA twins?

A

DCDA - 37-38 weeks
MCDA- 36 weeks with steroids
MCMA twins - 32-34 weeks

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12
Q

hwo are MCMA twins and triplets delivered ?

A

both by c-section . MCMA have higher risk of cord entanglement

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13
Q

what is given after the birth of one twin in labour and why?

A

synctocin to maintain contractions

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14
Q

after how many minutes should you aim to have delivered both twins by ?

A

30 mins

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15
Q

name the 3 kinds of breech and describe each

A

complete - legs in a basket at level of babys bum
frank - lets pointing up around head- bum first
footling - leg emerges first

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16
Q

if a baby is breech after how many weeks to you offer external cephalic version ?

A

after 36 weeks

17
Q

after how many weeks does it become a prolonged pregnancy ?

A

42

18
Q

how many ultrasounds does an uncomplicated pregnancy get ?

A

2

19
Q

up to how many days is a death referred to as a neonatal mortality

A

28 days

20
Q

what is the leading cause of direct maternal mortality

A

VTE

21
Q

when does gestational hypertension develop?

A

after 20 weeks

22
Q

what is hypertension in pregnancy defined as?

A

systolic >140mmHg or diastolic >90mmHg or an increase since booking visit of >30mmHg sys or >15mmHg diastolic

23
Q

after how many weeks is pre-eclampsia seen ?

A

after 20

24
Q

what is pre-eclampsia defined as ?

A

hypertension and proteinuria >0.3g/24hr

25
Q

what does pre-eclampsia increase the risk of

A

prematurity or IUGR, eclampsia, haemorrhage (due placental abruption), cardiac failure, stroke, VTE, PE,
HELLP, DIC

26
Q

what is seen in HELLP syndrome

A

haemolysis, increased liver enzymes, low platelets

27
Q

features of eclampsia are

A

> 170/100mHg, proteinuria, headahce(cerebral oedema), visial disturbance, papilloedema, RUQ/epigastric pain, sudden oedema, hyperreflexia, clonus, low plateletas, changed lft or hellp syndrome

28
Q

what is eclampsia charcterised by

A

grand mal seizures

29
Q

definitive treatment of eclampsia

A

delivery

30
Q

what is eclampsia managed with

A

IV magnesium sulphate

31
Q

what is secondary preventia of pre-eclampsia if a history

A

aspirin low dose 12 weeks onwards

32
Q

what date is classed as pre-term

A

37

33
Q

risk factors fro small for dates foetus

A

prev one, multiple pregnancy, uterine abnormalities, age, pariy extremes, smoking, drugs esp coke, BMI<20

34
Q

below what centile is classed as small for dates ?

A

10th

35
Q

a symphyseal fundal height greater than how many cm’’s for gestational age is classed as large for dates

A

> 2cm

36
Q

what are the values for amniotic fluid index and deepest verticle pool in order to be classed as polyhydramnios

A

amniotic fluid index >25cm and deepest verticle pool >8cm

pregnancy (5 decks)

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