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Pregnancy Drugs > Pregnancy Drug s > Flashcards

Pregnancy Drug s Flashcards

1
Q

Cleft lip / palate

A

Methotrexate ( folic acid antagonist )
Phenytoin

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2
Q

Seizure in pregnancy

A

Magnesium sulphate

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3
Q

Uterine inversion
- fundus of uterus drops down through the uterine cavity and cervix, turning inside out
Obstetric emergency

A

Johnson menoeruve - using hand - push the fundus back into the abdo
Hydrostatic - filling vagina with fluid to inflate it back up
Laparotomy

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4
Q

TRIAD of AMNIOTIC FLuid embolism
After birth

A

Coagulopathy, hypoxia and hypotension

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5
Q

Rupture of membrane followed by immediate bleeding

A

Vasa praveia

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6
Q

What happens if they have vasa Praveva

A

EMERGNECY c section

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7
Q

Cytomegalovrius infection

A

Hearing loss, visual impairment and learning disability

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8
Q

If stage 1 is prolonged, what do you do

A

1st : aminotomy
2nd : oxytocin infusion

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9
Q

Bright, red, fresh vaginal bleeding which is painless in nature

A

Placenta Praevia

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10
Q

What does molar pregnancies present

A

14 weeks

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11
Q

Treatment for hyperemesis gravidarum

A

1st line: anti emetic : Promethazine
2nd: electrolyte Imbalance

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12
Q

What is hypermeresis gravidum

A

Vvvv bad vomiting before 20 weeks. Leading to weight loss, dehydration and electrolyte imbalance

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13
Q

Drug to prime the cervix

A

Vaginal prostaglandin e2 pessay ( allows it to soften and become shorter for labour)

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14
Q

Hard, woody uterus
Little bit of bleed
Lots of pain

A

Placental abruption

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15
Q

What landmark do you use for a pudenal nerve block

A

Ischial spine

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16
Q

Most common cause of a post partum haemorrhage

A

Uterine Antony

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17
Q

Chorioamniontis

A

Pre rupture of the membrane - allows bacteria to enter

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18
Q

Another word for externally rotates

A

Restitution

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19
Q

Vaginal bleeding, rupture of foetal membrane and foetal deterioration

A

Vasa praevia

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20
Q

Painless bright red vaginal bleeding only after 24 weeks

A

Placenta praevia

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21
Q

What does corticosteroid steroid do ( given 24 and 34 week)

A

Aids foetal Lung maturation

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22
Q

Should you treat asymtomatic bacteriaemia ( uti)

A

Yesssssssssss

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23
Q

What week does antepartum haemorrhage cut off

A

24 weeks - birth

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24
Q

Branchial cyst

A

Embrological remnant from the development of the brachial arches which forms parts of the head and neck

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25
Q

How long should you breast feed for

A

Exclusively only breast feeding for 6 MONTHS
Then eating and breast feeeding till up to 2h years

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26
Q

Is breast milk high in vit d?

A

NO !! LOW

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27
Q

What issue does this cause in pregnancy?
- ciprofloxacin

A

Joint problems

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28
Q

What issue does this cause in pregnancy?
Methotrexate

A

Cleft lip

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29
Q

What issue does this cause in pregnancy?
Nitrofuraontin

A

G6PD deficiency - activates intra vascular haemolysis

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30
Q

What issue does this cause in pregnancy?
- aspirin

A

Reye ( cant see, cant pee, cant climb a tree)

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31
Q

Should hiv mothers do vaginal births and breast feed

A

No - c section
Refrain from breast feeding

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32
Q

Dm of mastitis

A

Antibiotics
Continue to breast feed

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33
Q

Ix for breech baby

A

At 36 weeks - over external cephalic version ie turn baby arohnd
Multiparous women - 37 weeks

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34
Q

Success rate of ECv

A

50%

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35
Q

What spinal block is c section occur under

A

Spinal !!

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36
Q

Indications for elective c section

A
  • previous c cession
  • vasa praevia
  • placental praevia
  • uncontrolled hiv
  • cervical cancer
  • mutiple pregnancy
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37
Q

Infection of membranes in the uterus

A

Chorioamniontis

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38
Q

Biggest risk factor for chorioamniotiurs

A

Preterm rupture of membranes

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39
Q

Ix of Chorioamniontis

A
  • delivery of baby
  • iv antibitocs… sepsis 6
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40
Q

Triad of cmv infection

A

Visual impairment
Hearing loss
Learning disability

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41
Q

What group does cmv belong to

A

Herpes

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42
Q

Triad for rubella

A

Cardiac defects, deafness, cataracts

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43
Q

Toxoplasmosis… from protozoan parasite toxoplasma gondii is found where

A

Cat, faeces, infected meat or soil

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44
Q

If a woman gets varicella zoster virus ( chicken pox) during pregnancy .,… is this bad

A

YESSSS - causies teratogenic
Avoid people with it once pregnancy ]
Give immunoglobulin as prophylaxis
Of acyclovir within 24 hours of rash … then baby get iv acyclovir after delivery

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45
Q

Is the anterior or posterior wall of the vagina longer?

A

POSTERIOR

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46
Q

Artery supply to vagina.

A

Internal iliac artery ( uterine and vaginal arteries)

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47
Q

Venous drainage from vagina

A

Internal iliac vein

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48
Q

Cord prolapse

A

The umbilical cord exits before delivery of baby - causes acute compromise of the umbilical blood supply to the infant

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49
Q

Mx of cord prolapse

A

Delivery of baby through forceps or c section if the cervix isn’t dilated
Knees - chest position to prevent further prolapse
Filling bladder with 500ml warm saline to prevent
Tocolytics e.g.terbutaline to stop uterine contractions

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50
Q

What limit is macrosomina

A

Birthweight >4kg

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51
Q

How does macrosomia occur

A

Maternal blood glucose crossing placenta and inducing increased neonatal insulin production
It can increase chance of shoulder dystocia

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52
Q

What are the 3 main genetic mechanisms for Down syndrome

A
  • gamete non disjunction
  • robertsonian translocation
    -mosaic
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53
Q

Pre- eclampsia

A

Proteinuria + hypertension at 20 weeks

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54
Q

Consequences of pre eclampsia

A

HELLP SYNDROME
DIC
Eclampsia ( seizures due to cerebrovascular vasospasm)
Organ failure

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55
Q

Treatment of preeclampsia

A
  • antihypertensiopns ( labetalol )
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56
Q

When do you do surgical option in ectopic

A
  1. Vvvv much in pain
  2. It is >35mm
  3. B - hcg are >5000
  4. Ultrasound identifies a foetal heartbeat
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57
Q

Type 1 FGM

A

Partial or total removal of the clit and or prepuce

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58
Q

Type 2 FGM

A

Partial / total removal of clit and inner labia, with /without other labia

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59
Q

Type 3 FGB

A

Narrowing of the vaginal opening, wee hole at the end.

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60
Q

Type 4 FGM

A

Any other harmful stuff
- piercing
- incising
- scarping
- cauterising

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61
Q

First stage of labour

A

Latent : up to 3/4 cm
Active : 3/4 - 10 cm

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62
Q

What is prolonged first stage

A

<2 cm in 4 hours

It should be 1 every 2

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63
Q

Gravity

A

Number of gravid events - number of times person been pregnanct
Each one count as one, doesnt matter if twin, or miscarriage.

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64
Q

Nulligravida

A

Never been pregnant

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65
Q

Primigravida

A

Pregnanct once

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66
Q

Multigravida

A

Pregnant more than once

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67
Q

Parity

A

Number of porous events
- number of times a person has given birth to a pregnancy with a gestational age of at least 24 weeks!!! Whether it was born alive or stillborn

Again even if c section of mutiple = still 1

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68
Q

Most women have group b strep, what issues can this cause baby

A

Sepsis
Pneumonia
Meningitis

So give iv penicillin during labour

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69
Q

Rhesus negative mother = becomes sensisted to rheuses blood of baby

A

Haemolytic disease of newborn

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70
Q

HELLP syndrome

A
  • haemolyiss
  • elevated liver liver enzymes
  • low platelet s
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71
Q

If mothers load ( Hiv) is <50
What is recommend

A

Normal vaginal delivery
If more - c section

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72
Q

Hyeremesis gravidarim

A

Severe vomiting before 20 weeks

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73
Q

Used to assess if patient is likely a good candidate for induction of labour

A

Bishops score

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74
Q

What are the components for bishops score

A

Pregnancy can enlarge dainty stomachs

  • position
  • consistency
  • effecament
  • dilation
  • foetal station
75
Q

Measure the volume of foetal hb present in mothers blood stream
Ie work out is there is a need for anti d - has there been a sensitaiton event

A

Kheihauer test

76
Q

Cheese

A

Listeria

77
Q

Can pregnancy people take lithium

A

NOOOOOOOO esp in 1st trimester

78
Q

What should be offered at 41 weeks

A

Membrane sweep - insert a finger into cervical opening and sweeping to separate the amniotic membrane from cervix - causes prostaglindins release - stimulate sponetanous labour

If failure - induce of labour visa prostaglandins to stimulate contractions

79
Q

Meconium

A

First faces passed by newborn .. usually after delivery and vvv green

If passed prior to birth - meconium stained liquor IE FOETAL DISTRESS

80
Q

Meconium aspiration syndrome

A

When the baby aspirates into lungs

81
Q

Mx of meconium aspiration syndrome

A

Gentle suctioning of the mouth and nose

82
Q

Miscarriage

A

Loss prior 24 weeks gestion

83
Q

Mild bleeding
Viable pregnancy
Os closed

A

Threatened

84
Q

Heavy bleeding
viable pregnancy
Os open

A

Inevitable

85
Q

Complete

A

Os may be open or closed
Uterus empty

86
Q

Incomplete

A

Os dilutes
Retained
Foetus

87
Q

Missed

A

Uterus has foetal tissue
Not viable
Cervical is closed

It’s missed cos woman is asymtomatic

88
Q

Complete

A

1 sperm and an empty egg
The sperm doubles to get a normal number of chromosomes

89
Q

Partial mole

A

2 sperm and a normal egg
Some evidnce of foetal parts

90
Q

Calculate the expectted delivery date based on LMP

A

Naegele rule
Add 1 year and 7 days to first day of last period and substract 3 months

91
Q

If you have herpes - what do you do

A

C section and iv acyclovir
Baby can get herpes on head if vaginal

92
Q

What is entonox

A

Gas and air

93
Q

Another name for obstetric cholestasis

A

Intra hepatic cholestasis

94
Q

what is cholestasis

A

After 24 weeks, bulid up of bile acid
Vvv itchy

95
Q

Lower than normal volume of amniotic fluid in uterus

A

Oligohydramnios

96
Q

Common complication of infertility treatment

A

Ovarian hyper stimulation syndrome
Causees bloating and abdo discomfort

97
Q

1st degree tear

A

Perineal skin or vaginal mucosa

98
Q

Second degree tear

A

Perneal muscles and fascia
Not anal spinchers

99
Q

What would espistomy be classed as as a tear

A

2nd degree

100
Q

3a tear

A

Less than 50% of external anal sphincter is torn

101
Q

3b tear

A

More than 50% of external anal sphincter but internal is fine

102
Q

3c tear

A

Interal gone nut anal mucosa is fi e

103
Q

4th tear

A

Anal mucosa gone

104
Q

Placenta accreta

A

Adherence of placenta directly to superfical myometrium but does not penetrate the thickness of muscle

105
Q

Placenta increta

A

Occurs where the villi innate but not through myometrium

106
Q

Placenta per create

A

Full thickness myometrium to the serosa

107
Q

Woody, heard I uterus
Bvvvvvv Pain
Little blood

A

Placental abruption

Abcde approach

108
Q

Placenta overlaying the cervical os

A

Bright red vaginal bleeding
PAINLESSSSSSSSSSS

109
Q

Ix and mX of placenta praevia

A

Reasses at 32 and 36

If at 35 and still there- plan a c section at 37 - 38

110
Q

Too much amniotic fluid in uterus

A

Polyhydramnios

111
Q

How long is contraceptive not needed for after pregnancy

A

3 weeks

112
Q

When can ius/ iud be inserted

A
  • immediately after delivery, up to 48 hours after delivery
  • if nottt then 28 days after
113
Q

When can pop be given after pregnancy

A

Anytime

114
Q

Should you give combined oral if breast feeding

A

Nooooooo

115
Q

When can you give oral combined pill after proegnacy

A

21 after child brith

116
Q

Iffff exclusive breast feeding, am i protected

A

Yes for 6 months

117
Q

Postpartum haemorrage

A

500ml blood within first 24 hours

118
Q

Causes of pph

A

Tone - uterine Antony, most common cause. Failure of uterine to contract after delivery

Trauma

Tissue - retained tissue

Thrombin - coagulopathies

119
Q

Mx of pph

A

Major haemorrage procotol

120
Q

Secondary pph

A

24 hours - 12 weeks posr partum

121
Q

Pre labour rupture of membranes e

A

Before 37 weeks … if labour doesn’t start within 24 hours - induce

122
Q

Prolonged 2nd stage labour

A

Null: >3 with epidural, 2 without … multi >2 with epidural, 1 without

123
Q

Shoulder dystocia

A

Delivery of head, shoulder get caught

124
Q

Mx of shoulder dystocia

A

Mc Robert’s manoeuvre - hyper flexion and abduction of mothers leg, apply suprapubic pressure .. if not then all fours .. if not interal rotation manoeuvre

125
Q

Mifepristone

A

Progesterone antagonist - blocks the progesterone - cant continue pregnancy there is a pppp in it

126
Q

misoprostol

A

Prostagladin analogue = causes smooth muscle contractions - explusion

127
Q

How long should 3rd stage last

A

30 mins naturally … 5- 10 with oxytocin

128
Q

How do you know 3rd stage is coming

A

Lengthing of the cord, feeling heaviness in vagina, gush of blood, hard uterine

129
Q

Terbutaline

A

Stop contractions, beta 2

130
Q

Most common cephalic presentations

A

Vertex

131
Q

Vasa praevia

A

Foetal vessels run near os

132
Q

1st trimester

A

First day of last periods- 12 weeks

133
Q

2nd trimester

A

13-28 weeks

134
Q

3rd

A

29 - term

135
Q

What issues does this cause in pregnancy

Bromocriptine

A

Suppress lactation

136
Q

What issues does this cause in pregnancy
Benox

A

Drowsiness , poor feeding

137
Q

What issues does this cause in pregnancy
Cytotoxic

A

Bone marrow suppression

138
Q

What issues does this cause in pregnancy

Amiodarone

A

Hypothyroidism

139
Q

What issues does this cause in pregnancy

Phenytoin

A

Cleft lip

140
Q

What issues does this cause in pregnancy

Warfarin

A

Limb and fascia defects

141
Q

What issues does this cause in pregnancy

Retinoids

A

Ear, cv and skeletal defects

142
Q

What issues does this cause in pregnancy

Lithium

A

Cv defects

143
Q

What issues does this cause in pregnancy

Androgens

A

Virislation of female foetus

144
Q

What issues does this cause in pregnancy

Acei /arbs

A

Renal hypoplaia

145
Q

Need to really have what to get a uterine rupture

A

A prior c section

146
Q

Normally what dose to give of folic acid

A

400 micro gram

147
Q

When do you give a higher dose of folic acid ( 5mg)

A

DIABETESSS

148
Q

What Down syndrome test in 1st trimester

A

Combined test :
Free bhcg
Papp a ( pregnancy associated plasma protein )

149
Q

What is nuchal translucency

A

Behind baby neck

150
Q

What test is done in 2nd trimester

A

Quadruple test
- afp
Bhcg
InhibiN a
Unconjugated oestriol

151
Q

If after combined and quadrade - what next?

A

NIPT ( NON INVIATE PRENATAL TESTING)
Placental cell free dna in maternal blood

152
Q

If nipt is positive - what next?

A

Chorionic villus sampling : cvs : 11 - 14 weeks ( sample of placenta)
After 15 weeks - amniocentesis ( sample of amniotic fluid)

153
Q

What do reduced variability on ctg show

A

Sleeping probs but no more than 40 mins

154
Q

What’ does acceleration during contractions mean

A

Healthy foetus

155
Q

what does absent acceleration in a normal ctg mean

A

Unknown sign

156
Q

Early Deceleration ie when the uterine begins to contract and recover once it stops

A

Physiological - due to increase fetal increased icp

157
Q

Variable deceleration - rapid fall for a variable amount of time

A

Umbukical cord compression

158
Q

Late deceleration ie starts at peak of uterine contractions

A

Reduced uteroplacental blood flow

159
Q

Prolonged deceleration : non reassuring

A

More than 2-3 minutes

160
Q

Prolonged deceleration : abnormal

A

3 minute s

161
Q

Sinousidal pattern of ctg

A

Fetal morbidity

162
Q

What is normal baseline variability

A

5-25 bpm

163
Q

Non reassuring baseline variability

A

Less than 5 for 30-50 mins
More than 25 for 15-25

164
Q

Abnormal baseline variability

A

Less than 5 for 50 mins
More than 25 for 25 mins
Sinusoidal

165
Q

What would you see in urine of hyperemesis gravidarum

A

Ketones

166
Q

What does help syndrome msot likely happen

A

Once born

167
Q

Most common lie of twins

A

Longitudinal with vertex presention

168
Q

Is there foetal matter in complete mole

A

No only partial

169
Q

What do you give for a magnesium sulfate overdose

A

Calcium gluconate

170
Q

Treatment of benzo overdose

A

Flumenazil

171
Q

Examples of tocyolti ( stops contractions

A

Nifedipine ( calcium channel blocker)

172
Q

When should induction of labour happen

A

Between 41 - 42 weeks obvvvv after a membrance sweep ( once)

173
Q

Can you do external cepoahtiv versioon during LABOUR

A

Nooo

174
Q

What are diagnostic test of Down syndrome

A

CVS
Amniocentesis

175
Q

What is nuchal testing done

A

11-14 weeks

176
Q

When is double testing for Down syndrome done ( a - Papp) and free bcg

A

10-14

177
Q

When is quadruple testing down
AFP, bhcg, serum oestroil and inhibin A

A

14 -20 WEEKS

178
Q

How is bhcg and a Papp showed in down

A

Increased bhcg
Decreased a Papp

179
Q

How is beta bcg, inhibin a, serum oestriol and afp represent in down

A

Increased bhcg
Increased inhibin
Decreased rest

180
Q

CVS is done when

A

11-14

181
Q

When is amnioncentiss down

A

15 weeks

182
Q

If obese - is nuchal a good test?

A

Nooo

183
Q

What do you do for a pph

A

Uterine massage
2nd line iv syntocinon
3rd line Iv ergometrine

Pregnancy Drugs (2 decks)

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