quesmed obs Flashcards
mx for maternal GBS colonisation
IV intrapartum abx
what immunoglobulin is given to baby if mum gets hep B
igG
when is aspirin given in pre eclampsia
from 12 weeks to term
how does
what class of antibody is synthesised in rhesus sensitisation
IgG
when are anti d prophylactic injections given
one dose at 28-30 weeks
or 2 doses and 28 and 34 weeks
when is early scan for dates and mx pregnancies performed
11-14 weeks
what is given in PPROM
streroids
IM betamethasone 2x 12 hrs apart
for foetal lung maturity as they are likely to deliver preterm
how to differentiate placenta praevia from vasa praevia
in vasa praevia there will be membrane rupture and foetal distress alongside bleeding
in placenta praevia there will not
preterm labour is defined as
before 37 weeks
preterm labour mx
steroids and tocolytics
examples of tocolytics
terbutaline
nifedipine
pregnancy and chickenpox rules
check antibodies
if not present and over 20 weeks GA, give oral aciclovir 7-14 days after exposure
postpartum depression first line mx
guided self help
CBT
post partum tears
1st degree
2nd degree
3rd degree A/B/C
4th degree
1st degree= perineal skin and vaginal mucosa
2nd degree= perineal muscle but no sphincter involvement
3rd degree
A= <50% external anal sphincter
B= >50% external anal sphincter
C= internal anal sphincter
4th degree= anal mucosa
what complication occurs during controlled cord traction
uterine inversion
how is uterine inversion managed
first try to push the fundus back into the abdomen
laparotomy if conservative mx fails
what abx is used in PPROM
erythromycin or clarithromycin
indications for surgical mx of ectopic
- significant pain
- bHCG >5000
- mass >35 mm
- foetal heartbeat visible
- haemodynamic instability
- unable to attend follow up
obstetric cholestasis mx
cholestyramine and emollient creams
ursodeoxycholic acid is no longer routinely given
postpartum haemorrhage mx
- uterine massage
- oxytocin/ syntocinon etc
- balloon tamponade
- b lynch suture
- uterine artery embolisation
- hysterectomy
weight loss in hyperemesis gravidarum
> 5% pre pregnancy weight despite anti emetics
what do you see in urine in hyperemesis gravidarum
ketones
first stage of labour latent vs active phase
latent <3cm
active 3-10cm
how does maternal diabetes affect the amniotic fluid
cause polyhydramnios because of foetal hyperglycaemia and therefore polyuria
when is folic acid taken during pregnancy
3 months before conception
12 weeks into pregnancy
indications for high dose folic acid
previous pregnancy with NTD
family hx of NTD
diabetes
epilepsy
BMI >30
poor intake or absorption eg veggie/vegan/IBD/coeliacs
what does the quadruple screening test look for
only downs syndrome
when is the quadruple test done
15-20 weeks
what does the combined screening test look for
downs, edwards and pataus syndrome
when is the combined screening test done
10-14 weeks
what is cell free foetal DNA test used for
for screening for downs syndrome
how is proteinuria quantified in pre eclampsia and what is a significant resulr
urine protein:creatinine
>30 is significant
complete vs frank breech
frank= legs extended
complete= legs flexed
in hyperemesis gravidarum what vitamin is given alongside treatment
thiamine
what is done when amniotic fluid embolism is suspected
oxygenate mother and call anaesthetist
what is used first to confirm foetal heartbeat
handheld doppler
if bishop score is above 6 how is labour induced
amniotomy
IV oxytocin
