Random 4 Flashcards
What are the reasons that a woman may need to be induced?
Post dates (induce at 41-42 weeks)
PROM
Diabetes
Pre-eclampsia
Induction should also be offered to all women who fail to go into labour after 24h of spontaneous rupture of membranes
How does pubic symphisis pain present?
What is the treatment?
May radiate to groin and medial thighs
Worse standing on one leg
Worse abducting hips
Pillow between legs at night
Physiotherapy assessment
Abdominal and pelvic floor exercises
Paracetamol
What are the effects of pregnancy on pre-existing diabetes?
Increased insulin requirement
Acceleration of retinopathy
Deterioration in renal function if pre-existing nephropathy
When does gestational diabetes impact pregnancy?
second trimester
Outline the formation of DCDA, MCDA, and MCMA twins?
Dizygotic = DCDA Monozygotic: Division 0-3 days = DCDA Division 4-8 days = MCDA Division 8-13 days = MCMA
On an ultrasound, how would you tell the difference between DCDA and MCDA twins?
DCDA = lamda sign MCDA = T sign
What are the principles of antenatal care in twins?
When do you give aspirin to a mother pregnant with twins?
5mg folic acid and iron
75mg aspirin for high risk women
Extra growth scans
First pregnancy
Age >40
BMI >35
Hx of HTN or pre-eclampsia
In monochorionic twins, how often do you ultrasound? When do you plan the delivery?
Ultrasound for TTTS every 2 weeks from 16-24 weeks
MCDA: deliver at 36 weeks
MCMA: deliver at 33 weeks C-section
If there are monochorionic twins with TTTS, what changes may be seen in the recipient and donor twins?
Recipient: polycythaemia, hypertensive, polyhydramnios, cardiac hypertrophy
Donor: anaemic, hypotensive, oligohydramnios, growth restriction
what are the reasons for a SGA baby?
wrong dates chromosomal abnormality genetic/constitutional smoking pre-eclampsia
what are the complications of IUGR?
perinatal mortality
neonatal hypoglycaemia
preterm birth
birth asphyxia
from the saving babies lives campaign (2016), what is the management depending on the classes ‘low risk’ and ‘high risk’?
low risk = measure SFH
high risk = serial USS and umbilical doppler in third trimester
what are the high risk pregnancies for IUGR?
'SHITS' Smoking Hypertension/pre eclampsia IUGR previously Twins Stillbirth previously
Outline when maternal steroids are indicated and what types are offered?
Indicated: PROM, spontaneous pre-term labour, planned pre-term birth
Single course of two IM injections of betamethasone or dexamethasone 12mg 12-24 hours apart, (26-34 weeks)
Used when delivery is expected in the next 48 hours
In major placenta praevias, when should you deliver?
Delivery by caesarean section at 39 weeks
