Repro - abnormal labour and neonatal complications

Question 1

what is a normal blood loss during pregnancy? what is an abnormal blood loss

Answer 1

normal <500mls

abnormal >500mls

Question 2

whats foetal malpresentation

Answer 2

This is any presentation of the foetus other than vertex

Question 3

what is defined as a delay in labour

Answer 3

<2cm in 4hrs

Question 4

what is defined as a delay in the 2nd stage of labour

Answer 4

first child >3hrs with analgesia, >2hrs without

not first >2hrs with analgesia, >1hr without

Question 5

what is defined as a delay during the 3rd stage of labour

Answer 5

Not completed the birth within 30mins of active management OR not completed the birth within 60 minutes of physiological management

Question 6

what is the cause of failure to progress in labour (3P’s)

Answer 6

Power - inadequate contractions

Passage = obstruction, trauma, shape, size

Passenger = size and position of baby

Question 7

what are the symptoms of failure to progress in labour caused by obstruction

Answer 7

moulding
caput
anuria
haematuria
vulval oedema

Question 8

what is the investigation of failure to progress

Answer 8

partogram

Question 9

what is a neonate

Answer 9

baby from 0-28 days

Question 10

what are the 3 shunts present in the foetal circulation? what happens to them after birth?

Answer 10

ductus venosus = ligamentum teres
foramen ovale = closes
ductus arteriosus = ligamentous arteriosus

Question 11

what is defined as physiological jaundice in neonates

Answer 11

jaundice <24hrs

Question 12

what is defined as a preterm infant

Answer 12

> 37wks gestation

Question 13

what is defined as a post-term infant

Answer 13

> 41wks gestation

Question 14

what is a normal weight for an infant

Answer 14

2.5-4kg

Question 15

what is jejunal atresia

Answer 15

“dead end” in the bowel that can occur at ANY point in the digestive tract

Question 16

what is the cause of jejunal atresia

Answer 16

genetic disorders

Question 17

what are the symptoms of jejunal atresia

Answer 17

vomits “green” within hrs of first feed
hasn’t passed stool
abdomen feels full

Question 18

what are the investigations of jejunal atresia

Answer 18

abdominal x-ray +/- contrast

Question 19

what is the treatment of jejunal atresia

Answer 19

laparotomy +/- temporary stoma

Question 20

what is malrotation

Answer 20

malposition of the owl which may result in abnormal twisting leading to an obstruction

Question 21

what are the symptoms of malrotation

Answer 21

vomits green

symptomatic at about 1 month

Question 22

what is the investigation of malrotation

Answer 22

upper GI contrast

Question 23

what is the treatment of malrotation

Answer 23

surgery (division of LADs bands)

Question 24

what is meconium ileus

Answer 24

type of intra-luminal bowel obstruction in the small intestine

Question 25

what is the cause of meconium ileus

Answer 25

cystic fibrosis

Question 26

what are the symptoms of meconium ileus

Answer 26

vomiting up feed and “green” after a few days
distended abdomen
never passed stool

Question 27

what is the investigation of meconium ileus

Answer 27

abdominal X-ray

Question 28

what is the treatment of meconium ileus

Answer 28

laparotomy +/- temporary stoma

Question 29

what is necrotising enterocolitis

Answer 29

portion of the bowel perforates or dies

Question 30

who is commonly affected by necrotising enterocolitis

Answer 30

premature neonates

Question 31

what is the investigation of necrotising enterocolitis

Answer 31

abdominal X-ray

Question 32

what is an inguinal hernia

Answer 32

bowel protruding through a weak spot in the abdominal muscles, commonly the inguinal canal

Question 33

what are the symptoms of necrotising enterocolitis

Answer 33

groin swelling that may extend into the scrotum

asymmetrical thigh creases