Reproduction Flashcards
What investigation is UNRELIABLE in pregnancy
D-dimer
What investigations would be used to diagnose a DVT/PE in a pregnant/postnatal woman
- ECG
- Leg Dopplers
- CXR +/- VQ scan or CTPA (CT Pulmonary Angiogram) [radiation risk during pregnancy and breast feeding]
What investigations would you carry out for female infertility
-Rubella immunity
-Chlamydia
-TSH
-Mid luteal progesterone, 7 days prior to expected period (if periods are regular)
-If periods are irregular day 1-5;
FSH
LH
PRL
TSH
Testosterone
-Pelvic ultrasound
-Tubal patency test
What investigations would you carry out for male infertility
Semen analysis
How to diagnose Polycystic Ovary Syndrome (PCOS)
- Testosterone level
- Ultrasound
- Hirsutism (clinical diagnosis)
Investigations for Azoospermia
- Testosterone level
- Karyotype
- PRL (prolactin)
- CF Screen (cystic fibrosis)
- FSH (Follicle-stimulating hormone)(gonadotropin)
- LH (Luteinizing hormone)
What is measured to confirm pregnancy
Beta-human Chorionic Gonadotropin (B-hCG) in urine
Investigations to confirm ectopic pregnancy
- US
- Serum B-hCG levels (may need to serially tack levels
- Serum progesterone levels
What would be seen on an Ultrasound scan of an ectopic pregnancy
- No intrauterine gestational sac
- May see adnexal mass
- Fluid in pouch of Douglas
How to diagnose placenta praevia
US to locate placental site
3 ways of confirming significant proteinuria
- Dipstick test: Urine protein estimation >1
- Spot urinary protein: Creatinine ratio >30 mg/day
- 24hrs urine protein collection >300 mg/day
What investigations would be carried in pre-eclampsia
- Blood investigations: FBC (for haemolysis), LFT’s, Renal function tests (serum urea, creatinine, urate), coagulation test if indicated
- Foetal investigation: Scan for growth + Cardiotocography (CTG)
How to screen for GDM
If risk factors are present
- Offer HbA1c at booking (first antenatal scan)
- If HbA1c >43 mmol/L do OGTT
- If OGTT normal repeat it at 24-28 weeks
-Can also offer a OGTT at 16 and repeat at 28 weeks is significant risk factor present (e.g. previous GDM)
3 investigations for UI
- Urinalysis, Multistix +/- MSSU
- Post voiding residual volume assessment, Only if symptoms of voiding difficulties
- Urodynamic, ONLY if surgical treatment is contemplated
Investigations for primary amenorrhea
- FSH
- LH
- Prolactin (PRL)
- Testosterone and oestrogen
- Pelvic US
