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4th year medicine > RHCN > Flashcards

RHCN Flashcards

1
Q

what are the leading causes of maternal mortality worldwide

A

postpartum haemorrhage syntocinon etc can cause postpartum haemorrhage - pushing out uterus can’t contract afterwards as too tired

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2
Q

what is the most common cause of PPH (post party haemorrhage)

A

uterine atony (uterine failing to contract after delivery 4 T’s - causes of PPH: - tone - atony - trauma - tissue retained - thrombin clotting abnormalities

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3
Q

what is the leading cause of maternal mortality in the uk?

A

cardiac disease

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4
Q

what is the first line medication for an eclamptic seizure

A

first line: IV magnesium sulphate will prevent further seizure activity IV labetalol for managing HTN

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5
Q

risk factors for gestational diabetes

A
  • PCOS (polycystic ovarian syndrome) - BAME ethnicities - older age - high BMI - previous big baby >4kg
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6
Q

what test do pregnant women need when high risk for gestational diabetes

A

GTT between 26 and 28 weeks gestational diabetes diagnosis: - fasting glucose > 5.6 - post sugar > 7.8 refer to gestational diabetes clinic

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7
Q

when choosing VBAC (virginal birth after Caesarean section) what is the risk of uterine rupture in spontaneous labour?

A

1/200 - best chance with spontaneous labour if induced with prostaglandin 1/50

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8
Q

a manoeuvre to aid delivery at shoulder dystocia

A

McRobert’s bed flat and knees up to chest

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9
Q

what is shoulder dystocia

A

anterior shoulder stuck behind pubic symphysis EMERGENCY delivery of head and then with the next push the baby should come out so if it doesn’t = shoulder dystocia

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10
Q

what injury is common with shoulder dystocia

A

brachial plexus injury

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11
Q

risk factors for shoulder dystocia

A
  • macrosomia (big baby) - diabetes -maternal high BMI - previous shoulder dystocia
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12
Q

what is the upper limit of normal for the post-menopausal endometrium?

A

4mm

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13
Q

post manopausal bleeding investigations

A
  • speculum and bimanual examination - transvaginal USS to look at endometrial thickening - normal <4mm if >4mm: - pipette endometrial biopsy/ hysteroscopy
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14
Q

a women presents with with postcoital bleeding and you see a mass on her cervix, what should you do

A

refer for urgent colposcopy

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15
Q

cervical smear

A

for people that are asymptotic screening checks for changes in cells

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16
Q

a 54yr old woman has USS, a complex ovarian cyst is seen, which blood test should be done

A

Ca125 - ovarian cancer USS

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17
Q

complex ovarian cyst in pre-menopausal woman which blood tests?

A

Ca125 AFP hCG CEA

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18
Q

what is recommended to all low risk women planning pregnancy and in the 1st trimester

A

folic acid 400mcg OD

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19
Q

who should get 500mcg folic acid during 1st trimester

A

high risk epilepsy previous fatal anomaly diabetes high BMI

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20
Q

what is the normal scan schedule in a low risk pregnancy

A

12 - dating scan - due date, screening offered here 20 weeks - anatomy scan

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21
Q

what is the scan schedule in a high risk pregnancy

A

12,20, 28, 36

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22
Q

how far away from the internal OS must the placenta be to allow vaginal birth

A

20mm

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23
Q

what is the UK gestational age viability

A

24 weeks

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24
Q

a 14yr old girl attends to ask for the pill, you deem her Fraser competent, what should you do

A

give her the pill, encourage her to discuss with her parents

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25
Q

what is the biggest risk factor for ectopic pregnancy + other risk factors

A
  1. tubal damage (ie from chlamydia) - endometriosis - previous surgery - conceiving while on the pill
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26
Q

a woman presents to the GP with shortness of breath 5 days post emergency CS, what should you do?

A

refer to hospital for investigation of PE commence LMWH if +ve

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27
Q

when is anti D prophylaxis required?

A

Rh -ve mother Rh +ve predicted fetus prophylaxis dose at 28 weeks then after delivery and at any desensitising events (eg bleed) Rh status checked at 16 weeks

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28
Q

what is a contraindication to fetal blood sampling

A

any maternal blood borne infection e.g.maternal HIV baby with predicted abnormal clotting mother been warfarinised (crosses placenta)

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29
Q

fatal blood sampling

A

look at pH of blood to see if baby is getting enough O2 to continue with labour need to be at least 3 cm dilated don’t do if under 36 weeks gestation

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30
Q

potential causes of polyhydramnios

A

too much fluid around baby - weeing too much or can’t wee it out - check for diabetes - check if they’ve had contact for acute CMV in pregnancy (cytomegalovirus) - foetal medicine to check for abnormalities

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31
Q

what is a normal FBS result?

A

pH > 7.25 if <7.20 - deliver within 30 mins 7.20 - 7.25: boarderline- repeat in 1hr

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32
Q

the different category Caesarean sections and how quickly they need to be carried out

A

cat 4: elective cat 3: no time limit but e.g.if they spontaneously rupture & so have to move elective CS forward cat 2: concern but not life threatening:<75mins cat 1: <30mins

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33
Q

what is the name for forceps

A

Keillands: rotational wrigleys: small Andersons and neville barnes: direct traction, straight delivery

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34
Q

a post menopausal woman has a multilocular ovarian cyst, her Ca125 is 100 what is the RMI (risk of malignancy index)?

A

RMI = Ca125 x ultrasound score x menopause status (RMI = Ca125 x U x M) ultrasound features: 1 point for: - multilocular cyst - solid areas - metasteses - ascites - bilateral lesions 0 points = U0 1 point = U1 2-5 points = U3 menopausal status: pre-menopausal = M1 post menopausal = M3 menopausal: woman with no period for 1yr or >50 with hysterectomy for this example: RMI = 100 x 1 x 3 = 300

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35
Q

which are the high risk strains of HPV

A

16 & 18

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36
Q

which surgical procedure should be performed for stage 1a endometrial cancer

A

1a: confined to the uterus total laparoscopic hysterectomy

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37
Q

how many sets of chromosomes are in a partial molar pregnancy

A

3 (69 total) two paternal + egg (3 sets)

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38
Q

molar/ partial molar pregnancy

A

abnormal pregnancy - molar and partial molar potential to cause malignancy - gestational trophoblastic disease

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39
Q

how many sets of chromosomes are in a molar pregnancy

A

2 (46) no maternal + 2 paternal

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40
Q

management for a partial/ molar pregnancy

A

evacuation of pregnancy and refer mother to specialist to get hCG to normalise

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41
Q

what is the most common site for an ectopic pregnancy

A

ampulla of the Fallopian tube (main length) - due to damage of cilia from things like chlamydia

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42
Q

what classifies as HTN in pregnancy?

A

two episodes >20mins apart > 140/90 beyond 20th week of pregnancy severe HTN: >160/100 without proteinuria: pregnancy induced HTN with proteinuria: pre-eclampsia

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43
Q

most common cause of post-menopausal bleeding

A

atrophic vaginitis endometrial atrophy

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44
Q

chocolate cyst diagnosis?

A

endometriosis

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45
Q

investigations and management for endometriosis

A

investigations: - pelvic examination - transvaginal USS if persistent/ pelvic signs - serum Ca125 - MRI for assessing other organ damage - diagnostic LAPAROSCOPY management: - first line= analgesia - NSAIDs & PARACETAMOL - COCP - IUS - mirena - excision or ablation - hysterectomy

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46
Q

endometriosis presentation

A

chronic pelvic pain - period related pain - deep pain during or after sexual intercourse - painful bowel movements - urinary symptoms

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47
Q

20yrs contraceptive advice UPSI four days ago most appropriate method of contraception

A

copper-containing intrauterine device acts as emergency contraception for up to 5 days after UPSI

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48
Q

movement of the fatal head from occipital-transverse to occipital-anterior position during labour. what is the most appropriate term for this

A

internal rotation the occiput leads and meets the pelvic floor first and rotates anteriorly 1/8th of the circle to come under the pubic symphysis. the anteroposterior diameter of the head now lies in the anteroposterior diameter of the pelvic outlet

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49
Q

newborn baby weight 3.8kg not moving left arm after difficult forceps delivery left arm is floppy, reflexes absent, hand in backward position. right arm moves normally which anatomical structure is most likely to have been damaged?

A

brachial plexus complete brachial plexus palsy: lies with arm held limp at side deep tendon reflexes in affected arm absent moro response is asymmetrical no active abduction of ipsilateral arm

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50
Q

48yrs regular periods till 45y now more frequent, bleeding twice a month and heavier. sweating, severe hot flushes, decreased libido single best management choice

A

take endometrial biopsy histological diagnosis in patients > 45yrs

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51
Q

descent of labour

A

due to forceful uterine contraction and retraction, rupture of membranes, complete cervical dilatation and maternal efforts

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52
Q

flexion of labour

A

flexion increased throughout labour. when head meets resistance of pelvic floor flexion is increased. this decreases the presenting diameter to a smaller diameter (9.5cm). the occiput becomes the leading part

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53
Q

mechanism of labour order

A
  • flexion - internal rotation of head - crowning - extension of head - restitution
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54
Q

crowning in labour

A
  • occiput slips beneath the subpubic arch - crowning occurs when the head no longer recedes back btwn contractions - widest transverse diameter (biparietal) is born
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55
Q

extension of head in labour

A

fatal head pivots around the pubic bone while the sinciput, face and chin sweep the perineum and head is born by the movement of extension

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56
Q

restitution in labour

A

the twist in the neck of the foetus that resulted from internal rotation is now corrected by a slight untwisting movement. the occiput moves 1/8th of a circle towards the side from which it started

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57
Q

antiphospholipid syndrome =

A

recurrent miscarriages + thrombocytopenia can be secondary to SLE

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58
Q

antiphospholipid syndrome ix

A

increased APTT antiphospholipid antibodies: anti-cardiolipin lupus anticoagulant antibodies

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59
Q

antiphospholipid mx in pregnancy

A

aspirin (after confirmation on urine testing) + LMWH (after seen on USS) during pregnancy for preventing arterial and venous thromboembolisms

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60
Q

why is warfarin teratogenic

A

crosses placenta

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61
Q

risk factors for endometrial cancer

A

obesity nulliparity early menarche late menopause unopposed oestrogen diabetes mellitus tamoxifen polycystic ovarian syndrome HNPCC

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62
Q

risks of COCP

A

heart attack stroke breast cancer cervical cancer

63
Q

ix for polycystic ovarian syndrome

A

pelvic USS

check for impaired glucose tolerance

hyperinsulinaemia

high LH (high LH:FSH ratio)

64
Q

endometriosis features

A

chronic pelvic pain dysmenorrhoea dyspeunia subfertility urinary symptoms and painful bowel movements

65
Q

gold standard ix for endometriosis

A

laparoscopy

66
Q

most common organism for pelvic inflammatory disease

A

chlamydia trachomatis

67
Q

features of PID

A

lower abdo pain fever deep dyspareunia dysuria menstrual irregularities vaginal or cervical discharge cervical excitation

68
Q

ix for PID

A

exclude ectopic pregnancy screen for chlamydia and gonorrhoea high vaginal swab

69
Q

mx for PID

A

abx oral ofloxacin + oral metronidazole or IM ceftriaxone + oral doxy + oral metronidazole

70
Q

complications of PID

A

perihepatitis (Fitz-Hugh Curtis syndrome) - RUQ pain infertility chronic pelvic pain ectopic pregnancy

71
Q

risk factors for ovarian cancer

A

BRCA1 or BRCA2 mutations early menarche late menopause nulliparity

72
Q

ix for ovarian cancer

A

CA125 USS diagnosis: laparotomy

73
Q

bHCG >1,500

A

points towards ectopic pregnancy

74
Q

risk factors for cervical cancer

A

HPV 16,18, 33 smoking HIV early first intercourse many sexual partners high parity lower socioeconomic status COCP

75
Q

drugs to avoid during breast feeding

A
76
Q

placenta accreta

A

attachment of placenta to the myometrium

as the placenta does not properly separate during labour there is a risk of post partum haemorrhage

risk factors:

previous caesarean section

placenta praevia

77
Q

HPV screening

A

tested for HrHPV

  • negative = return to normal recall
  • positive = cytology

cytology abnormal = colposcopy

cytology normal = test repeated at 12 months

if repeat test -ve = return to normal recall

if repeat test hrHPV still +ve and cytology normal = further repeat in 12 months

if hrHPV -ve at 24months = return to normal recall

if hrHPV +ve at 24 months = colposcopy

if cytology sample inadequate = repeat within 3 months

if two consecutive inadequate samples = colposcopy

78
Q

how often do you get the injectable contraceptive (depo provera)

A

every 12 weeks

79
Q

contraindication of injectable contraceptives

A

breast cancer

80
Q

< 40yrs

secondary ammenorrhoea

raised FSH, LH

infertility

hot flushes, night sweats

A

premature ovarian failure

  • simialr to normal menopause symptoms but in earlier age
81
Q

mode of action of contraceptive

A
82
Q

which contraceptive can be relied upon immediately

A

copper coil

all others take 7 days to be relied upon

83
Q

teenage girl

primary amenorrhoea

undescended testes causing groin swelling

breast development

diagnosis

A

androgen insensitivity syndrome

x-linked recessive

resistance to testosterone causing genotypically male children (46XY) to have a female phenotype

84
Q

how long does the progesterone only pill take to become effective

A

after 2 days

if commenced on or before day 5 of cycle it provides immediate protection

85
Q

missed pill >3hrs for POP

A

if > 3hrs late: take missed pill as soon as possible, continue with rest of pack, extra precautions for 48hrs

86
Q
A
87
Q

booking visit and bookking bloods when?

A

8-12 weeks (ideally <10)

88
Q

anomaly scan time

A

18-20+6 weeks

89
Q

first dose of anti-D prophylaxis to rhesus neg women

A

28 weeks

90
Q

dating scan

A

10-13+6 week

91
Q

10 weeks pregnant

vaginal bleeding

USS - snowstorm appearance, no fetus

B-hCG markedly elevated

A

hydatidiform mole

  • happens when sperm fertilises empty egg so doubles its own DNA
  • usually bleeding if first or early second trimester
  • exaggerated symptoms of pregnancy

high hCG

92
Q

pregnant

vaginal bleeding but haemodynamically stable

A

placenta praevia

= low lying placenta

usually picked up on 20wk abdo USS

do transvaginal USS to locate placenta

risk factors:

multiple pregnancies

previous caesarian

93
Q

hydatidiform mole mx

A

urgent referral for evacuation of uterus

contraception to avoid pregnancy in next 12 months

risk of choriocarcinoma (cancer of uterus)

94
Q

partial hydatidiform mole

A

normal haploid egg may be fertilised by two sperms or by one sperm with duplication of paternal chromosomes e.g. 69XXX or 69XXY

95
Q

complete vs partial hydatidiform mole

A

complete: 46 2 paternal
partial: 69 XXX or XXY (2 paternal, 1 maternal)

fetal parts may be seen

96
Q

down syndrome screening including nuchal scan

A

11-13+6 weeks (one week after dating scan)

97
Q

early pregnancy ovarian cyst

A

usually physiological - corpus luteum - usually resolve from second trimester

98
Q

first line mx for eclampsia

A

magnesium sulphate

  • for preventing seizures in severe pre eclampsia and stopping them once developed

given once a decision to deliver has been made

should be continued 24hrs after last seizure or delivery

99
Q

first line mx for magnesium sulphate induced respiratory depression

A

calcium gluconate

magnesium sulphate given for eclampsia

100
Q

what weeks for antenal

first blood tests

urine culture to detect asymptomatic bacteriuria

booking visit

A

8-12 weeks

101
Q

at how many weeks do you offer external cephalic version (to turn baby in to cephalic lie)

A

36 wks

102
Q

pre-eclampsia presentation

A

after 20wks

pregnancy induced HTN

proteinuria (>0.3g/24hrs)

features of severe pre-eclampsia:

  • HTN >170/110

proteiunuria ++/+++

headache

visual disturbance

papilloedema

RUQ/ epigastric pain

hyperreflexia

platelet count low

103
Q

mx of pre-eclampsia

A

women at moderate/ high risk of pre-eclampsia = aspirin 75mg from 12 weeks until birth

treat BP >160/110 = oral labetalol

delivery of baby

104
Q

risk factors for pre-eclampsia

A
105
Q

36 wks pregnant

vaginal bleeding

shock out of keeping with visible loss

pain constant

tender, tense uterus

normal lie and presentation

fetal heart absent/ distressed

A

placental abruption

maternal haemorrhage

vaginal bleeding but shock out of keeping with visible loss

106
Q

anti D propylaxis dates

A

anti D given to rhesus negative women

28 weeks

34 weeks

107
Q

baby born with:

blunted upper incisor teeth

keratitis

saber shins

saddle nose

deafness

A

congenital syphilis

108
Q

baby born with

sensorineural deafness

congenital cataracts

patent ductus arteriosus

purpuric skin lesions

‘salt and pepper’ chorioretinitis

A

congenital rubella syndrome

classic triad of:

  • cataract
  • cardiac abnormalities - PDA
  • deafness

purpuric skin lesions

‘salt and pepper’ chorioretinitis - on fundoscopy - grainy appearance

caused by togavirus

109
Q

mx of rubella in pregnancy

A

Igm raised

should also be checked for parovirus B19

suspected cases discussed with local health protection unit

non-immune mothers should be offered MMR vaccination in post-natal period - should not be administered to women known to be pregnant or attempting to become pregnant

110
Q

what type of contraceptive is nexplanon

A

implant

111
Q

safest form of contraception for suspected/ personal hx of breast cancer or confirmed BRCA mutation

A

copper coil - category 1 on UKMEC

COCP is 3 - shouldnt be given

all others are 2

copper coil can also be given in current or past breast cancer but is the only one

112
Q

UK Medical Eligibility Criteria for Contraceptive Use (UKMEC)

A

contraception should only be offered in primary care if it is considered category 1 or 2

113
Q

routine recall for cervical smear

A

25-49: every 3yrs

50+: every 5yrs

114
Q

tearing pelvic pain

vaginal bledding

haemodynamically unstable

A

ectopic pregnancy

USS shows no intra uterine pregnancy but bHCG is elevated

115
Q

RUQ pain

fever

white vaginal discharge

pelvic pain and dyspareunia

A

pelvic inflammatory disease

RUQ pain –> Fitz Hugh Curtis syndrome - perihepatic inflammation occurs

116
Q

usually mid cycle mild supra pubic pain

sharp onset

no systemic disturbance

A

Mittelschmerz

mid cycle pain due to small amount of fluid released during ovulation

inflammatory markers normal

FBC normal

USS - small quantity free fluid

usually subsides over 24-48hrs

117
Q

sudden onset deep seated colicky abdo pain

vomiting and distress

vaginal examination - adnexial tenderness

A

ovarian torsion

  • laparoscopy
118
Q
A
119
Q

mx for ectopic

A

laparoscopy or laparotomy if haemodynamically unstable

salphingectomy is usually performed

120
Q

anti D should be given immediately in which scenarios

A

delivery of a Rh +ve infant, whether live or stillborn

any termination of pregnancy

miscarriage if gestation is > 12 weeks

ectopic pregnancy (if managed surgically, if managed medically with methotrexate anti-D is not required)

external cephalic version

antepartum haemorrhage

amniocentesis, chorionic villus sampling, fetal blood sampling

abdominal trauma

121
Q

mx for the affected foetus from rhesus neg mother

A

transfusions and UV phototherapy

can result in hydrops fetalis

122
Q

coombs test: direct vs indirect

A

Direct Coombs: Is a investigation used to look for autoimmune haemolytic anaemia

Indirect: Used antenatally to detect antibodies in the maternal blood that can cross the placenta and result in haemolytic disease of the newborn.

123
Q

pregnant woman in third trimester

pruritis in soles of hands and feet

deranged LFTs

A

obstetric cholestasis

pruritis

raised bilirubin

124
Q

first line medical mx for obstetric cholestasis

A

ursodeoxycholic acid

increased risk of still birth - induction of labour at 37-38wks

125
Q

at what stage do most people present with endometrial cancer - mx

A

most people present in stage 1

treated with hysterectomy + bilateral salpingo- oophorectomy

126
Q

rupture of membranes followed by painless vaginal bleeding

fetal bradycardia

A

vasa praevia

classic triad

significant risk to fetus but no risk to mother

127
Q

types of spontaneous abortion

A

threatened miscarriage: painless vaginal bleeding typically around 6-9 wks

missed (delayed) miscarriage: light vaginal bleeding and symptoms of pregnancy disappear

inevitable misscarriage: complete or incomplete

complete: all fetal and placental tissue expelled : little bleeding
incomplete: not all tissue expelled: heacy bleeing and crampy lower abdo pain

128
Q

cardiotocography normal fetal heart rate

A

100-160

bradycardia: <100
tachycardia: > 160

129
Q

decelerations in tocography

A

a single prolonged deceleration lasting 3 mins or more is abnormal

early decelerations: deceleration of heart rate which commences with contraction and returns to normal on completion of contraction

  • head compression

late decelerations: lags behind onset of contraction

  • fetal distress e.g. asphyxia or placental insufficiency

variable decelerations: independent of contractions

  • cord compression
130
Q

normal features of cardiotocography

A

100-160 beats/min heart rate

baseline variability of 5 or more beats/min

fetal heart rate accelerations

131
Q

need for contraception after menopause

A

contraception after menopause:

>50: 12months after last period

<50: 24months after last period

132
Q

why is the injectable contraceptive not advised in high BMI women

A

causes weight gain

133
Q

contraceptive of choice for patient on epilepsy drug (carbamazepine)

A

copper coil - prefered (only one for lamotrigine)

progesterone injection

mirena intrauterine system

if taking others then they need to also use barrier protection - COCP and POP is UKMEC 3 so not recommended

134
Q

down’s antenatal screening

A

nuchal translucency - thickened

+ bHCG - increased

+ pregnancy associated plasma protein A (PAPP-A) - decreased

can also assess for edwards and pataus - PAPP-A lower

135
Q

taking COCP

post-coital bleeding

cervical smear negative

A

cervical ectropion

  • elevated oestrogen levels leads to larger transformation zone on cervix –> post coital bleeding and vaginal discharge
136
Q

breast lump after recent cessation from breast feeding

painless

no systemic symptoms

A

galactocele

can be differentiated from breast abscess with hx and ex so no further investigation necessary

  • breast abscess more likely painful, fever
137
Q

medical mx of ectopic pregnancy

A

methotrexate

for unruptured ectopic with no significant pain

138
Q

expectant mx for ectopic pregnancy when?

A

if <35mm

unruptured

asymptomatic

no fetal heart beat

serum bHCG < 1000

139
Q

visible fetal heart beat on ectopic pregnancy - mx

A

surgical mx

  • salpingectomy (tubes removed) or salpingotomy (tubes preserved)
140
Q

ix of choice for ectopic

A
141
Q

cervical screening programme for HIV positive women

A

offered cytology at diagnosis

then offered cervical cytology annually

at increased risk of cervical cancer

142
Q

first line mx for menorrhagia

A

requires contraception: intra-uterine system (mirena)

does not require contraception: tranexamic acid or NSAIDs (e.g mefenamic acid)

143
Q

most common cause of early onset infection of baby in neonatal period

A

group B streptococcus

risk factors:

prematurity

prolonged rupture of the membranes

previous sibling GBS infection

maternal pyrexia e.g. secondary to chorioamnionitis

144
Q

mx of GBS +ve mother during pregnancy

A

women with GBS detected in previous pregnancy:

  • intrapartum antibiotic prophylaxis (IAP) or testing in late pregnancy and then abx if still +ve

previous baby with early or late onset GBS disease: IAP

preterm labour regardless of GBS status: IAP

women with pyrexia during labour (>38) = IAP

IAP = benzylpenicillin

145
Q

chickenpox exposure in pregnancy >20 wks (if not immune)

A

antivirals (acyclovir) of VZIG (varicella zoster immunoglobulins IM) given at days 7-14 post-exposure, not immediately

if theyre not sure if theyre immune (had it before): urgent bloods for varicella antibodies - if -ve then not immune

146
Q

chicken pox exposure in pregnancy <20 weeks

A

varicella zoster immunoglobulin ASAP

effective up to 10 days post exposure

147
Q

mx chickenpox in pregnancy

A

if presenting within 24hrs and >20 wks = oral acyclovir

if <20 weeks should be considered with caution

148
Q

medical mx to shrink fibroid size

A

GnRH agonists

  • short term shrinkage

eg before sugery

149
Q

mx for large fibroids causing problems with fertility and woman wishes to conceive in future

A

myomectomy

150
Q

bladder still palpable after urination

A

retention with urinary overflow incontinence

151
Q

mx of PCOS symptoms

A

weight loss + smoking cessation - first line

contraception: COCP
hirsutism: COCP
infertility: clomifene or metformin

152
Q

appropriate next step for postmenopausal women with ovarian cyst

A

referred to gynae for assessment regardless of nature or size - less likely physiological

153
Q

next step of ovarian cyst in premenopausal women

A

if simple small (<5cm) cyst on USS: repeat USS in 8-12 wks and referral considered if it persists

154
Q

stages of labour

A

stage 1: from the onset of true labour to when the cervix is fully dilated

latent phase: 0-3cm

active phase 3-10cm

stage 2: from full dilation to delivery of the fetus

stage 3: from delivery of fetus to when the placenta and membranes have been completely delivered

false labour: in last 4 weeks of pregnancy. contractions in lower abdo, irregular, no cervical changes

4th year medicine (8 decks)

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