Risk factors Flashcards
RFs for placenta praaevia
Previous caesarean-section: causes uterine scarring, resulting in an adherent placenta
Increasing parity
Multiple pregnancy
Increasing maternal age
Smoking
Previous miscarriage
Previous abortion
RFs for vasa praaevia
Low lying placenta
IVF pregnancy
Multiple pregnancy
placenta accreta RFs
Previous placenta accreta
Previous endometrial curettage procedures (e.g. for miscarriage or abortion)
Previous caesarean section
Multiparity
Increased maternal age
Low-lying placenta or placenta praevia
Uterine structural abnormality
placental abruption RFs
Previous placental abruption
Pre-eclampsia or HTN
Bleeding early in pregnancy
Trauma (consider domestic violence)
Multiple pregnancy
Foetal growth restriction
Multigravida
Increased maternal age
Smoking
Placenta praevia.
Cocaine or amphetamine use
Polyhydramnios multihydamnios
pre-eclampsia RFs
Moderate risk factors:
≥ 40 years of age
First pregnancy
Pregnancy interval > 10 years
BMI ≥ 35
Family history of pre-eclampsia
Multiple pregnancies
High risk factors:
Chronichypertension
Chronic kidney disease
Hypertensionduring a previous pregnancy
Type 1 or2 diabetes
Autoimmune disease: such assystemic lupus erythematosusor antiphospholipid syndrome
cord prolapse RF
Premature rupture membranes
Polyhydramnios(i.e. a large volume of amnioticfluid)
Long umbilical cord
Foetalmalpresentation(e.g. if baby’s head notdown)
Multiparity
Multiple pregnancy
shoulder dystocia RF
Macrosomia(most cases occur in normally grown babies)
Maternal diabetes
Previous shoulder dystocia
Disproportion between mother andfetus
Postmaturityand induction of labour
Maternal obesity
Prolonged 1stor 2ndstage of labour
Instrumental delivery
PPH RF
Previous PPH
Multiple pregnancy
Obesity
Large baby
Failure to progress in the second stage of labour
Prolonged third stage
Pre-eclampsia
Placenta accreta
Retained placenta
Instrumental delivery
General anaesthesia
Episiotomy or perineal tear
VTE RF
Smoking
Parity ≥ 3
Age > 35 years
BMI > 30
Reduced mobility
Multiple pregnancy
Pre-eclampsia
Gross varicose veins
Immobility
Family history of VTE
Thrombophilia
IVF pregnancy
uterine rupture RF
Hx of C-section OR uterine surgery scar rupture
Previous uterine rupture
VBAC
High BMI
High parity
Induction of labour with oxytocin
↑ age
ectopic pregnancy RF
Pelvic inflammatory disease
Prior ectopic pregnancies
IVF
In situ intrauterine device.
Endometriosis – scarring + adhesion
Smoking
POP or implant due to fallopian tube ciliary dysmotility
Genital infection e.g. gonorrhoea
Older maternal age >35
miscarriage RFs
↑ maternal age >35.
↑ paternal age >45
Previous miscarriage. Significantly ↑ risk after 3 consecutive miscarriages.
Lifestyle: smoking, alcohol and recreational drug use during pregnancy
Previous gynaecological surgery
antiphospholipid syndrome andSLE
Uncontrolled DM or thyroid disorders
molar pregnancy RFs
Extremes of reproductive age : < 16 years or > 45 years
Prior gestational trophoblastic disorder
Family history
ovarian torsion RFs
women of reproductive age
ovarian cysts
PID RFs
Not using barrier contraception
Multiple sexual partners or new partner
Younger age
Existing sexually transmitted infections
Previous pelvic inflammatory disease
Intrauterine device (e.g. copper coil).
Recent instrumentation of the uterus [e.g. TOP, IVF]
Endometriosis RFs
Family hx, early menarche, late menopause, nulliparity, smoking.
low BMI white ethnicity
fibroid RFs
family hx
black ethnicity
obesity
early puberty
nulliparity
lichen sclerosis RFs
other autoimmune conditions
T1DM
alopecia
vitiligo
hypothyroidism etc
atrophic vaginitis RFs
Menopause
Ovariectomy
Anti-oestrogen medication:tamoxifen, aromatase inhibitors
Postpartum +/- breastfeeding
chemo/radiotherapy.
BV RFs
Multiple sexual partners (although it is not sexually transmitted)
Excessive vaginal cleaning (douching, use of cleaning products and vaginal washes)
Recent antibiotics
hormonal changes such as those that happen in pregnancy.
Smoking
Copper coil
PCOS RFs
Family history of PCOS
Obesity
Insulin resistance
STI RFs
<25 yrs
Unprotected sex/contact with genital fluid:
oral, vaginal, anal
Multiple partners
Sharing unwashed sex toys
Social deprivation
RFs / methods of transmission of syphilis
Oral, vaginal or anal sex via direct contact with an infected ulcer. Can penetrate skin or mucous memb.
Vertical transmission via placenta foetal or congenital infection
IVDU
Blood transfusions or other transplants
ovarian cancer RFs and protective factors
Advanced age
Smoking
Increased number of ovulations (early menarche, late menopause, no preggos)
Obesity
Hormone replacement therapy (HRT)
BRCA1 and BRCA2 genes (consider the family history)
Recurrent use of clomifene
Protective factors
Pregnancy
Breastfeeding
COCP uses
endometrial cancer RFs and protective factors
Exposure to unopposed oestrogen is the main RF, which can manifest via:
Nulliparity or fewer pregnancies
Early menarche or late menopause
Oestrogen-only HRT
Tamoxifen – anti oestrogen in breast but oestrogenic in endometrium
Obesity – aromatase converts androgens –> oestro.
PCOS [lack of ovulation + corpus luteum –> chronic oestrogen exposure]
↑ age, T2DM, HNPCC, Lynch syndrome [unrelated to oestrogen.]
Protective factors: COCP, smoking, Mirena coil, many pregnancies.
cervical cancer Rfs
Increased risk of catching HPV:
Early sexual activity
Increased number of sexual partners
Sexual partners who have had more partners
Not using condoms
Later detection of precancerous and cancerous changes (non-engagement with screening)
Other risk factors:
Smoking
HIV
COCP use for >5 years [↓ risk of endometrial + ovarian cancer]
Family history
↑ number of full-term pregnancies
vulval cancer RFs
↑ Age [>75 especially]
Exposure to HPV
Conditions causing chronic inflammation of the vulva
Immunosuppression
Lichen sclerosus ~5% of women with LS develop vulval cancer
IUGR RFs
Previous SGA baby
Smoking / alcohol
Obesity
Diabetes
Existing HTN / pre-eclampisa
Mum>35yrs
Multiple pregnancy
Antiphospholipid syndrome
Antepartum haemorrhage
GDM RFs
Previous gestational diabetes
Previous macrosomic baby (≥ 4.5kg)
BMI > 30
Ethnic origin with ↑ risk of T2DM (black Caribbean, Middle Eastern and South Asian)
Family history of diabetes in first-degree relative
foetal complications of GDM
SHAME
Shoulder dystocia, birth injuries and emergency C-section.
Hypoglycaemia: Neonatal Hypoglycaemia
Regular blood glucose checks and frequent feeds are needed. Aim to maintain blood sugar >2mmol/l, using IV dextrose and NG feeds is needed.
Amniotic fluid excess = polyhydramnios
Macrosomia – LGA [contributes to 1]
Early birth: Pre-term delivery
Perinatal foetal death
↑ risk of developing T2DM later in life
Also, at risk of jaundice, cardiomyopathy, congenital heart diseases and polycythaemia.
Breast cancer RFs
Female (99% of breast cancers)
Increased oestrogen exposure (obesity, earlier onset of periods and later menopause)
COCP ↑ risk slightly but falls after 10yrs stopping it.
More dense breast tissue (more glandular tissue)
Late pregnancy/nulliparity. Breastfeeding and multiparity are protective.
Smoking
Family history (first-degree relatives) BC + OC
BRCA 1 or 2 mutation [chromosome 17 + 13 respectively]
pelvic organ prolapse
- Multiple vaginal deliveries
- Traumatic or prolonged or instrumental deliveries
- Obesity
- Advanced age +/ or postmenopausal status
- Chronic coughing
- Chronic constipation causing straining.
- Hysterectomy
- Heavy lifting
urinary incontinence RFs
↑ age
Previous pregnancies and vaginal deliveries
High BMI
Neurological conditions e.g. MS
Pelvic organ prolapse or past pelvic surgery
Cognitive impairment / dementia.
Lifestyle factors: caffeine, alcohol, BMI, meds.
preterm delivery RFs
- MC =Infection introduced iatrogenically, ascending up the genital tract or retrograde from peritoneum
- Ischaemia
- Uterine over distension – seen in polyhydramnios, multiple pregnanices + uterine abnormalities
- Cervical weakness, 1º due to prior procedures [C-sections at full dilatation, LETZ, cone biopsy]
