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MRCOG Part 2 > Scientific Impact Papers > Flashcards

Scientific Impact Papers Flashcards

1
Q

What are the limits in gestation for flying by most airlines?

A

36/40
If risk of preterm labour e.g. multiple pregnancy - 32/40
Most need a letter >28/40 to say no anticipated complications and confirmation of EDD

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2
Q

What is the increase in VTE risk for long haul flights?

A

3 fold

18% for each 2 hours flight time

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3
Q

What is the advice re: DVT and flying?

A

Hydration, TEDs, mobilise

If other riskes e.g. prev DVT, obese etc consider LMWH for day of travel and several days after

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4
Q

What is the rate of neural tube defects in the UK?

A

1.5/1000

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5
Q

What proportion of women are estimated to be taking folic acid preconceptually?

A

1/3

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6
Q

What is the population coverage of the cervical screening programme in the UK?

A

77-80% (only 63% 25-29)

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7
Q

When was HPV immunisation introduced to the UK?

A

2008 for 12-13 yo - bilvalent 16/18 vax - Cervarix

2012 - quadrivalent - 6/11/16/18 - Gardasil

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8
Q

What % of IVF births are multiple pregnancies?

A

Approx 25%

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9
Q

What is the increase in relative risk for preterm birth following IVF?

A

x2 (23% of IVF twins>natural)

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10
Q

What in the relative risk of LBW/SGA for singleton IVF pregnancy?

A

RR 1.6

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11
Q

What is the increase in risk of congenital abnormalities with IVF?

A

30-40% but absolute risk is low

3-5% are diagnosed after birth

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12
Q

What is the increase in perinatal mortalitlity with IVF?

A

Results inconsistent but approx 70% compared with natural conceptions
Higher with PGD/screening compared to standard ICSi

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13
Q

What is the increased probability of live birth with D5 blastocyst vs D2 cleavage stage embryo selection?

A

40%

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14
Q

What % of women with PCOS are overweight?

A

40-50%

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15
Q

How does metformin work in PCOS?

A
  • Inhibits production of hepatic glucose
  • Enhances cellular insulin sensitivity
  • ?Direct effect on ovarian function

No good data for metformin; best reserved for patients with glucose intolerance or T2DM

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16
Q

How much additional blood is there in a baby’s cord at term?

A

80-100ml

17
Q

In what % of CVS samples are abnormal cell lines in the placenta not present in the fetus (ie mosaicism)?

A

1%

18
Q

What % of fetal energy requirements is provided by glucose?

A

75%

19
Q

What % of the general population have a folate deficiency?

A

5%

20
Q

What are the obstetric complications of treatment to the cervix for CIN?

A

Cold-knife, laser, LLETZ - increased risk LBW, PTB if >10mm depth - similar to risk if previous PTD history
Cold-knife conisation also increased risk CS
LLETZ - PPROM
Consider TVUS serially but ?no improvement in outcome

21
Q

What is the miscarriage rate at 35-39?

And 40-44?

A 
35-39 = 24%
40-44 = 51%
22
Q

Where is Inhibin B produced?

A

Small antral follicles secondary to FSH

23
Q

What is the chance of a pregnancy from a vitrified oocyte?

A

4%

Effect of prolonged vitrification unknown

24
Q

What is the incidence of cerebral palsy at:

  • 22-27/40
  • 28-31/40
  • 32-36/40?
A
  • 22-27/40 = 15%
  • 28-31/40 = 6%
  • 32-36/40 = 0.7%

50% considered perinatal in origin

25
Q

What was found to be the odds ratio for cerebral palsy when MgSO4 was given for PET/tocolysis?

A

0.14

26
Q

What is the most common lesion seen in cases of cerebral palsy and what pathological process is important? How does MgSO4 help?

A

Periventricular white matter injury
NMDA receptors on oligodendrocytes important in the glial injury process
MgSO4 acts as Ca2+ antagonist - ?reverses hypoxic injury

27
Q

What is the relative risk for cerebral palsy and gross motor dysfunction with MgSO4 given to women at risk of PTL as per the Cochrane review?

A

CP - 0.68

Gross motor dysfunction - 0.61

28
Q

At what gestation should MgSO4 be considered for neuroprotection?

A

<30/40

29
Q

What % of maternities in 2006-8 were in women >35? and >40?

A

> 35 - 20%

>40 - 3.6%

30
Q

What is the rate of stillbirth in 25-29 yo and in >=40?

A

25-29 - 4.6/1000 maternities
>=40 - 7.6/1000

x2 in Afrocaribbean across all age groups

31
Q

What is the estimate for how many stillbirths could be prevented if all women aged 40 or above had IOL at 39/40 (or 40?)

A

39/40 - 17

40/40 - 7

32
Q

How many cervical, endometrial, and ovarian cancers are diagnosed in those <45 every year?

A

Cx - 1000
Endo - 120
Ovarian - >500

33
Q

What is the rate of recurrence following radical vaginal trachelectomy?

A

4.2 - 5.6%

34
Q

How many pregnancies have congenital CMV infection?

A

0.2-2.2%

35
Q

What are transmission rates of CMV with 1)primary infection 2)re-activation

A

1) 30-40% (13% asymptomatic at birth)
1st trimester = 30%
3rd trimester = 47%
2) 1-2%

36
Q

CMV diagnosis

A 
Maternal 
1) CMV IgG +ve when previously -ve
2) CMV IgM +ve, IgG low avidity 
Fetal
Amniocentesis after 20/40 PCR for CMV

MRCOG Part 2 (97 decks)

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