WEEK 1

Question 1

What are the common medical disorders in pregnancy?

Answer 1

GHTN; GDM; Pre-eclampsia and eclampsia; Anemia

Question 2

What are some of the complications that can occur when the pregnant women is experiences the above disorders?

Answer 2

IUGR; IUFD; Macrosomia; Neural tube defects in the fetus; Angina in the maternal

Question 3

Differentiate between Pre-existing HTN, Gestational HTN, Pre-eclampsia, Eclampsia.

Answer 3

*Pre-existing HTN; BP greater or equal to 140/90 mmHg prior to 20 weeks GA, which persists for more than 7 weeks postpartum.
*Gestational HTN; BP greater or equal to 140/90 mmHg after taking 2 reading within 4-6hrs W/O proteinuria and other symptoms of organ failure after 20 weeks GA.
*Pre-eclampsia; new onset of HTN and presence of proteinuria/ symptoms of end organ failure typically after 20 weeks GA.
*Eclampsia; new onset, generalized seizures in a pregnant woman with pre-eclampsia/ GHTN. The seizure are not attributable to any other neurological condition.

Question 4

What are the severe features that are associated with pre-eclampsia?

Answer 4

• Systolic BP greater or equal to 160mmHg; Diastolic BP greater or equal to 110mmHg on 2 occassions at least 4hrs apart
  *HELLP Syndrome ( Hemolysis Elevated Liver enzymes Low Platelets)
  *Symptoms of CNS dysfunction ( scotomata, somnolence, photophobia)
  *Pulmonary edema

Question 5

What are the risks of pre-eclampsia?

Answer 5

*Nulliparity; history of pre-eclampsia in previous pregnancy; molar pregnancy; pre-existing DM, HTN

Question 6

What are the reasons of unintended pregnancies among women?

Answer 6

*limited access to contraceptives
*culture or religious opposition
*limited choice of family planning methods.

Question 7

List the classes of contraceptives based on efficacy and give 2 examples under the listed classes.

Answer 7

*Most effective: sterilization( permanent) and Intrauterine Device( reversible)
*Effective: Oral contraceptives and vaginal ring
*Least effective: Condoms and Spermicide.

Question 8

What are the factor affecting selection of a family planning method.

Answer 8

• Speed to return of fertility after method cessation
• Ability to withstand the side effects
  *Culture and social barrier

Question 9

Describe the general mechanism of action of the hormonal contraceptive methods.

Answer 9

*Thinning of the endometrial lining
* Thickening of the cervical mucus to keep sperm from reaching the egg.
*Suppresses ovulation by blocking LH and FSH surge

Question 10

What is capacitation and state its importance.

Question 11

The mechanisms employed by the oocyte to prevent polyspermy.

Answer 11

*Cortical Granule (CG) exocytosis: once sperm penetration occurs, intracellular release of calcium induces the membrane of the cortical granules to fuse with ooplasma and the CG contents are exposed to the perivitellline line.
*Modification of Zona Pellucida, by enzymes released from the cortical granules. Enzymes like proteinases change the ability of the zona pellucida to inhibit sperm acrosome reaction, thus preventing further sperm penetration.

Question 12

“Coordinated cycle of stimulatory and inhibitory effects that results in release of a single mature oocyte from a pool of primordial oocytes”.

Answer 12

Menstrual cycle

Question 13

List the phases of blastocyst implantation

Answer 13

Apposition
Adhesion
Invasion

Question 14

What is the function of the decidua

Answer 14

Protects the embryo from being attacked by maternal immune cells and provides nutritional support for the developing embryo prior to placenta formation.

Question 15

An ideal contraceptive should be: ( list 4)

Answer 15

Effective
Safe
Accessible
Affordable

Question 16

Function of oestrogens

Answer 16

*Suppresses ovulation by inhibiting GnRh
*Inhibits FSH and LH and therefore inhibits ovulation
*Prevention of folliculogenesis and prevention of dominant follicle selection via FSH suppression

Question 17

“The number of pregnancies that will occur in 100 sexually active women in one year”

Answer 17

Pearl Index