Women's health Flashcards
Name 8 contraindications for COCP use:
- more than 35 years old and smoking >15 / day
- migraine with aura
- history of thromboembolic disease
- history of stroke / ischaemic heart disease
- breast feeding <6 weeks post-partum
- uncontrolled hypertension
- current breast cancer
- major surgery with prolonged immobilisation
ame 8 contraindications for COCP use:
- more than 35 years old and smoking >15 / day
- migraine with aura
- history of thromboembolic disease
- history of stroke / ischaemic heart disease
- breast feeding <6 weeks post-partum
- uncontrolled hypertension
- current breast cancer
- major surgery with prolonged immobilisation
Management of urge incontinence:
bladder retraining - minimum 6 months
bladder stabilising drugs e.g. antimuscarinics e.g. oxybutynin, tolterodine, darifenacin
mirabegron - in frail elderly patients
Management of stress incontinence?
pelvic floor muscle training - 3 months
surgical procedures
duloxetine
How does incomplete miscarriage present?
pain and vaginal bleeding
cervical os OPEN
not all products of conception have been expelled
How does inevitable miscarriage present?
heavy bleeding with clots and pain
cervical os OPEN
How does missed (delayed) miscarriage present?
gestational sac which contains a dead fetus <20 weeks
may have light vaginal bleeding / discharge, usually painless
cervical os CLOSED
How does a threatened miscarriage present?
Painless vaginal bleeding <24 weeks
cervical os CLOSED
How does the lactational amenorrhoea method work?
Woman has to be fully breast-feeding, amenorrhoeic and <6 months post partum
When can you start contraception after prengnacy?
- progesterone only pill
- COCP
- IUD / IUS
- can be started immediately
- if breastfeeding, contraindicated <6 weeks. Should not be used within first 21 days due to thromboembolism risk.
- within 48 hours or after 4 weeks
Management of uterine hyperstimulation:
removal of vaginal prostaglandin / stop oxytocin infusion
TOCOLYSIS with TERBUTALINE
Complication of induction of labout?
uterine hyperstimulation = prolonged and frequent uterine contractions
Options for induction of labour:
Membrane sweep - at 40-41 weeks Vaginal prostaglandin E2 (PGE2) = preferred method maternal oxytocin infusion amniotomy cervical ripening balloon
Interpretation of bishop’s score:
<5 = labour unlikely to start without induction >/= 8 = high chance of spontaneous labour
5 indications for induction of labour:
1-2 weeks overdue diabetic mother >38 weeks premature rupture of membranes when labour doesn't start pre-eclampsia rhesus incompatibility
Management of obstetric cholestasis:
induction of labour at 37-38 weeks
URSODEOXYCHOLIC acid
vitamin K supplementation
Who can access the cervical screening programme and how regularly is it?
25-49: every 3 years
50-64: every 5 years
What medication is used to suppress lactation?
cabergoline
Management of premature prelabour rupture of membranes (PPROM)?
admission regular observations oral erythromycin for 10 days antenatal corticosteroids delivery considered at 34 weeks gestation
Management of hyperemesis gravidarum:
antihistamines - promethazine
ondansetron / metoclopramide second line
admission for IV hydration
Features of trichomonas vaginalis:
offensive green / yellow frothy discharge
vulvovaginitis
strawberry cervix
pH <4.5
Management of trichomonas vaginalis:
oral metronidazole for 5 days
Features of BV:
vaginal discharge - ‘fishy’
thin white discharge
clue cells on microscopy
positive whiff test
Management of BV:
oral metronidazole for 5-7 days
