Women's health examination

Question 1

What is the symphysial fundal height

Answer 1

• A measure of the size of the uterus used to assess fetal growth& development during pregnancy.
• used to assess the growth of the pubic symphysis to fundus(top) of uterus
• Measured in cm
• Measured at every antenatal visit from 24 weeks
• It should equal the week of pregnancy +/- 2cm

Question 2

Explain hypotension in pregnant women.

Answer 2

common in mid-trimester(physiological BP drop)

<90/60

Question 3

Why must we take care with maternal positioning in the 2nd and 3rd trimester?

Answer 3

Hypotension results in the supine position so we ask pregnant women to lay on their side when sleeping/ if they faint.
The consequences of incorrect positioning include impaired venous return via the inferior vena-cava and it also compromises the blood flow to the baby.

Question 4

What types of hypertension may be present during pregnancy

Answer 4

• pre-eclampsia
• gestational/pregnancy induced
• chronic HT with superimposed pre-eclampsia

Question 5

What is pre-eclampsia?

Answer 5

• Raised BP( <140/90)
• Proteinuria
• oedema: pitting, swelling and weight gain
• usually occurs after 20 weeks
• affects 6% of pregnancies
• Symptoms: frontal headache, visual disturbance, RUQ pain, oedema
• Risks: mother-stroke, seizures, liver/kidney damage
  foetus: growth restriction/death

REMEMBER PRE ACRONYM (Proteinuria, Raised blood pressure, Edema).

Question 6

What is a MEOWS chart made up of and what is it used to document?

Answer 6

• SaO2
• Pulse
• RR
• Temp
• sBP
• dBP

Question 7

How do we quantify protein to check form things like pre-eclampsia or renal disease?

Answer 7

Calculate a protein:creatinine ratio

Question 8

If glucose is present on a mid-stream urine sample, what may this indicate?

Answer 8

• Diabetes, pregnancy induced
• Diabetes-type 1 or 2
• May be physiological in the 3rd stage

Question 9

If leukoctyes/nitrites is present on a mid-stream urine sample, what may this indicate?

Answer 9

They are a product or WBCs so this may indicate a UTI. The microscopy, culture and sensitivity must therefore be sent off to the lab.

Question 10

What is the significance of the last menstrual period in dating a pregnancy.

Answer 10

• Last menstrual period is used to determine when to scan a patient
• Nagele’s rule (add 1 year to the first day of LMP, count back 3 months, add 7days)

Question 11

How do we work out the expected date of delivery?

Answer 11

• based on crown to rump and length of the foetus

- This date is used to calculate a gestational age which can be confirmed with a Beta-HCG test

Question 12

What dates should an obstetric wheel contain and what is it used for?

Answer 12

• Last menstrual period IF IT’S AN EARLY PREGNANCY
• Expected delivery date
• Used to date a pregnancy—> We find today’s date on the outer wheel and read off gestation from the inner wheel.