Womens Health

Question 1

What antenatal care should be done at 8-12 weeks

Answer 1

Booking visit:
- general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
- BP, urine dipstick, check BMI
Booking bloods/urine:
- FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
- hepatitis B, syphilis
HIV test is offered to all women
- urine culture to detect asymptomatic bacteriuria

Question 2

What types of HPV are more likely to cause cancer?

Answer 2

hrHPV (highr risk HPV)= Type 16 & 18 - cause 4/5 cervical ca’s in uk

Question 3

what kind of drugs slows/stops preterm labour

Answer 3

Tocolytics

Question 4

What is Sheehans Syndrome?

Answer 4

rare complication of post-partum haemorrhage, where the drop in circulating blood volume leads to avascular necrosis of the pituitary gland. Low blood pressure and reduced perfusion of the pituitary gland leads to ischaemia in the cells of the pituitary, and cell death.
Therefore affects: LH, FSH,ACTH, TSH, prolactin, GH

Question 5

What are the causes of PPH? (4 Ts)

Answer 5

Tone (uterine atony): the vast majority of cases
Trauma (e.g. perineal tear)
Tissue (retained placenta)
Thrombin (e.g. clotting/bleeding disorder)

Question 6

What are the steps in PPH management?

Answer 6

ABCDE approach: IV access & warm crystalloid,
Mechanical: palpating the uterine fundus (‘rubbing up the uterus’) to stimulate uterine contraction &
catheterisation to prevent bladder distention.
Medical: IV oxytocin 1st line
Surgical: Intrauterine balloon tamponade 1st line