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3 Women's Health EJR > Womens health basics > Flashcards

Womens health basics Flashcards

(72 cards)

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1
Q

what is the definition of

  • LMP
  • Cycle
  • Parity
  • Gravidity
A

LMP = first day of last normal menstrual period

Cycle = number of days from first day of bleeding to next period e.g. 5/28 is 5 days of bleeding with 28 day cycle

Parity = number of deliveries after 24 weeks incl stillborn, miscarriage, terminations and ectopic pregnancies, if terminated before 24 weeks, ^x

Gravidity = total number of pregnancies inc current pregnancy, regardless of outcome

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2
Q

if someone has 4 children, currently pregnant and has had 2 miscarriages how would that be expressed in GxPn

A

G7P4^+2

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3
Q

what would G4P4 mean

A

pregnant 4 times, gave birth 4 times.

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4
Q

how do you ask if someone has been having heavy periods

A

flooding through pad
clots
frequency of changing pad

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5
Q

what are some abnormal bleeding

A

heavy periods
intermenstrual bleeding
postcoital bleeding

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6
Q

what is dyspareunia

A

painful intercourse

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7
Q

what to clarify in painful intercourse

A

superficial or deep pain

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8
Q

what is the guideline for taking pap smears

A

from 25, every 3 years

till 49 then every 5 till 65 the stop

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9
Q

in gynae history, what to ask about previous pregnancy

A

how many, when, mode of delivery, birth weights

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10
Q

what is naegeles rule, what is it used for

A

to calculate EDD from LMP

LMP + 1 year - 3 mths + 7 days

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11
Q

other way to calculate EDD?

A

crown-rump length

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12
Q

when is booking appointment usually done

A

8 weeks

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13
Q

what are some definitions of high risk pregnancies

A

> 35 age
35 BMI
H/T
difficult pregnancy hx

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14
Q

what blood information is required in obs history

A 
blood type/group
rhesus factor
blood born virus (HIV, HBV)
syphillis
FBC (anaemia)
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15
Q

who are required to go for monthly growth scans

A

high risk pregnancies

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16
Q

what scans are done for low risk pregnancies

A

12 and 20 weeks

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17
Q

when is the first scan done and what does it look for

A

12 weeks
viability dating scan

is baby viable
position of baby
EDD (crown rump length)
number of babies
combined test (13 18 21)
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18
Q

what ways of managing miscarriages are there

A

conservative
medical
surgical

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19
Q

what 5 past medical history are important in Obs history

A 
Diabetes
Epilepsy
Asthma
Thromboembolism/thyroid
Hypertension
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20
Q

what is normal fetal movement like

A

after 20 weeks, fetal movements should be the same throughout, any reduction is abnormal

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21
Q

what is the folic acid recommendation

A

400micrograms for low risk till 13 weeks pregnant

5 miligram for high risk

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22
Q

what is the combined screening

A

scan done 11-14 weeks (can be done during first scan)

look at patau, edwards and downs by nuchal thickness

also bloods assoc with downs - beta hcg and low PAPP-A

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23
Q

what can be done to confirm a positive result from a combined screening

A

chrionic villus sampling

amniocentesis

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24
Q

what scan is done from 18 to 20+6 weeks?

A

anomaly scanning - 11 conditions

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25
what is done during a growth scan
est fetal weight via HC, AC, FL amniotic fluid index umbilical artery doppler
26
who gets serial growth scans
high risk pregnancies medical disorders previous IUGR multiple pregnancies
27
what 2 hormones rise in normal labour
prostaglandins, estrogen and oxytocin
28
what is the most common baby head position during birth
occiput-anterior
29
how often are contractions at the maximum during labour
5 every 10 mins
30
describe stage 1 2 3 of labour
stage 1 onset of labour to full dilatation of cervix (10cm) stage 2 full dilatation to delivery of baby stage 3 delivery of baby and placenta
31
describe stage 1 of labour
latent phase - irreglar painful contractions, start of cervical changes, up to 4cm dilatation active phase - regular painful contractions + 10cm dilatation
32
how is stage of descent described using the fifths and ischial spines?
before baby head at ischial spines, palpate abdomen to feel for how much of baby head is still above, count in fifths (e.g. 4/5ths of baby head is above) when baby's head is at ischial spines, that is zero station, once below is +1 station e.g
33
how are fetuses monitored during labour
intermittent auscultation with doppler or pinnard - 1 min, after contraction every 15 minutes for first stage and every 5 mins in second stage
34
what pharmacological options are there for women in labour?
paracetamol entonox diamorphone epidurals
35
describe second stage of labour
passive second stage - from full dilatation, allow spontaenous descent, don't push yet. active second stage, when head is visible, encourage mother to push
36
mechanism of body regarding babies' positions
``` descent flexion internal rotation crowning extension restitution internal rotation of shoulders expulsion ```
37
what is caput succedaneum
temporary swelling of head due to compression by cervix
38
when is the cord cut?
after pulsation of cord stops
39
ways that placenta can be delivered
physiological or active
40
different degrees of perineal tear
1st degree is down to fourchette 2nd is skin, vaginal wall and perineal muscles 3rd includes anal sphincter 4th includes rectum
41
what to inspect the placenta for?
is it complete, how many vessels? (3), how many membranes (2), any malformations, histology or cytogenetics
42
most common cause of abnormal labour regarding "powers"
inefficient uterine action | hyperactive uterine action
43
how to manage inefficient uterine action?
augmentation - ARM, oxytocin
44
common abnormal fetal presentations
``` OP OT brow face breech ```
45
management of different abnormal fetal presentations
``` OP - instrumental OT - CS if progress to deep transverse arrest brow - C section face - C section if chin is posterior breech - C section ```
46
what is deep transverse arrest
if baby is stuck in OT position after 1 hour
47
common causes of abnormal labour regarding Passage
cephalo-pelvic disproportion (head>pelvis)
48
2 types of forceps
rotational and non-rotational
49
where are rotational forceps used?
in theatre because failure => csection
50
which instrument is more likely to fail
ventouse
51
why can using a ventouse cause jaundice to the baby
suction causes bruising on head leading to blood break down and build up of heme
52
what are the indications for isntrumental delivery
prolonged 2nd stage leading to maternal exhaustion fetal compromise prophylatically in high risk pregnancies
53
what analgesic is given to the mother in a low cavity instrumental delivery
pudendal block/local anaesthesia. low cavity = baby below 0 station
54
prerequisites for instrumental delivery
maximum 1/5s head palpable on abdomen cervix fully dilated analgesia consent empty bladder consider venue e.g theatre
55
what can be done to reduce instrumental delivery rates
midwife encouragement encourage mobilisation of mother during labour altering maternal position using oxytocin for slow 2nd stage progress allow longer passive 2nd stage when epidural present
56
definition of inducing labour
at least 24 weeks gestation intact or ruptured membranes, but not active labour
57
maternal indications for induction of labour
``` abnormal bleeding GDM/obesity prolonged pregnancy (41 weeks) risk to maternal life preterm-prelabour ruptured membranes hypertensive d/o obstetric cholestasis symphysis pubis dysfunction maternal request ```
58
fetal indications for induction of labour
``` growth restrictions risk to fetal life IUGR isoimmunisation IUD post maturity previous still birth recurrent reduced fetal movements ```
59
contraindications of induction of labour
active genital herpes/HIV major placenta praevia transverse or oblique fetal presentation prior uterine incisions
60
how to induce labour?
membrane sweep prostaglandin amniotomy IV oxytocin
61
what is included in the modified bishops score
``` dilatation length of vaginal canal consistency of cervix position of cervix head station ```
62
what do the scores in the modified bishops score mean
less the points the less advance labour >9 means labour imminent
63
risks of labour induction
``` failure can lead to C section uterine hyperstimulation infection (chorionamnioitis) fetal compromise cord prolapse post partum haemorrhage increased analgesic use ```
64
maternal indications for continuous EFM
high risk pregnancies, previous c section
65
fetal indications for continuous EFM
``` IUGR oligohydramnios preterm labour multiple pregnancies breech presentations rhesus iso-immunisation ```
66
describe DR C BRAVADO
``` define risk contractions Baseline rate variability accelerations decelerations overall assessment and plan ```
67
what does variability of baby heart rate indicate
working connection between parasymp and symp nervous system
68
what should be done if abnormal CTG
fetal scalp blood pH measurement to ascertain hypoxia status <7,20 is abnormal
69
what is used in customised growth charts?
height, weight, ethnicity previous birth weights weeks and decile chart symphisis pubis length
70
in obs hx, what to ask in past gynae hx?
contraception smear history fertility problems gynae surgery
71
in obs hx what to ask about in past pregnancy hx?
``` year of births weeks gestation any pregnancy problems how they were delivered outcome and birth weight ```
72
at which stage of labour is the mother encouraged to push?
active phase of stage II

3 Women's Health EJR (6 decks)

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