Y2 The midwives exemption

Question 1

Diclofenac

Answer 1

Analgesia, PO 50mgx3/day.

Do not use in Pregnancy (unless necessary), BF is fine.

Question 2

Hydrocortisone Acetate

Answer 2

Mild corticosteroid, for eczema, allergies, swelling, itching, dermatitis, rash. Topical cream. Not known to cause issues in pregnancy of BF. Don’t use in face, groin, armpits.

Question 3

Miconazole

Answer 3

(Monistat), Antifungal, used to treat ringworm or yeast infections, vaginal candidiasis. Topical cream. Fine in pregnancy and for BF

Question 4

Nystatin

Answer 4

(Nystan) Antifungal, oral thrush, skin infections. Mouthwash or available as creams. Fine for pregnancy and BF.

Question 5

Phytomenadione

Answer 5

(Vitamine K, Konakion) Administered to newborns at birth to prevent bleeding. Can be given in 1 dose IM or 3 doses orally.

Question 6

Diamorphine

Answer 6

Analgesia, Opioid. IM injection during labour. Not to be administered closer than 6-4 hrs to birth as can affect baby (make them sleepy). Alternatives are Pethidine hydrochloride.

Question 7

Pethidine hydrochloride

Answer 7

Analgesia, Opioid. IM injection during labour. Not to be administered closer than 6-4 hrs to birth as can affect baby (make them sleepy). Alternatives are Diamorphine.

Question 8

Pethidine hydrochloride

Answer 8

Analgesia, Opioid. IM injection during labour. Not to be administered closer than 6-4 hrs to birth as can affect baby (make them sleepy). Alternatives are Diamorphine.

Question 9

Adrenaline

Answer 9

Treating anaphylactic shock. IM injection, 0.5 ml of 1:1000 adrenaline.

Question 10

Anti-D Immunoglobin

Answer 10

Given to Rh- mothers IM in case of sensitising event(20 w< 250 IU,>500IU), at 28-30 w gestation 1500 IU and within 72 hrs of birth 500 IU.

Question 11

Carboprost

Answer 11

Treating PPH, uterine atony and not responding to ergometrine/oxytocin. IM 250 mcg, max 8 doses (2mg) no less than 15 mins apart. Contraindication: Cardiac/ pulmonary disease, pelvic infection.

Question 12

Cyclizine Lactate

Answer 12

Antiemetic, for nausea, vomiting, vertigo, motion sickness. 50mg up to 3x day, 8hrs apart for morning sickness.

Question 13

Ergometrine maleate

Answer 13

(Syntometrine), Treating PPH due to uterine atony. IM or IV 250-500 mcg. Contraind: eclampsia, woman still in labour, sepsis, severe cardiac disease/hypertension, vascular disease.
Ergometrine w Oxytocin is for 3rd stage of labour, IM 1 mL.

Question 14

Gelofusine

Answer 14

Fluids/ plasma volume substitute.

Question 15

Hartmanns solution

Answer 15

Fluids, Sodium lactate+ sodium chloride+ potassium chloride in water. Replacing fluids and electrolytes. Balanced isotonic solution, crystalloid. Considered to be more physiological than normal saline 0.9% but they are generally the same thing.

Question 16

Hepatitis B vaccine

Answer 16

Ambirix, Twinrix. 1mLx2 1 month apart and then 1mLx1 after 5 months. Deltoid IM.

Question 17

Lidocaine hydrochloride

Answer 17

Anaesthesia infiltration during suturing.

Only to administered to a woman in childbirth, up to 20 doses.

Question 18

Oxytocin (natural or synthetic)

Answer 18

Induction of labour, causing uterus to contract. IV 0.001-0.004 units/min. increase interval 30 mins until 3-4 contractions/10 mins. Soonest 6hrs after prostaglandins.
Caesarean section: IV 5 units directly after delivery.
Prevention of PPH 3rd stage: slow IV or IM (instead of oxytocin with ergometrine)
PPH: Slow IV 5 Units, if severe: 40 units in 500mL given at rate to sufficiently control uterine atony.

Question 19

Prochlorperazine

Answer 19

Antiemetic, nausea and vomiting. 5-10mg 2-3x/day. Can be given IM 12.5mg as required. Also used for schizophrenia/mania.
Contraindication: depression amongst other things.

Question 20

Sodium chloride 0.9%

Answer 20

NORMAL SALINE. Water for injection, fluids for IV infusion.