obstretic conditions

Question 1

tight glucose control is important in pregnancy why?

Answer 1

risk of spina bifida, malformation increases

Question 2

Hba1c levels

Answer 2

<48 is good

Question 3

what drives diabetes in pregnancy?

Answer 3

human placental lactogen and steroids

Question 4

can insulin cross placenta?

Answer 4

no so high glucose can make a baby macrosomic

Question 5

timeline of contacts in pregnancy
booking scan?

Answer 5

12 week

Question 6

anomaly scan?

Answer 6

20 weeks

Question 7

gestational diabetes when

Answer 7

24-28 weeks

Question 8

GDM risk factors?

Answer 8

BMI>30
asian
previous baby 4.5kg
FHx
previous GDM

Question 9

diagnostic? GDM
fasting glucose?
2-hour OGTT?

Answer 9

5,6,7,8

> 5.6 mmol/l
7.8 mmol/l

Question 10

mx of GDM

Answer 10

diet and exercise

2nd : metformin
3rd line : insulin
4th line : glibenclamide

Question 11

booking scan?

Answer 11

8-12 weeks

Question 12

routine scan

Answer 12

16 weeks

Question 13

primip only scan?

Answer 13

24-28 weeks
OGTT for those at risk of GDM

Question 14

second routine scan?

Answer 14

28 weeks

Question 15

primip second scan?

Answer 15

32 weeks

Question 16

risk factors for pre eclampsia?

Answer 16

> 40
nulliparous
BMI>30
HTN
CKD

Question 17

what is the OGTT

Answer 17

oral glucose tolerance test
75mg glucose
bloods checked

> 7.8mmol/l

Question 18

16 week visit
hb levels?

Answer 18

> 110, if not why? check Fe,B12, folate

offer pertussis vaccine
and influenza
bp and proteinuria

Question 19

25 week primp visit

Answer 19

symphysis - fundal height
BP+ proteinuria

Question 20

if rhesus D- ?

Answer 20

offer first anti-D at 28 week scan

Question 21

28 week scan?

Answer 21

SFH
BP+proteinuria
offer first anti-D

Question 22

34 week scan

Answer 22

offer second anti d
SFH

Question 23

36 week scan

Answer 23

bp +proteinuria
SFH
check presentation
give info on breastfeeding
newborn care
vit K

Question 24

if breech presentation at 36 weeks?

Answer 24

offer ref external cephalic version

Question 25

what is External cephalic version

Answer 25

manually rolled and push baby from breach to head down position

Question 26

38 week visit

Answer 26

bp +proteinuria
sfh
give information on risk of pregnancies last 42 weeks

Question 27

management for prolonged pregnancy?

Answer 27

membrane sweep
vaginal prostaglandins

Question 28

when do you offer membrane sweep?

Answer 28

40 weeks PRIMP
41 week multiparous

Question 29

Downs is HIgh

Answer 29

increased Hcg and inhibin

Question 30

Edwars is HE is low

Answer 30

hcg and estradiol are both low

Question 31

what is high in patau?

Answer 31

AFP

Question 32

ectopic pregnancy location most common?

Answer 32

ampulla - pregnancy outside of uterus

Question 33

traid of pre-eclampsia

Answer 33

htn
proteinuria
oedema

Question 34

defn - pre eclampsia
when is it?
what is the blood pressure reading and what other sign?

Answer 34

new onset blood pressure >140/90 mmHg after 20 weeks of pregnancy

one or more of
proteinuria
renal insufficiency - creatinine
liver,
neuro- head
etc

Question 35

management of pre eclampsia

Answer 35

oral labetalol
Nifidepine if asthmatic
delivery

Question 36

post partum haemorrhage is defined as?

Answer 36

500ml of blood

Question 37

shoulder dystocia most common complication?

Answer 37

brachial plexus injury

Question 38

McRoberts manouvre?

Answer 38

legs up to abdo
suprapubic pressure

Question 39

why does the McRoberts procedure help?
straightens what?
roating what?
this increases the diameter of what?

Answer 39

lumbosacral angle,

rotates the maternal pelvis towards
the mother’s head and

increases the relative anterior-posterior diameter of the pelvis