intro to obs and gynae

Question 1

what is obstetrics:

Answer 1

Any aspect that rated to childbirth, delivery, antecedents and sequels

Question 2

Which are the 3 periods of obstetrics?

Answer 2

Antenatal : carries for a period of nine months and divided into 3 trimesters

Intrapartum and postpartum: during the birth and few hours/ days post delivery

Pueripum: up to 6 weeks after delivery

Question 3

What are semiotics?

Answer 3

The theory of sign and meaning helps physicians complement the project of interpreting signs and symptoms into diagnoses

Medical:
Study of symptoms , signs and laboratory signs , history taking and physical examination
Aim is to identify the man at risk of complications

Question 4

how to make a risk assessment:

Answer 4

History: sociobiological, PMH, POH
Examination: full medical obstetric exam and follow up visits
Investigations: ultrasound, foetal heart monitoring

Question 5

Menstrual history:

Answer 5

last menstrual period
cycle: duration, amount

Question 6

POH:

Answer 6

Early pregnancy loss: foetal loss <24 weeks may indicate cervical incompetence
Trophoblastic disease
Ectopic pregnancy
Late 3rd trimester pregnancy

Question 7

Past medical history:

Answer 7

Blood transfusions: check for Rhesus negative blood and administer accordingly
Past operations: uterine surgery
General: CV, resp, endocrine, GI

Question 8

Drug history:

Answer 8

Drugs taken in early pregnancy
Drugs taken during pregnancy
Drug allergies
Drugs of abuse, alchol and smoking

Question 9

Examination of the pregnant women:

Answer 9

General: height, cardiovascular, respiratory system, weight, oedema, blood pressure

Abdominal: inspection for signs f pregnancy (lines nigra, striae gravid
General: Hepatosplenomegaly , Kidneys , Uterine fundus
Vaginal

Question 10

Bishop score:

Answer 10

assess cervical dilatation and effacement
Soft/ hard uterus

Question 11

Advice given to the mother regarding self care:

Answer 11

Nutrition
Exercise
Vaccinations
Self management of pregnancy

Question 12

Routine investigations during pregnancy:

Answer 12

Blood grouping
CBC
Blood glucose
Urinalysis: look out for glucose and protein
Infection screen: hep B, syphilis in the mother, hep C and HIV
Direct investigations: LFTs, renal function
U/S assessment: 1 at 10-14 weeks, 18-22 weeks and then as required

Question 13

visits to the doctor:

Answer 13

first trimester: x2 visits
Second trimester: x3 vistis
Third trimester: x8 visits

Question 14

When planning pregnancy:

Answer 14

At least a month before take folic acid: important for growth as the neural tube starts to develop even before the mother know she is pregnant

Question 15

During pregnancy tell mother to avoid dangerous infections:

Answer 15

Raw seafood : risk of Hep A
Unpasteurised milk or soft cheeses: Brucellosis
Raw or undercooked meat and poultry: typhoid
Raw eggs

ask them to limit tuna and other cooked fish to about 12 oz a week

Need to take:
Folic acid
Increase fruit: oxidant effects in educing malfrormatins especially via C

Iron supplementation during he second tributes

Question 16

Which vaccines can be given during pregnancy:

Answer 16

Inactivated vaccines can be given but live vaccines cannot

Question 17

Symptoms during pregnancy:

Answer 17

Nausea and vomiting: especially during the first trimester can be severe : hyperemesus gravid
Gastric disturbances
heartburn: due to the pressure on the stomach and large uterus => tell them to eat frequent small meals
Urinary frequency
syncope
Varicose veins
Hypercoaguable :lowe climb pain

Question 18

When should they start feeling foetal movement:

Answer 18

18-22 weeks
Tend to decrease int he final few weeks