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zFrom questions > Antenatal care > Flashcards

Antenatal care Flashcards

1
Q

When can you perform an amnio to detect prenatal fetal CMV?

A

7 weeks after infection and over 21/40

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2
Q

Chicken pox timeline - VZIG and aciclovir and infectious period?

A
  1. From contact until 10 days - can give VZIG
  2. If given VZIG - infectious period is 21 days, if not 28 days
  3. If present in first 24 hours of the rash - give aciclovir if 20/40 or more
  4. Lesions take around five days to crust (and then are non-infective)
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3
Q

Risk of early onset GBS

  1. overall risk
  2. positive vaginal swab
  3. Intrapartum pyrexia
A
  1. overall risk 0.5:1000
  2. positive vaginal swab - 2.3:1000
  3. intrapartum pyrexia - 5.3:1000
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4
Q

What percentage of IUDs have chromosomal abnormality?

A

6%

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5
Q

Indications for referral to fetal medicine specialist for HDFN?

A

history of previous HDFN
IUT
Titre of 1:32 or above
Rising titres as it indicates the risk of severe fetal anaemia
anti-D level over 4IU/ml
any anti-K level
anti-d - 4-15 moderate risk - referral needed. Over 15 - URGENT referral

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6
Q

What percentage of women with OC have a family history of it?

A

14%

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7
Q

Which drugs used in solid organ transplant are teratogenic?

A

ARB
ACEi
Mycophenolate
Warfarin

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8
Q

Which drug to treat IBD should be avoided in pregnancy?

A

Fluroquinolones

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9
Q

HUS vs TTP

A

HUS has defects in complement regulation

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10
Q

When should you reduce the dose of MgSO4 and by how much

A

Half the dose of MgSO4 when urine output falls below 20mls/hr

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11
Q

What is the only anti-TNF which crosses the placenta the least so is the safest in pregnancy?

A

Certolizumab

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12
Q

What liver lesion may grow in pregnancy?

A

Haemangiomas show accelerated growth with oestrogen

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13
Q

What percentage of monochorionic pregnancies does TTTS complicate?

A

15%

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14
Q

What percentage of monochorionic pregnancies who have laser ablation for TTTS result in TAPS?

A

13%

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15
Q

when should the anomaly scan for twins take place?

A

18 to 20+6

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16
Q

when should the NT scan for twins take place?

A

11 to 14+1

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17
Q

What is the stillbirth rate in the UK?

A

1:200

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18
Q

When is the lowest risk of stillbirth in the UK?

A

39/40

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19
Q

What did the TRUFFLE study show?

A

No difference in stillbirth when ductus venosus doppler measurement was used compared to CTG

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20
Q

What did the TIPPS study show?

A

No help with placenta-related complications or change in SB rate with LMWH

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21
Q

What are the key symptoms in the diagnosis of symphysis pubis dysfunction?

A

pubic bone pain

walking, turning in bed, lifting or parting legs

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22
Q

What are the key signs in the diagnosis of symphysis pubis dysfunction?

A

Positive trendelenburg sign (sagging of one bumcheek on one leg)
Pain over SI joint or SP

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23
Q

What are the risk factors for osteomyelitis of the pubis?

A

Gynaecological surgery, urogenital procedures and operative delivery

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24
Q

What are the symptoms and signs for osteomyelitis of the pubis?

A 
low grade pyrexia
pain at SP and pubic rami
Pain on hip abduction
NN anaemia
inc WCC and CRP
25
Q

What is osteitis pubis?

A

Symmetrical pubic pain
Especially on climbing stairs, kicking, pivoting on one leg

Normal bloods
Xray - erosions cytic changes of the pubis

26
Q

What is pregnancy-induced osteomalacia?

cause?
Sx?
Ix?

A

Vit D deficiency
aches and pains
Looser zones
waddling gait - proximal myopathy

Low serum calcium and raised ALP
Low serum vit D

27
Q

What is transient osteoporosis of pregnancy affecting the hip joint?

A

Usually left hip
Rare

Pain in the hip
NOT tender on the SP

Marginal rise in inflammatory markers
Xrays - osteopenia - localised and involves the femoral head and acetabulum

28
Q

What is the incubation period for rubella?

A

14-21 days

29
Q

what is the period of infectivity for rubella?

A

7 days before and after the rash

30
Q

When is maternal infection most likely to cause congenital rubella?

A

First trimester

31
Q

What are the signs of congenital rubella?

A

PDA, ocular defects, sensorineural deafness and mental retardation

32
Q

Dose of anti D up to 20 weeks?

A

250IU

No Kleihauer required

33
Q

Dose of anti D after 20 weeks? Additional testing and anti D?

A

500IU, and a kleihauer to test for FMH over 4mls - more would be required

34
Q

What is the rate of spontaneous reversion after ECV?

A

5%

35
Q

Why do we offer CS for footling breech presentations?

A

High risk of cord prolapse - 7%

36
Q

What does an absence Duffy blood group antigen provide some protection against?

A

P. vivax

37
Q

Who has significant protection against P. falciparum?

A

haemoglobinopathies (eg: SCD)

erythrocyte enzyme defects (G6PD def)

38
Q

What is the mortality rate of congenital tuberculosis?

A

50%

39
Q

When can peripartum cardiomyopathy present?

A

AN (late) or up to 6 months postpartum

40
Q

Risk factors for peripartum cardiomyopathy?

A 
Afro-Caribbean 
Older
Multip
Multiple pregnancy
HTN
PET
41
Q

Treatment of peripartum cardiomyopathy?

A

beta-blockers
Diuretics
ACEi

42
Q

What proportion of maternal deaths due to cardiac causes are due to cardiomyopathy?

A

25%

43
Q

What proportion of women with peripartum cardiomyopathy with have a spontaenous recovery?

A

50%

44
Q

When is pregnancy contraindicated in a woman with Marfans syndrome?

A

When the aortic root is over 4-4.5cm

45
Q

What is the treatment for severe malaria?

A

IV artesunate

46
Q

What is the treatment for non-severe P. falciparum?

A

Oral quinine 600mg 8H and oral clindamycin 450mg 8H 7/7

47
Q

What is the treatment for non-falciparum malaria?

A

Oral chloroquine 600mg followed by 300mg 6 hours later, then 300mg day 2 and day 3

48
Q

What is the incubation period of parvovirus

A

13-18 days

49
Q

What is the management for a person neg for IgG parvovirus who is exposed?

A

2/40 USS until 30 weeks. If normal - discharge.

50
Q

What is the dose of anti-D given per ml?

A

500u for up to the first four mls, then 125u after that for each ml.

51
Q

What is the dose of lidocaine/kg

A

3mg//kg

52
Q

Previous abruption means abruption how likely in next pregnancy?

A

4.4%

53
Q

Risk of postnatal depression

A

8-15%

54
Q

Risk of perpeural psychosis?

A

0.1-2%

55
Q

Risk of suicide in postpartum psychosis?

Infanticide?

A

5%

5%

56
Q

Bipolar - risk of PP psychosis

A

25%

57
Q

Above what level of spinal cord injury is there a risk of autonomic dysreflexia?

A

T6

58
Q

Above what level of spinal cord injury will a woman not feel labour?

A

T10

59
Q

What is the risk of vertical transmission of CMV in a woman who has seroconverted during pregnancy?

A

1st and 2nd trimester - 40%

3rd - 65%

zFrom questions (11 decks)

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