Obs Stats Flashcards

1
Q

Proportion twin pregnancies

A

3%

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2
Q

Twin SCBU admissions

A

15%

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3
Q

Preterm twin deliveries <37 weeks

A

50%

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4
Q

Preterm twin deliveries <34 weeks

A

20%

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5
Q

Twin pregnancy rate with IVF

A

24%

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6
Q

Asymptomatic twins, cx length <25mm, risk of delivery before 28 weeks

A

25%

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7
Q

Asymptomatic twins, cx length <20mm, risk delivery before 32 weeks

A

42%

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8
Q

Asymptomatic twins, cx length <20mm, risk delivery before 34 weeks

A

62%

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9
Q

Premature twins delivered for medical reasons

A

1/3

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10
Q

Diabetes insipidus rate

A

2-4 per 100,000

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11
Q

Mortality rate pulmonary hypertension

A

17%

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12
Q

Mortality idiopathic or congenital heart disease

A

33%

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13
Q

Preterm delivery pulmonary hypertension

A

> 85%

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14
Q

Neonatal death with pulmonary hypertension

A

7-13%

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15
Q

Malignancy in pregnancy

A

1 in 1000

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16
Q

Re-laparotomy after CS

A

0.12-1.04%

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17
Q

PPH risk at delivery

A
  1. 1% ELCS

6. 0% vaginal birth & CS

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18
Q

Wound infection post CS

A

EMCS 97 in 1000

ELCS 68 in 1000

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19
Q

Endometritis post CS

A

EMCS 184 per 1000

ELCS 39 per 1000

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20
Q

Pregnancy VTE risk

A

4-6 times higher

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21
Q

Success ECV

A

50%
60% multips
40% primula

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22
Q

Spontaneous breech turn cephalic

A

8%

3-5% after unsuccessful ECV

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23
Q

Cephalic to breech after ECV

A

3%

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24
Q

Recurrence breech position

A

9.9%

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25
Q

EMCS after ECV

A

0.5%

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26
Q

Breech

A

3-4% term

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27
Q

Breech in labour

A

25% diagnosed in labour

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28
Q

Vagina breech conversion to EMCS

A

40%

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29
Q

2nd twin non-vertex

A

40%

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30
Q

Success VBAC

A

72-75%

85-90% if previous VBAC

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31
Q

Uterine rupture VBAC

A

0.5%
Induced 1.5%
Augmented 1.9%

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32
Q

Uterine rupture rate if previous rupture

A

5%

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33
Q

V2BAC success

A

71%

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34
Q

OASIS with VBAC

A

5%

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35
Q

Instrumental delivery with VBAC

A

39%

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36
Q

Maternal death CS

A

13 in 100,000

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37
Q

Maternal death VBAC

A

4 in 100,000

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38
Q

Risk stillbirth >39 weeks VBAC

A

0.1%

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39
Q

Hysterectomy with uterine rupture

A

14-33%

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40
Q

Planned ELCS in labour <39 weeks

A

10%

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41
Q

Uterine rupture planned ELCS

A

<0.02%

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42
Q

Uterine rupture in labour

A

90%
Majority 4-5cm
2nd stage 18%
AN 2%

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43
Q

Abnormal CTG with uterine rupture

A

66-76%

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44
Q

Asymptomatic uterine rupture

A

48%

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45
Q

Percentage women offered invasive testing

A

5%

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46
Q

Weeks for amnio

A

From 15 onwards

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47
Q

Miscarriage rate amnio/CVS

A

1%, inc CVS

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48
Q

Weeks for CVS

A

From 10

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49
Q

Epilepsy in pregnancy

A

0.5 - 1%

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50
Q

Increased risk SUDEP

A

10 x increased risk death

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51
Q

Women not having seizure in pregnancy

A

67%

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52
Q

Epilepsy without AED risk of congenital malformations

A

2.8% (same as gen pop)

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53
Q

Risk congenital malformation with sodium valproate

A

10.7%

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54
Q

Risk congenital malformation with poly therapy

A

16.8%

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55
Q

Tonic clinic seizures in labour

A

1-2% in labour

1-2% 24 hours after delivery

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56
Q

Status epilepticus in pregnancy

A

1%

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57
Q

Epilepsy risk for postpartum depression

A

29%

11% without epilepsy

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58
Q

Minor bleed

A

<50mls

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59
Q

Major bleed

A

50-1000mls

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60
Q

Massive bleed

A

> 1000 mls

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61
Q

APH in pregnancy

A

3-5%

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62
Q

Association preterm delivery with APH

A

20%

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63
Q

Risk of placental abruption

A

4.4% if 1 previous

19-25% if 2 previous

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64
Q

Placental abruption in low risk pregnancies

A

70%

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65
Q

US detection of placental abruption

A

25%

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66
Q

Uterine rupture previous 2CS

A

1.7%

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67
Q

Uterine rupture previous classical CS

A

12%

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68
Q

VBAC success previous indication

A

Breech 84%
Distress 74%
Dystocia 64%

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69
Q

Risk placenta praevia

A

After 1CS 1%
2CS 1.7%
3CS 2.8%

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70
Q

Risk placenta accreta

A

After 1CS 11-14%
2CS 23-40%
3CS 61%
4CS 67%

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71
Q

Success first attempt amnio/CVS

A

94%

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72
Q

Miscarriage amnio

A

1%
Inc CVS
1.8% twin

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73
Q

Blood stained amnio

A

0.8%

5% third trimester

74
Q

Fetal varicella transmission

A

<12 weeks 0.4%
13-20 2%
20-28 rare

75
Q

Primary herpes transmission

A

41%

76
Q

Secondary herpes transmission

A

0-3%

77
Q

FBS pH

A

Normal >7.25
Borderline 7.21-25
Abnormal <7.21

78
Q

FBS lactate

A

Normal <4.1
Borderline 4.2-4.8
Abnormal 4.9+

79
Q

NNT sweep

A

8 to prevent 1 IOL

80
Q

APGAR

A

0, 1, 2

Skin colour, pulse rate, reflex, activity, respiration

81
Q

Risk preterm delivery

A

7.3%

75% preterm labour, 25% elective preterm birth

82
Q

Incidence 3rd/4th degree

A

2.9%
Primips 6.1%
Multips 1.7%

83
Q

Recurrent OASIS

A

5-7%

20% have symptom reoccurrence

84
Q

Residual EAS defect after OASIS

A

19-36%

85
Q

Symptoms after OASIS

A

60-80% asymptomatic after a year

86
Q

Neonatal herpes

A

1.65 in 100,000

87
Q

Types neonatal herpes

A

30% local infection

70% disseminated +- CNS

88
Q

Types herpes in pregnancy

A

50% HSV1 or 2

89
Q

Risk primary herpes transmission in third trimester with VD

A

41%

90
Q

Risk secondary herpes transmission with vaginal delivery

A

0-3%

91
Q

Haemorrhage cause of maternal death

A

3rd direct

10%

92
Q

Anaemia

A

1st <110
2nd/3rd <105
PP <100

93
Q

Improvement anaemia with oral iron

A

50%

94
Q

Fibrinogen level associated with increased risk of PPH

A

<2.9

95
Q

Breast cancer and pregnancy <30 years old

A

10-20% with pregnancy or 1 year PP

96
Q

Pregnancy rates after breast ca

A

<10%

97
Q

Length of time stop Tamoxifen before pregnancy

A

3 months

>2 years after treatment

98
Q

Amenorrheoa after breast ca

A

20-70%

50% if over 36

99
Q

Congenital heart disease risk of heart disease of fetus

A

4%

100
Q

After one preterm delivery risk of preterm in next pregnancy

A

15%

101
Q

Risk of 2nd twin death of first demise of MC twins

A

15% death
26% neurodisability
Fetal MRI 4 weeks after

102
Q

Breech at 28 weeks

A

20%

103
Q

Breech at 32 weeks

A

16%

104
Q

Cord prolapse with vaginal breech

A

Footling 15%
Complete breech 5%
Frank breech 0.5%
Cephalic 0.4%

105
Q

Uterine inversion

A

50% no risk factors

106
Q

Enzyme inducing AED

A

PPPTC

Phenytoin, phenobarbital, primidone, topiramate, carbamazepine

107
Q

Diabetes in pregnancy

A

5%
87.5% GDM
7.5% T1DM
5% T2DM

108
Q

Aim HbA1c before pregnancy

A

48 mmol

Advise against if over 86

109
Q

BM in labour

A

4-7 mmol

110
Q

BM ranges

A

Fasting 5.3 mmol
1 hour after meal 7.8
2 hours after meal 6.4

111
Q

Ketone level DKA

A

> 1.5 high risk

3 DKA

112
Q

Chance FVS with chickenpox

A

<1%

Highest risk 6-28 weeks

113
Q

Chicken pox infection rules

A

2 days before rash, 5 days after

114
Q

Dural puncture headache risk

A

70-80%

115
Q

Success rate blood patch

A

60-90%

116
Q

Screening with T21

A

Low pappa, aFP, estradiol

High inHibin, Hcg

117
Q

Risk of pregnancy over 6 months with lactational ammenorrhoea

A

2%

118
Q

CMV rate in pregnancy

A

2% primary CMV in pregnancy

Transplacental infection

119
Q

CMV infection in newborns

A

Most common congenital viral infection

1% newborns

120
Q

Transmission rate CMV

A

40%
10% have clinical manifestations when born
5-15% go on to have sequelae

121
Q

CMV effects

A

Leading cause deafness

Hepatosplenomegaly

122
Q

Toxo rate in pregnancy

A

2 in 1000

123
Q

Mother to fetus rate toxo

A

1st trimester - 10%
2nd - 25%
3rd - >85%

124
Q

Rate complications toxo

A

Early 85%

Late 10-80%

125
Q

Toxo triad

A

Intracerebral calcification
Hydrocephaly
Chorioretinitis

126
Q

Parvovirus B19 rate

A

Primary infection 1.1%

60% adults already immune

127
Q

Parvovirus effects

A

Maternal rash

Fetal anaemia, hydrops (MCA peak velocity up)

128
Q

Rubella pregnancy rate

A

1-2%

Maternal RASH - infectious 7 days before and after

129
Q

Parvovirus transmission rate

A

15% <15 week
25% to 20 weeks
75% near term

130
Q

Rubella transmission risk

A

Conception-16/20 weeks

131
Q

Rubella 16-20 weeks

A

Deafness

132
Q

Rubella effects

A

Pulm valve stenosis, deafness,

DM, thyroid, GH deficiency, cataracts

133
Q

Risk of mental health problems in pregnancy

A

1 in 5

134
Q

History of repeat psychosis

A

50%

135
Q

History of repeat depression

A

15%

136
Q

‘Baby blues’

A

50-80%

Peak day 3-5

137
Q

Depression postnatal

A

5-25%

138
Q

Psychosis rate

A

1-2 per 1000

139
Q

Rate bipolar

A

7 per 100,000

140
Q

Lithium associated with anomaly

A

Epstein anomaly - need fetal ECHO and 4 weekly levels

141
Q

Relapse anorexia in pregnancy

A

22%

142
Q

DV in pregnancy

A

13-24%

143
Q

Substance misuse in pregnancy

A

3-4 in 1000

144
Q

HG incidence

A

0.3-3.6%

Resolves by 20 weeks in 90%

145
Q

Wernike encephalopathy

A

B1 thiamine deficiency

146
Q

Levels factor VIII, IX and vWF

A

Treat if <0.5iu/ml, aim 1
Haem A VIII (inc pregnancy)
Haem B IX (stable pregnancy)

147
Q

Liver iron dry weight

A

<7mg/g

148
Q

HDFN risk anti-D

A

> 4 moderate

>15 high

149
Q

HDFN risk anti-c

A

> 7.5 moderate
20 high
Made worse so lower with anti-E

150
Q

HDFN risk anti-K

A

Even low levels risk

Refer all to FMU

151
Q

GBS

A

Strep aga

152
Q

GAS

A

Strep pyogenes

153
Q

AN steroids

A

24-34+6

154
Q

OA

A

SubOccipital- bregmAtic

9.5cm

155
Q

OP

A

OcciPital frontal

11.5cm

156
Q

Brow

A

Mento-vertical

13cm

157
Q

Face presentation

A

Submento- bregmatic

9.5cm

158
Q

CffDNA

A

4-5% needed

10 weeks

159
Q

Chickenpox prevalence

A

0.3% pregnancy

160
Q

Congenital syphilis

A

Rhinitis, sloughing rash, anaemia, splenomegaly

161
Q

Miscarriage

A

Gestational sac >25mm with no yolk sac

CRL >7mm with no FH

162
Q

Erbs palsy

A

Damage C5-6

Waiters tip

163
Q

Epidural

A

L3/4

Epidural space between ligamentum flavum and dura mater

164
Q

Dermatomes for epidural

A

T10-S4

165
Q

Dermatomes for CS / trial

A

T6-S4

166
Q

Dermatomes for vaginal repair

A

S2-4

167
Q

Dose of local anaesthetic

A

Lidocaine 3mg/kg
Bupivicaine 2mg/kg
Antidote 20% lipid emulsion

168
Q

TTTS in monoc twins

A

15%

169
Q

TAPS in monoc twins

A

2%

170
Q

sGR in monoc twins

A

10-15%
sGR >20% discrepancy
sGR II/III deliver 32 weeks

171
Q

Delivery monochorionic

A

MCDA 34-37 if TTTS
sGR 34-36
SGR II or III 32 weeks
MCMA 32-34 weeks

172
Q

Cord prolapse rate

A

0.1-0.6%

1% breech

173
Q

OC IOL

A

From 37 weeks

174
Q

Recurrence rate SD

A

1-25%

Or 10 times

175
Q

Risk of SD diabetic VS non diabetic

A

2-4 times higher diabetic

176
Q

AntiD dose

A

<20 weeks 250
20-28 weeks 500
28 weeks 1500

177
Q

Clexane epidural rules

A

Tx dose 24 hours before epidural
Prophylactic dose 12 hours before epidural
LMWH 4 hours after epi

178
Q

Warfarin post natal

A

Do not start til day 5, later if PPH

179
Q

Chance of GBS carrier if previous carrier

A

50%

180
Q

TTTS

A

15% MC pregnancies