Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Laura MRCOG Part 2 > 10/11) Labour & Delivery - PTB > Flashcards

10/11) Labour & Delivery - PTB Flashcards

1
Q

Prevention of PTB:

(1) History of PTB + short CL
(2) History of PTB + normal CL
(3) History of 2nd trimester miscarriage + short CL
(4) History of 2nd trimester miscarriage + normal CL
(5) No history + short CL
(6) History of PPROM + short CL
(7) History of cervical trauma + short CL

A

(1) OFFER Suture or progesterone
(2) CONSIDER progesterone
(3) OFFER Suture or progesterone
(4) CONSIDER Progesterone
(5) CONSIDER Progesterone
(6) CONSIDER Suture
(6) CONSIDER Suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When to consider rescue cerclage?

A

16-27+6 with dilated cervix, intact membranes and no bleeding/infection/contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How to diagnose PTL?

A

If <30 weeks - Treat as TPTL

If >30 weeks

(1) Cervical length scan - if <15mm treat as PTL
(2) If cervical length scan unavailable then do fFN - if >50 treat as PTL
(3) If neither available - treat as PTL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

First line tocolysis

A

Nifedipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When to offer tocolysis?

A

Consider 24-25+6

Offer 26+0-33+6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When to offer steroids?

A

Discuss 23-23+6
Consider 24-25+6
Offer 26+0-33+6
Consider 34+0-35+6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When to offer MgSO4?

A

Offer 24+0-29+6

Consider 30+0-33+6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Monitoring during PTB

A

Offer either CTG/IA
Try to avoid FSE <34 weeks and ideally <37
No FBS <34, discuss it up to 37

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When to consider CS for breech PTB?

A

Consider 26+0 onwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long to delay cord clamping for?

A

Ideally 30s-3 minutes if mother and baby well but otherwise milk cord and clamp immediately.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Indications for trans abdominal cervical cerclage

A
  • Grossly disrupted cervix
  • Absent vaginal cervix
  • Previous failed elective vaginal cerclage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Successful pregnancy rate for trans abdominal open cervical sutures

A

85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Timing of trans abdominal cerclage to improve outcomes

A

Pre-pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fetal loss rate associated with trans abdominal cerclage

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Conversion rate to laparotomy for laparoscopic abdominal cerclage

A

10%

  • 1st: Due to bleeding uterine vessels
  • 2nd: Due to poor visualisation from obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Incidence of preterm birth

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is cerebral palsy the most common cause of?

A

Severe physical disability in childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common pattern of CP seen secondary to prematurity?

A

Diplegia

19
Q

What percentage of cases of CP are due to preterm delivery?

A

35%

20
Q

What percentage of cases of CP due to preterm delivery have experienced a perinatal insult?

A

49%

21
Q

What are the two patterns of CNS injury underlying CP?

A
  • Intraventricular haemorrhage

- Periventricular leucomalacia (white matter injury)

22
Q

What is the main CNS injury affecting preterm infants with CP?

A

Periventricular leucomalacia

23
Q

What percentage of infants <1500g have PVL?

A

2-3%

24
Q

What percentage of infants <1500 with PVL will later develop CP or cognitive/behavioural defects?

A

10% CP

50% cognitive and behavioural defects

25
Q

What percentage of preterm infants show impairments in fine motor skills?

A

40-60%

26
Q

What percentage of infants have developmental coordination disorder?

A

18%

27
Q

What percentage of infants have visual impairment?

A

3% (50% if PVL)

28
Q

What percentage of infants have hearing impairment?

A

2%

29
Q

Risk of CP at term, 32-37 weeks, 28-31 weeks and 22-27 weeks?

A

Term: 0.1%
32-37 weeks: 0.7%
28-32 weeks: 6.2%
22-27 weeks: 14.6%

30
Q

What percentage of women receiving MgSO4 experience side effects?

A

70%

31
Q

What are the main side effects of MgSO4?

A

Hypotension + tachycardia, facial flushing, nausea + vomiting.

32
Q

Benefit of MgSO4

A

Reduced risk of cerebral palsy and substantial gross motor dysfunction

33
Q

NNT with MgSO4 at <30 weeks and 32-34 weeks

A

<30 weeks: NNT 46

32-34 weeks: NNT 56

34
Q

How much MgSO4 aiming for before delivery?

A

4 hours

35
Q

Which gestations are referred to by “threshold of viability”?

A

22+0 to 25+6

36
Q

Percentage of live births at each gestation 22-26 weeks

A

Overall: 87% live birth rate

22 weeks: 55%
23 weeks: 80%
24 weeks: 90%
25 weeks: 95%
26 weeks: 98%
37
Q

Percentage of 28 day survival at each gestation 22-26 weeks

A

Overall: 57%

22 weeks: 3%
23 weeks: 25%
24 weeks: 50%
25 weeks: 75%
26 weeks: 80%
38
Q

What antibiotics should be given to PTB?

A

IV Ben Pen

39
Q

Likelihood of classical CS being required at 24/28/30 weeks gestation

A

24 weeks: 20%
28 weeks: 10%
30 weeks: <5%

40
Q

What is the threshold birthweight?

A

<500g only resus after very careful consideration

41
Q

Monitoring in labour with extreme prematurity?

A

Only if you are going to act on abnormalities

42
Q

Incidence of head entrapment with breech 24-27 weeks

A

10% Vaginal

5% CS

43
Q

Delayed cord clamping in extreme prematurity?

A

Milking cord x 4 has similar benefits

Laura MRCOG Part 2 (56 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions