Antenatal

Question 0

What are the routine visits for low risk women?

Answer 0

Booking visit
Dating scan 12 weeks
Feral anomaly scan 20 weeks
36 weeks??

Question 1

What time period can chorionic cilia sampling take place?

Answer 1

11-14 weeks

Question 2

How much frolic acid should a woman take and how long for?

Answer 2

400 micrograms a day

For the first 12 weeks (and preconception)

Question 3

What is the purpose of taking folic acid?

Answer 3

Prevent neural tube defects eg anencephaly and spinabifida

Question 4

In a low risk pregnancy what dates are USS performed?

What is done in each scan?

Answer 4

12 week - early gestational age

20 week - structural fetal abrnomalities

Question 5

What infections are screened for at booking?

Answer 5

TORCH

Bacteruria

Question 6

What does TORCH stand for?

Why are they screened for?

Answer 6

Toxoplasmosis
Rubella
Cytomegalovirus
Herpes/HIV

Can cause congenital abnormalities

Question 7

How many times should a woman’s height and weight be measured during preganancy?

Answer 7

Just once at booking unless there is concern about weight

Question 8

What are the symptoms of preeclampsia?

Answer 8

Headaches (usually frontal) 
Visual disturbances
RUQ pain
Vomiting 
Breathless
Sudden onset oedema

Question 9

What is the purpose of a dating scan?

Answer 9

Determine gestational age
Diagnose multiple pregnancies
Confirm viability
Downs screening

Question 10

The combined test for Down’s syndrome can be done in which dates?

Answer 10

11 weeks to 13 weeks 6 days

Question 11

The combined test for Down’s syndrome involves which tests?

Answer 11

Nuchal translucency
bHCG
PAPPA - pregancy associated plasma protein a

Question 12

What does the triple/ quadruple test measure?

Answer 12

bHCG
Unconjugated estriol
Alpha feroprotein

+inhibin A for quad

Question 13

What age the triple or quadruple test offered?

Answer 13

15 weeks -20 weeks

Question 14

What would make a woman high risk for neural tube defect?

How much folic acid should she take?

Answer 14

Previous neural tube defect 
Coeliac
Diabetes 
Sickle cell
Antiepileptics

Question 15

How much vitamin D should women take and how long for?

Answer 15

10 micrograms OD

During pregnancy and breast feeding

Question 16

What foods should be avoided in pregnancy?

Answer 16

Blue cheese/ Brie - listeria
Pate -listeria
Liver - too much vitamin a
Raw shellfish - salmonella
Caffeine - low birth weight

Question 17

Where should you refer women to get more info on pregnancy?

Answer 17

NHS website

The pregancy book by DOH

Question 18

What foods should be avoided in pregnancy?

Answer 18

Soft cheeses
Undercooked meat
Vitamin A
Lots of fish

Question 19

Why is vitamins A supplementation not recommended in pregnancy?

Answer 19

It can impair folic acid absorption

Question 20

What has too much vitamin A in?

Answer 20

Fish liver oil

Eating liver

Question 21

In a woman with previous baby with neural tube defects or a woman who hasn’t taken foic acid 3 months prior to pregnancy
How much do they take?

Answer 21

5mg

Question 22

How common is Down’s syndrome?

Answer 22

1:650-1000

Question 23

What is the chance of miscarriage with
CVS
Amniocentesis?

Answer 23

2% cvs

1% amniocentesis

Question 24

What is the difference between a threatened miscarriage and an antepartum haemorrhage?

Answer 24

Threatened is before 24 weeks and haemorrhage is after

Question 25

Name some causes of antepartum haemorrhage? A

Answer 25

``` Placenta praevi Placental abruption Local bleeding from vagina/vulva Ectropion Cervical polyps ```

Question 26

How common is placenta praevia?

Answer 26

1:200

Question 27

If someone has a low lying placenta at 24 weeks, is this worrying?

Answer 27

Not really, the placenta may migrate up, only about 5% will end up with placenta praevia

Question 28

What can cause placental abruption?

Answer 28

The cause is unknown but it is associated with Trauma SROM in polyhydramnios (sudden reduced pressure)

Question 29

What are the risk factors for placental abruption?

Answer 29

Low socioeconomic class Hypertension Preeclampsia Smoking

Question 30

At what week gestation is the uterus normally palpable?

Answer 30

12-14 weeks

Question 31

How many weeks is the uterus at the level of the umbilicus?

Answer 31

20 weeks

Question 32

What signs of the abdomen do you look for in an obstetric examination?

Answer 32

``` Abdominal distension Scars Linea nigra Stiae Fetal movements ```

Question 33

When palpating in an obstetrics examination what 3 things do you feel for?

Answer 33

Lie - ?longitudinal Presentation -?cephalic/ breech Engagement - 5ths palpable

Question 34

What percentage of babies are breech at 28 weeks? 37 weeks?

Answer 34

30% | 3%

Question 35

How might antiphospholipid syndrome effect pregnanacy?

Answer 35

Recurrent miscarriage IUGR Preeclampsia

Question 36

What can antiphospholipid syndrome be treated with?

Answer 36

Aspirin And Low molecular weight heparin

Question 37

What antibodies are present in | Antiphospholipid syndrome?

Answer 37

Lupus anticoagulant | Anticardiolipin antibodies

Question 38

How much is the risk of VTE in preganacy increased by?

Answer 38

x6

Question 39

How common is a PE DVT In preganacy?

Answer 39

0.3% | 1%

Question 40

What is used to treat VTE?

Answer 40

Low molecular weight heparin

Question 41

What are the risk factors for VTE?

Answer 41

``` High parity Obesity Varicose veins Age over 35 Infection Preeclampsia Immobility (ie after c section) ```

Question 42

Who are given anti D prophylaxis Rh -be or +be women?

Answer 42

Rh negative

Question 43

What categories are there on the thesis system? Which predominates?

Answer 43

C D and E D predominates

Question 44

At what weeks gestation is anti D routinely given?

Answer 44

28 weeks And 34 weeks

Question 45

How quickly after a sensitising event should anti D be given?

Answer 45

Within 72 hours although could still have benefit 9 days later

Question 46

What dose of anti d should be given after 20 weeks?

Answer 46

500 IU

Question 47

What is the name of the test performed after birth to assess the levels of anti D antibodies in the mothers blood?

Answer 47

Kleihaur

Question 48

What can transfer of the anti D antibodies do to the baby?

Answer 48

Neonatal jaundice Neonatal anaemia - haemolytic disease of the newborn Anaemia in utero if severe

Question 49

What is the name of the test which looks for antibodies against red blood cells in the baby's blood?

Answer 49

Coombs test (direct)

Question 50

What does HELLP stand for?

Answer 50

Haemolysis Elevated liver enzymes Low platelet count

Question 51

What may also occur in HELLP?

Answer 51

DIC | Liver failure

Question 52

What are normal protein levels excreted in the urine did a pregnant lady?

Answer 52

0.3g in 24 hours

Question 53

What is the triad of preeclampsia?

Answer 53

Hypertension Proteinuria Oedema

Question 54

What trimester is blood pressure lowest?

Answer 54

Second trimester

Question 55

How common is pre- eclampsia? | Severe preeclampsia?

Answer 55

6% of nulips 5:1000

Question 56

What symptoms might be present in pre eclampsia?

Answer 56

Head ache Drowsiness Visual disturbances Nausea / vomiting

Question 57

How do you treat HELLP ?

Answer 57

Supportive treatment | Mg sulphate to prevent seizures

Question 58

What is the main complication of pre eclampsia in relation to the fetus?

Answer 58

IUGR Premature labour Mortality

Question 59

What is considered high blood pressure? What blood pressure dictates immediate admission to hospital?

Answer 59

140/90 160/110

Question 60

What is the first line anti hypertensive in pregnanacy?

Answer 60

Labetalol

Question 61

What drug may also be prescribed in a wan with hypertension

Answer 61

Asprin if she has risk factors for pre eclampsia

Question 62

What are the risks of mg sulphate?

Answer 62

Loss of patellar reflexes Respiratory depression Hypotension

Question 63

Define 'pre existing hypertension in preganancy'

Answer 63

BP above 140/90 before 20 weeks gestation

Question 64

Where does fertilisation usually take place?

Answer 64

Ampulla of Fallopian tube as the egg normally waits there for up to 38 hours

Question 65

Is the infundibulum lateral or medial to the ampulla of Fallopian tube?

Answer 65

Lateral

Question 66

Is the isthmus lateral or medial to the ampulla?!

Answer 66

Medial

Question 67

What feature on USS is used to estimate gestational age At 10-14 weeks? Over 14 weeks

Answer 67

Crown rump length Bi parietal diameter

Question 68

When is the estimated due date after LMP if regular 28 day cycle?

Answer 68

40 weeks after the first day of LMP

Question 69

What is the risk of passing maternal rubella to the fetus in the first trimester? In the second trimester?

Answer 69

80% 25%

Question 70

What is the success rate of extra cephalic version?

Answer 70

50%

Question 71

When should extra cephalic version be performed?

Answer 71

36 weeks for nullip | 37 weeks for multip

Question 72

What are the risks of extra cephalic version?

Answer 72

Placental abruption Uterine rupture Feto maternal haemorrhage Increased risk of needing intervention when cephalic after ECV

Question 73

Can extra cephalic version be performed at home?

Answer 73

No needs to be in hospital where there is monitoring and facilities available to deliver baby if any thing goes wrong

Question 74

What are the absolute contra indications for extra cephalic version?

Answer 74

``` Antepartum haemorrhage in the last 7 days Abnormal CTG Major uterine abnormality Ruptured membranes Multiple preganacy ```

Question 75

What are the relative contraindications for extra cephalic version?

Answer 75

``` SGA Preeclampsia Oligohydromnios Scarred uterus Unstable lie Major fetal abnormalities ```

Question 76

Women who are at risk of pre eclampsia are advised to take aspirin, what are the tisk factors?

Answer 76

Previous pregnancy hypertension Chronic kidney disease Autoimmune disorders - SLE Diabetes

Question 77

In these women at risk of pre eclampsia when should they take aspirin?

Answer 77

OD | From 12 weeks till birth