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MC > High Risk Pregnancy > Flashcards

High Risk Pregnancy Flashcards

1
Q

A _______ is one in which the fetus is
at increased risk of stillbirth, neonatal morbidity or
death, and/or the expectant mother is at increased
risk for morbidity or mortality

A

high-risk pregnancy

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2
Q

The WHO definition of maternal mortality is the
death of a woman during ______, _______, __________, irrespective of
duration or site of the pregnancy, from any cause
related to or aggravated by the pregnancy or its
management.

A

pregnancy, childbirth or

in the 42 days of the puerperium

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3
Q

The ________ is the number of deaths per 100 000 confinements. In first world countries it is approximately 10.

A

maternal mortality ratio

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4
Q

The latest
triennium statistics for Australia was ____________ confinements—

_______ for non-Indigenous
Australians and 21.5 for ASTI people (c.f. Africa
approx. 900).

A

8.4 deaths per
100 000

8

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5
Q 
The main causes of direct maternal deaths in
Australia are (in order)
A
  • amniotic fluid embolism
  • thrombosis and thromboembolism
  • haemorrhage
  • hypertensive disorders of pregnancy
  • cardiac conditions
  • anaesthetic-associated deaths
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6
Q

Some Australian obstetric statistics for 2003:

  • average age of all mothers was _____
  • spontaneous vaginal births—______
  • caesarean section (CS) rate—______
  • instrumental delivery rate—_____
  • multiple pregnancies—____
A
  1. 5 years
  2. 3%
  3. 5%
  4. 7%
  5. 7
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7
Q

The_______ is the total number of deaths
of children within 28 days of birth (early neonatal
deaths) plus fetal deaths at a minimum gestation
period of 20 weeks or a minimum fetal weight of 400 g
expressed per 1000 births

A

perinatal mortality

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8
Q 
The major factors  associated with perinatal mortality
in NSW are 
1
2
3
A

very premature birth, congenital
abnormalities and hypoxia during the antenatal
period or in labour.

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9
Q

A review of perinatal deaths
occurring in 2003 in Australia found that _____
of perinatal deaths (or 45.7% of stillbirths) were
unexplained antepartum deaths

A

30.9%

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10
Q

The earlier that ultrasound is performed after _______of gestation, the more accurate the determination.

A

6–7 weeks

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11
Q

Hypertensive disorders complicate about _____ of all

pregnancies

A

10%

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12
Q

________ which in
fact complicates 2–8% of pregnancies, can occur at
any time in the second half of pregnancy or even just
following delivery

A

Pre-eclampsia,

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13
Q

What is pregnancy induced HPN

A

— SBP >140 mmHg and DBP >90 mmHg,
occurring for first time after 20th week of
pregnancy and regressing postpartum
or
— Rise in SBP >25 mmHg or DBP >15 mmHg
from readings before pregnancy or in first
trimester

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14
Q

_____________BP up to 170/110 mmHg in

absence of associated features (

A

Mild pre-eclampsia.

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15
Q 
Severe pre-eclampsia. BP >170/110 mmHg and/or
associated features, such as 
1
2
3
4
5
A

kidney impairment, thrombocytopenia, abnormal liver transaminase levels, persistent headache, epigastric tenderness or fetal compromise

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16
Q

____________ Chronic
underlying hypertension occurring before the
onset of pregnancy or persisting postpartum

A

Essential (coincidental) hypertension.

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17
Q

__________ Underlying

hypertension worsened by pregnancy

A

Pregnancy-aggravated hypertension.

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18
Q

Test for pre-eclampsia:
1
2
3

A

spot urinary albumin– creatinine ratio, or 24-hour urinary protein excretion

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19
Q

The following are risk factors for pregnancy-induced

hypertension

A
  • nulliparity/primigravida
  • family history of hypertension/pre-eclampsia
  • chronic essential hypertension
  • diabetes complicating pregnancy
  • obesity
  • donor sperm or oocyte pregnancy
  • multiple pregnancy
  • hydatidiform mole
  • hydrops fetalis
  • hydramnios
  • kidney disease
  • autoimmune disease (e.g. SLE)
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20
Q 
Clinical features of superimposed pre-eclampsia
include
1
2
3
A

hypertension, excessive weight gain,
generalised oedema and proteinuria (urinary protein
>0.3 g/24 hours).

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21
Q

Risks of severe pre-eclampsia/ hypertension

Maternal risks (poor control)

A
  • Kidney failure
  • Cerebrovascular accident
  • Cardiac failure
  • Coagulation failure
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22
Q

Risks of severe pre-eclampsia/ hypertension

Risks to baby

A
  • Hypoxia
  • Placental separation
  • Premature delivery
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23
Q

In pre-eclampsia

The BP level should be kept below _______
mmHg because at this level intra-uterine fetal death is
likely to occur and there is a risk of maternal stroke

A

160/100

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24
Q

Contraindicated drugs for pre-eclampsia are

A

ACE inhibitors and diuretics

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25
Q

Commonly used medications for pre-eclampsia

A

• beta blockers (e.g. labetalol, oxprenolol and
atenolol) (used under close supervision and after
20 weeks gestation)
• methyldopa: good for sustained BP control
• nifedipine

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26
Q

_____, _______ and _______are useful
for rapid control of BP in hypertensive crises (e.g.
hydralazine 5 mg IV bolus every 20–30 minutes or
continuous infusion).

A

Labetalol, hydralazine and diazoxide

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27
Q

Guidelines for urgent referral/admission
to hospital

Maternal factors

A

•Progressing pre-eclampsia including development
of proteinuria
• Inability to control BP
• Deteriorating liver, blood (platelets), kidney
function
• Neurological symptoms and signs

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28
Q

Guidelines for urgent referral/admission
to hospital

Fetal factors

A

• Abnormal cardiotocograph (CTG) indicating fetal
distress
• Intra-uterine growth retardation

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29
Q

Treatment of severe pre-eclampsia: prevention of convulsions

1
2
3

A

• Control BP: use IV hydralazine or diazoxide—don’t
suppress to <140/80 as this can induce fetal hypoxia

• Magnesium sulphate 50% 4 g IV (given over
10–15 minutes) followed by an infusion 1 g/hour
for a minimum of 24 hours (if normal kidney
function)

• Corticosteroid therapy IM for fetal lung maturity
if gestation ≤ 34 weeks

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30
Q

What to monitor is severe pre-ecl

A

Monitor fetus and maternal BP, urine output,

urine protein, coagulation profile

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31
Q

The best treatment for pre-ecl is

A

termination of pregnancy with early delivery—by CS or vaginal delivery if favourable circumstances

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32
Q

Treatment of convulsion

A

bolus of 2 g MgSO 4 .

Consider an alternative—IV diazepam or clonazepam

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33
Q

In Mx of eclampsia

  • Avoid _____ in the third stage.
  • Be prepared for a possible _____
A

ergometrine

postpartum haemorrhage

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34
Q

What is HELLP syndrome

A

Haemolysis Elevated Liver enzymes Low Platelets is
a severe form of pre-eclampsia occurring in 20% of
these patients. Treat as for severe pre-eclampsia with
early delivery

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35
Q

Anaemia is defined as a haemoglobin _____.
Levels below this, particularly less than __, require
investigation.

A

<110 g/L

100 g/L

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36
Q

Important types of anaemia in pregnancy:

1
2
3

A

• iron deficiency (approximately 50%)
• megaloblastic anaemia (usually due to folic acid
deficiency)
• thalassaemia (most commonly β -thalassaemia

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37
Q

Treatment of anemia according to cause:

— iron deficiency: ______

— megaloblastic anaemia: ______

— thalassaemia: no treatment is possible but
_____

A

ferrous sulphate 0.9 g (o) daily, iron infusion may be required

folic acid 5 mg (o) bd

partner also needs to be screened

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38
Q

Fetal effects of DM

A

Large for dates (macrosomia), fetal abnormalities
(neural tube, cardiac, kidney, vertebral, etc.
defects), hypoxia and intra-uterine death (IUFD),
miscarriage, malpresentation, IUGR, preterm
delivery

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39
Q

Postnatal effects on fetus of DM

A

Early hypoglycaemia, respiratory distress

syndrome, jaundice

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40
Q

Effects on the mother of DM

A

Increased risk of pre-eclampsia, diabetic
ketoacidosis, polyhydramnios, intercurrent
infection, psychological effects, first trimester
miscarriage, obstructed labour (shoulder
dystocia), placental abruption, CS

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41
Q

Aim for diabetic control:

FBS and Hba1c

A

fasting blood sugar 4–7

mmol/L: HbA1c <7%

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42
Q

When to do fetal morphology tests in DM mothers

A

• Screen for fetal morphology and growth:
ultrasound at 18 weeks then 4 weekly and as
required; cardiotocography as required—usually
weekly from 32–34 weeks until delivery

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43
Q

Aim to deliver in DM mothers at term at latest:
— vaginally if optimal control
— CS if __________

A

large fetus (>90th weight percentile
or >4000 g) or evidence of fetal distress or
breech presentation

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44
Q

In DM, postpartum care involves:

A

Cease insulin infusion and ↓ insulin to
pre-pregnancy regimen immediately after
delivery; organise contraception; avoid oral
hypoglycaemics during breastfeeding

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45
Q

Gestational diabetes is the onset or initial recognition
of abnormal glucose tolerance during pregnancy. If
suspected a diagnostic________

A 
oral glucose (75 g) tolerance
test is indicated.
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46
Q

GDM

Diagnosis: fasting blood glucose ______
or
2-hour level______

A

> 5.5 mmol/L

> 8.5 mmol/L

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47
Q

_______ in pregnancy is unhelpful for
screening because it is common in pregnancy and
lacks specificity

A

Glycosuria

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48
Q

On GDM

Follow up GTT at 6 weeks and then every
5 years. Gestational diabetes is likely in subsequent
pregnancies and there is a ______ risk of developing
diabetes in later life—even <10 years

A

30%

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49
Q

_______ in pregnancy is uncommon and
usually mild. It is associated with infertility. It is
associated with a higher rate of fetal loss, miscarriage,
fetal abnormalities and IUGR

A

Hypothyroidism

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50
Q

When to do testing for TFT

A

TFTs should be checked at first presentation if past history is relevant and at 36 weeks

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51
Q

_______ is usually the preferred agent in Graves in pregnancy

A

Propylthiouracil

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52
Q

The highest risk of maternal mortality during pregancy is where

A

pulmonary blood flow cannot be increased
(e.g. pulmonary hypertension, Eisenmenger
syndrome

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53
Q

______ and _______ may be a pointer to a

cardiac disorder

A

Syncope and dyspnoea

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54
Q

________is important for those
with structural cardiac problems (e.g. valvular
problems), most congenital malformations

A

Antibiotic prophylaxis

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55
Q

Patients with an increased risk of bacterial
endocarditis (especially with rheumatic heart
disease) require an antibiotic cover in labour of
______ and _______

A

penicillin and gentamicin

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56
Q

What to avoid in Cardiac do

A

As a rule avoid lithotomy, ergometrine,

sympathomimetic drugs

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57
Q

Crea level with increased CX

A

↑ maternal and fetal complications in moderate
failure (s. creatinine 0.125–0.25 mmol/L) and
severe kidney failure (>0.25 mmol/L).

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58
Q

T or F

Pregnancy does not seem to cause exacerbations
of SLE.

A

T

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59
Q

SLE in pregnancy

Increased incidence of spontaneous abortions
and stillbirths—related to_____ and ______

A

lupus anticoagulant

and anticardiolipin antibodies

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60
Q

_________ includes blood
disorders and cardiac abnormalities in the
neonate.

A

Neonatal lupus syndrome

61
Q

SLE

___________if anticardiolipin antibodies present, to prevent onset of preeclampsia or IUGR.

• Low molecular weight heparin may be used
as alternative to aspirin and in presence of
________

A

Low dose aspirin (100 mg daily)

prolonged APTT.

62
Q

The two most common causes of significant
thrombocytopenia (TCP) in an otherwise normal
pregnancy blood film are _______ and ______

A

gestational thrombocytopenia

and immune thrombocytopenia

63
Q

Other causes of TCP

A

SLE, anti-phospholipid syndrome (APS), drug-induced thrombocytopenia and HIV infection.

64
Q

Because of the increasing hazard of epidural
anaesthesia in platelet counts under 75/nL, a 2-week
course of _______ is often prescribed at 37–38
weeks gestation, aiming for a platelet count in excess
of 100/nL at the time of delivery

A

prednisolone

65
Q

Although less common than gestational ITP, it is
clinically more significant since it is typically severe
and arises earlier in pregnancy

A

Immune TCP

66
Q

_________ are found in at least

50% of ITP patients

A

Platelet-specific antibodies

67
Q

________ results from the transplacental passage of
maternal IgG anti-platelet antibody into the fetal
circulation

A

Fetal ITP

68
Q

________ accounts for 40% of all cases of jaundice

during pregnancy

A

Viral hepatitis

69
Q

This condition is due to an oestrogen sensitivity. The
symptoms, which are mild, include low-grade jaundice
and pruritus during the latter half of pregnancy

A

Cholestasis of pregnanc

70
Q

Cholestasis of pregnancy

The condition clears up rapidly after delivery,
but it often recurs in future pregnancies and if the
patient is prescribed _______ which are
contraindicated

A

oral contraceptives,

71
Q

About 25% of women have
an increased number of seizures, due mainly to a_______________ with a small increased
frequency during labour and the puerperium

A

fall

in anti-epileptic drug levels

72
Q

It is important to take oral folic acid supplementation

(5 mg daily) during pre-pregnancy and up to_____

A

12 weeks

gestation,

73
Q

For subsequent contraception a higher dose oestrogen

pill is recommended because

A

the anti-epileptic agent

usually increases liver enzyme activity

74
Q

Bleeding from the genital tract after the

20th week of gestation and before the onset of labour

A

Antepartum haemorrhage

75
Q

If haemorrhage occurs at less than 24 weeks

treat as for ___________

A

threatened miscarriage

76
Q

Main causes og Hge post 26 wks

A

The main causes are placental, namely
placenta praevia (unavoidable APH) and placental
abruption (accidental).

77
Q

_______ in
particular has a high risk of causing fetal death in
utero with coagulopathy complications

A

Placental abruption

78
Q

The placenta has a low attachment onto the lower
uterine segment and may cover the cervix. Incidence
is about 1%.

A

PP

79
Q

PP SSx

A

Presentation usually
includes painless bleeding at 28–30 weeks gestation.
There is a high presenting part on palpation

80
Q

__________is always required for major

placenta praevia

A

Caesarean section

81
Q

__________ is retroplacental
bleeding from a normally situated placenta resulting
in detachment of a segment of decidua from
the uterine wall

A

Placental abruption (incidence 1%)

82
Q

SSx of AP

A

The patient presents with midabdominal
pain, bleeding PV, and a tense and tender
uterus (large for dates) and signs of hypovolaemic
shock.

83
Q

It is

the commonest obstetric cause of coagulopathy

A

Abruptio Placenta

84
Q

Tests for AP

A

Perform tests—FBE, coagulation profile,
Kleihauer test to define any feto-maternal
haemorrhage, blood for cross-matching, kidney
function, electrolytes

85
Q

AP

Give course of ________ if <34 weeks to
mature the baby’s lungs as urgent delivery may
be necessary

A

corticosteroids

86
Q

What is the aim for AP

A

The objective is to aim for vaginal delivery, especially

if the baby is dead

87
Q

AP

Caesarean
section has been recommended where the baby’s life
is immediately threatened, but this is hazardous in the
presence of ________

A

coagulopathy.

88
Q

______ is a rare cause of APH due to rupture of
fetal blood vessels. It coincides with rupture of the
membranes

A

Vasa praevia

89
Q

Diagnosis of VAsa Previa is by a
1
2

A

characteristic ominous pattern on CTG and the

Apt test. Emergency delivery is indicated

90
Q

Primary postpartum haemorrhage is loss of _____
of blood within 24 hours of delivery. A severe PPH is
defined as ______ blood loss.

A

> 500 mL

> 1000 mL

91
Q

Causes of Primary postpartum Hge (PPH)

A 
• Uterine atony
• Retained placenta/placental fragments
• Soft tissue laceration of genital tract (e.g.
episiotomy, cervical tear)
• Ruptured or inverted uterus
• Coagulation disorder
92
Q

Mx of PPH

A

• IV oxytocin (Syntocinon) 10 IU followed by 40 IU
in IV infusion of Hartman solution
• If continuing heavy bleeding ergometrine

93
Q

PPh

If retained placenta—deliver ________

A

with cord traction

or manual removal

94
Q

If a persistent atonic uterus is not controlled

by oxytocics, 1–2.5 mg doses of _______

A

intramyometrial prostaglandin F2- α can be injected through the abdominal wall

95
Q 
Life-saving measures for PPH can include
1
2
3
4
A

insertion of a Bakri balloon for tamponade, uterine
artery ligation, internal iliac artery ligation (usually
bilateral) or hysterectomy

96
Q

Blood group or red cell isoimmunisation is primarily
related to Rhesus D (RhD) isoimmunisation leading
to ______________from the effect
of the development of anti-D antibodies

A

haemolytic disease of the newborn

97
Q

Cause of Blood group isoimmunisation

A

These
antibodies develop from feto-maternal haemorrhage/
transfusion in RhD-negative women carrying an
RhD-positive fetus.

98
Q

Blood group isoimmunisation

Effects of haemolytic disease on the fetus includes
__________

A

hydrops (oedema), FDIU

99
Q

Blood group isoimmunisation

Effects on the neonate include
1
2
3
4
A

anaemia, heart failure, jaundice and hepatosplenomegaly

100
Q 
Indications for giving anti-D Ig to the RhD-negative
mother free of immune anti-D:
1
2
3
4
5
A

• after spontaneous miscarriage at any stage of
pregnancy
• after threatened miscarriage
• after delivery of an RhD-positive baby
• following termination of pregnancy or ectopic
pregnancy
• following any sensitising event during pregnancy
that may provoke a transplacental haemorrhage
• prophylactically at 28 and 34 weeks in an
apparently normal pregnancy

101
Q

This is a test on maternal blood after a sensitising event
to detect the degree of feto-maternal transfusion and
whether increased anti-D Ig is required

A

Kleihauer test

102
Q

This usually occurs when the mother is group O and
the baby A or B and can occur in the first pregnancy
without a tendency to become increasingly severe
in subsequent pregnancies

A

ABO incompatibility

103
Q

ABO incompatibility

A small number of babies have ______

A

mild jaundice while severe haemolytic consequences are rare

104
Q

Pregnancy is associated with an increased risk of

thromboembolism with an incidence of about _____

A

1%

of deep venous thrombosis (DVT)

105
Q

Untreated DVT

carries about ______ risk of pulmonary embolism.

A

15%

106
Q

If a______ is suspected, low molecular weight heparin
is recommended until investigation and specialist
advice are obtained.

A

DVT

107
Q

________ is an overgrowth of gestational

trophoblastic tissue.

A

Hydatidiform mole

108
Q

Types of H mole

A

The moles may be complete (no

fetal tissue) or partial (some fetal tissue)

109
Q

SSx of H mole

A

Bleeding in early pregnancy ± passage of grapelike
debris
• May be exaggerated symptoms of pregnancy
(e.g. hyperemesis)
• Uterus large for dates

110
Q

UTz of H mole

A

typical ‘snow-storm’ appearance

111
Q

FF up for h mole

A

• Weekly serum (or urine) hCG until zero (usually
takes 8–12 weeks), then monthly for 12 months
• Avoid pregnancy for 12 months after hCG levels
norma

112
Q

H mole Tx

A

Refer for possible cytotoxic therapy (e.g.
methotrexate and folinic acid) if hCG does not
become normal or the process is >3 months, or it
becomes elevated again and a new pregnancy has
been excluded

113
Q

Maternal Cx of multiple pregnancy

A

increased risk anaemia; symptoms of
pregnancy (e.g. morning sickness, varicose veins);
pre-eclampsia × 3; antepartum and postpartum
haemorrhage; malpresentation; cord prolapse; CS

114
Q

Fetal/neonatal Cx of multiple pregnancy

A

increased risk abnormalities,
preterm delivery (premature labour, premature
rupture membranes); intra-uterine growth
restriction of one fetus; twin–twin transfusion;
perinatal mortality × 5; prematurity;
malformations × 2–4; (also those of mother)

115
Q

Monozygotic twins need a scan every 2–3
weeks from 16 weeks until delivery to recognise
evidence of ___________

A

twin-to-twin transfusion syndrome

TTTS

116
Q

Multiple pregnancy

As a rule, elective CS is favoured at_______

A

37 or 38 weeks

117
Q

Preterm or premature labour is confirmed labour

after ________ and before ________

A

20 weeks and before 37 weeks gestation

118
Q

Causes of spontaneous preterm labour

A 
• unknown (approx. 40%)
• multiple pregnancy
• cervical incompetence
• polyhydramnios
• uterine abnormality
• maternal medical conditions (e.g. diabetes, drug
abuse, infection)
• antepartum haemorrhage
119
Q

________________ is
rupture of the membranes with amniorrhoea before
labour commences

A

Premature rupture of the membranes (PROM)

120
Q

___________is rupture of the

membranes at <37 weeks gestation.

A

Preterm PROM (PPROM)

121
Q

50% of PPROM progress to labour within_____

A

24

hours (80% within 7 days).

122
Q

Differential diagnosis of PROM includes profuse

`

A

vaginal discharge, incontinence of urine—20%

false alarms for amniorrhoea (amniorrhexis).

123
Q

T or F
PROM
Do not perform a vaginal examination.

A

T

124
Q

Abx to be given for PROM

A

Give prophylactic antibiotics (erythromycin) until

culture results indicate that no infection is present

125
Q

PROM

Give corticosteroid therapy if delivery prior to______

A

34

weeks likely

126
Q

Prolonged pregnancy is pregnancy lasting longer than

________

A

42 weeks

127
Q

Induce labour at 42 weeks as perinatal mortality
rate is ↑ ___________ from 42–43 weeks and more so after
43 weeks.

A

× 2

128
Q

Induction is probably best achieved using
___ and ________, followed by ARM if labour does not
follow

A

prostaglandin E2 vaginal gel, or oral or vaginal

misoprostol

129
Q

What is the dx

• Liquor volume: usually >2000 mL
• Multiple risks (e.g. PROM, prem labour, cord
prolapse, APH, malpresentation)

A

Polyhydramnios

130
Q

Causes of polyhydramnios

A 
• Fetal abnormalities: CNS, upper GIT atresia,
ectopic vesicae
• Hydrops fetalis
• Diabetes
• Multiple pregnancy
• Chorioangioma of placenta
• Fetal infection—cytomegalovirus, toxoplasmosis
• Unknown caus
131
Q

Fundus less than dates

A 
• oligohydramnios—liquor volume usually
<500 mL
• small baby
• intra-uterine growth restriction
• wrong dates
• ruptured membranes
132
Q 
Oligohydramnios is associated with conditions
such as
1
2
3
4
5
A

fetal abnormality, prolonged pregnancy,
kidney disease, pre-eclampsia, congenital infections
(CMV, toxoplasmosis), PROM and placental
insufficiency

133
Q

____________ is defined

as an estimated birth weight <10th percentile

A

Intra-uterine growth restriction (IUGR)

134
Q

PE of oligohydramnios

A

symphysis–fundal height is at least 2 cm less than that expected for the appropriate gestation.

135
Q

Fresh meconium is______ and ______

A

dark green and sticky.

136
Q

_______ is an important cause of Meconium-stained liquor

A

Cord prolapse

137
Q

The important malpresentations are breech (4% of all
babies) and transverse or oblique lie. A primary concern is
the high risk of _____ and______

A

cord presentation and prolapse

138
Q

Breech presentation

The general rule is to deliver by _________

A

caesarean section (CS),

139
Q

If spontaneous version to a cephalic presentation has not occurred, what to do next?

A 
If appropriate, an external cephalic version can
be attempted (with a small risk of haemorrhage).
140
Q

These presentations are more common in
multigravida. Perform an ultrasound examination
to exclude placenta praevia

A

Transverse or oblique lie

141
Q

What to do if transverse lie persists beyond __________: admit to hospital and if it persists or labour
commences CS is the best option

A

37

weeks

142
Q

Impacted shoulders causing sudden arrest of delivery

after delivery of the baby’s head is a terrifying complication of childbirth

A

Shoulder dystocia

143
Q

Manuevers for the delivery during shoulder dystocia

A

(Consider
McRoberts manoeuvre 12 —suprapubic pressure,
shoulder rotation performed vaginally, delivery of
the posterior shoulder.)

144
Q

Mx of inverted uterus

A

The easiest way to manage this complication is to return the uterus to its normal position with the cord still attached immediately after the event

145
Q

Considerations for induction

A
  • post-term (41 weeks or over)
  • maternal hypertension
  • maternal distress
  • diseases of pregnancy (e.g. pre-eclampsia)
  • intra-uterine growth restriction
  • intra-uterine fetal death
  • diabetes mellitus
  • isoimmunisation
  • unstable lie
146
Q

Obstetric indications for CS

A 
• previous CS (commonest)
• failed progress of labour
• cephalo-pelvic disproportion—relative or
absolute
• cord prolapse and presentation
• placenta praevia
147
Q

Complications of CS

A

• increased risk of maternal mortality
• anaesthetic complications
• damage to adjacent viscera (e.g. bladder, bowel)
• infection
• adhesions
• need for repeat (maximum of three) CS advised
• increased risk of placenta praevia in subsequent
pregnancies

148
Q

Abdominal trauma in pregnancy is usually associated
with _________ during motor vehicle
accidents

A

seat-belt restraints

149
Q

The incidence of__________ following
accidents is related to the severity of the accident and
the extent of the external injuries

A

placental abruption

MC (90 decks)

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