O+G Flashcards
criteria for emergency c-section on ctg (if not in labour)
prolonged deceleraiton >3 minutes or acute bradycardia
what analgesia is contraindicated in pregnancy?
NSAIDS e.g. ibruprofen, naproxen
teratogenic such as renal agensis in first trimester.
pretern delivery, lbw premature closure of ductus arteriosis.
analgesia of choice in pregnancy?
paracetamol (crosses placenta but no increase in congenital abnormalities)
can also take codeine phosphate at low dose as second-line if required
IUS post partum
can be inserted within 48h but after this must be delayed 4 weeks
methotrexate IM for ectopic criteria
return for follow up tests no significant pain US reveals unruptured ectopic adenexal mass <35 and no visiblle heartbeat No intertuterine pregnancy on US serum BHCG <1500iu/L
woman with breast carcinoma tamoxifen in pregnancy
tamoxifen is CI
chemo in 3rd trimester is ok
Pe in pregnancy : warfarin in pregnancy congenital symptoms
how do you treat?
Use in the first trimester confers
the most risk of teratogenicity, and is associated with fetal warfarin
syndrome, a constellation of symptoms comprising nasal hypoplasia,
vertebral calcinosis and brachydactyly. The risk of teratogenicity with
warfarin use in the mid- and third trimesters is reduced but evidence exists
to show a chance of cerebral malformations and ophthalmic disorders.
enoxaparin
imaging for PE in pregnancy
v/q scan lower radiaiton than CTPA
herpes infection in 3rd trimester
deliver by c-section if within 6 weeks, cover with acyclovir oral tds until delivery
herpes infection in 1st/2nd trimester
low risk of transmission oral acyclovir for aorund 5 days tds, restart acyvlovir at 36 weeks normal delivery
OC induction of labour
37/38weeks to decrease still birth risk
CI for ecv
multiple gestation placenta praevia pre-clampsia major uterine abnormalty antepartum haemorrhage within 7 days ruptured membranes
SGA+ABNORMAL doppler only relative
which drug is not absolute CI fluconazole acritretin mebendazole sodium valproate methotrexate
trick quesiton they all are
GDM post meal glucose aim.
In diabetes in pregnancy the reference ranges for sugar control are
slightly different. Ideally before every meal the blood sugar should
be less than 5.5 μmol/L and 1 hour after a meal less than 7.8 μmol/L.
Outside of pregnancy 2-hour post meal readings are taken.
The appointment will involve referral to the dietician,
the diabetes nurse (to learn how to test and record her blood sugars) and
counselling about the risks of diabetes in pregnancy. These risks involve
when should we see foetal pole and foetal HR
6 weeks
