Obs Flashcards
(24 cards)
Investiagtions to explore fertility in men and women
Men: Serum analysis
Women: Serum progesterone at 21 days and Consider ultrasound scan.
Counsel on: folic acid, SNAPV
9 weeks pregnant women comes with PV bleeding. Tissue has passed through her vagina and her cervix is closed.
Complete miscarriage.
Pain and uterine contractions stop after fetus has been expelled
Diagnosis: U/S shows an empty uterus
A gestational sac which contains a dead fetus before 20 weeks without the symptoms of expuslion
Missed (delayed) miscarriage
Pregnant lady with slight bleeding, discharge. Cervical os is closed.
when the gestational sac is > 25 mm and no embryonic/fetal part can be seen it is sometimes described as a ‘blighted ovum’ or ‘anembryonic pregnancy’
Missed (delayed) miscarriage
heavy bleeds in a pregannt lady with clots and pain. Cervical os is open:
Inevitable miscarriage
Not all products of the conception have been expelled. Pain and vaginal bleeding - cervical os is open
Incomplete miscarriage
In a female with Post menopausal bleeding the diagnosis is _____ until proven otherwise
Endometrial adenocarcinoma
What is Sheehan’s syndrome?
Hypopituitarism caused by ischaemic necrosis due to blood loss and hypovolaemic shock
What are the features of Sheehan’s syndrome?
Agalactorrhea, Amenorrhea, Symptoms of hypothyroidism, Symptoms of hypoadrenalism
Four causes of primary amenorrhea?
Turner’s syndrome, testicular feminisation, Congenital adrenal hyperplasia, congenital malformations of the genital tract
A second degree perineal tear goes to the ______
subcutaneous or submucosal tissue
RF for perineal tears?
Primigravida, large babies, precipitant labour, shoulder dystocia, forceps delivery
What is the down syndrome serum screening in the second trimester?
AFP, Unconjugated Oestriol, b-hCG, Inhibin A
Anaemia in pregnancy:
1st trim, Hb < ____
2nd/3rd Trim Hb < ____
First trimester less than 110
Second trimester less than <105
Mother in third trimester. Faints and has severe abdominal pain. Low BP, tachycardic. Cold to touch…
Placental abruption
A 31-year-old woman presents with painless vaginal bleeding at 15 weeks gestation. She has not yet had any antenatal care despite suffering from severe vomiting. On examination the uterus is large for dates
Hydatiform mole
_____ and _______ can be used as tocolytics
indomethacin and salbutamol
4 T’s of PPH
Tone
Tissue (retained placenta)
Trauma
Thrombin (coagulation abnormalities)
Vitamin _____in high doses can be teratogenic
Vit A
Role of D-Dimer in pregnancy?
No role - as it is already physiologically elevated.
Haematocrit and Hb - increase or decrease in pregnancy?
They decrease - because of volume expansion, the blood dilutes and hence they become less concentrated.
TBG - increase or decrease in pregnancy?
Increased TBG and T4/T3.
Beta-hCG acts on the TSH receptors hence causes hyperthyroidism?
What is the strongest risk factor for pre-term birth?
Prior pre-term birth
Immediate management after a seziure?
First give MgSO4 Bolus - then labetalol for BP
