obs and gyn Flashcards
(24 cards)
reduced fetal movement factors
Ix for fetal movements reduced
handheld doppler, CTG, USS
pt not immune to chickenpox exposure management
Give either varicella-zoster immunoglobulin (VZIG) or aciclovir on days 7-14 of exposure
pregnant woman with chickenpox symptoms
Seek specialist advice from an obstetrician
Oral aciclovir should be given if the patient presents within 24 hours of onset of the rash
fetal varicella syndrome baby impact
chickenpox in pregnant
external thrush Mx
A 32-year-old woman who is 30+2 weeks pregnant, G3 P2+0, presents to the maternity triage unit. Her past deliveries were both elective Caesarean sections. Her pregnancy has been uneventful up to this point but she presents to the maternity triage unit this morning with an episode of vaginal bleeding. She describes the amount as about a tablespoon. There is no associated pain.
What should be done next to determine the diagnosis?
USS for placenta praevia
VIt d reccomendations
All women should be informed at the booking appointment about the importance for their own and their baby’s health of maintaining adequate vitamin D stores during pregnancy and whilst breastfeeding’
‘women may choose to take 10 micrograms of vitamin D per day, as found in the Healthy Start multivitamin supplement’. This was confirmed in 2012 when the Chief Medical Officer advised: ‘All pregnant and breastfeeding women should take a daily supplement containing 10micrograms of vitamin D, to ensure the mothers requirements for vitamin D are met and to build adequate fetal stores for early infancy’
particular care should be taken with women at risk (e.g. Asian, obese, poor diet)
natural remedies for N and V
natural remedies - ginger and acupuncture on the ‘p6’ point (by the wrist) are recommended by NICE
most risky form of breach
Footling presentations are a rare but the most risky form of breech- there is a 5-20% risk of cord prolapse, which can obstruct foetal blood flow and is an obstetric emergency.
Raised FSH/LH in primary amenorrhoea - consider
gonadal dysgenesis (e.g. Turner’s syndrome)
A 82-year-old woman presents to the general practitioner with a 2-week history of a labial lump. She denies pain but says that it is very itchy and rubs on her underwear. Her past medical history includes hypertension and type 2 diabetes mellitus for which she takes amlodipine, metformin and sitagliptin daily.
On examination, there is a 2cm x 3cm firm lump on her left labia majora. The surrounding skin appears normal with no erythema or induration. There is palpable inguinal lymphadenopathy.
Older woman with labial lump and inguinal lymphadenopathy → ?vulval carcinoma
If low-lying placenta is found at the 20-week scan then
rescan at 32 weeks to assess
first-line for non-pregnant women with vaginal thrush
Oral fluconazole single-dose is first-line for non-pregnant women with vaginal thrush
prophylaxis of resus sensitisation
one dose followed by a Kleihauer test.
A Kleihauer test is a test for FMH which detects fetal cells in the maternal circulation and, if present, estimates the volume of FMH to allow calculation of additional anti-D immunoglobulin. According to BCSH guidelines, it is required for any sensitising event after 20 weeks gestation.
The most common ovarian cancer
serous carcinoma - 90% epithelial in origin
ctg HR
100-160
deceleration concern
3 mins
arbs/acei în pregnancy?
NO
spironolactone in pregnancy?
can feminise fetus
HTN
labetalol or nifedipine if asthmatic
umbilical cord prolapse Mx whilst awaiting theatre
Tocolytics may be useful in umbilical cord prolapse to reduce uterine contractions
terbutaline
