1. in vagina 2. at introitus 3. out of vagina Old, preggers, heavy bleeding.

Obs and Gynae Flashcards by Celestine Weegenaar

Bartholin’s cyst

posterior and medial labia minora
painful sex
no symptoms

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Cervical ectropion/erosion

red endo cervix visible

young women, OCP, preggers

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Cervical polyp

benign tumour endocervix
red
preggers
biopsy to exclude
twist and pull or liquid nitrogen

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Uterine prolapse

in vagina
at introitus
out of vagina
Old, preggers, heavy bleeding.

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Cystocele

Prolapse anterior wall and bladder
frequency and more infections
pessaries

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Rectocele

Posterior wall

Bowel symptoms

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Fibroid uterus

smooth muscle tumour
common
painful periods
red degeneration in pregnancy

Rx: GnRH agonists
Hysterectomy/ myomectomy.

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Gartner’s duct cyst

Remnant of mesonephric duct

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Nabothian cyst

surface of cervix
ECTO grows over ENDO
impairs mucus drainage.

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Ovarian torsion

risk necrosis and ovarian loss

ooporopexy

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Osteitis pubis

inflammation of pubis symphysis

NO infection

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Suprapubic abscess

After pelvic surgery

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Addisons during pregnancy

may need more T3 to cope with stress

if not controlled may cause IUGR.

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Gestational diabetes

OGTT at 24-28 weeks
Gone after
Less birth defects.

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Management of hypertension in pregnancy?

Methyldopa

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Epilepsy in pregnancy

lowers seizure threshold
medications cause neural tube defects.
Increase folic acid dose
Carbamazepine and lamotrigine (NOT valproate).

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Epilepsy vs. eclampsia

generalised seizure in eclampsia.

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Hyperthyroidism in pregnancy

may improve
but anti-thyroid Abs can cross placenta and may make baby hyperthyroid with goitre
give propylthiouracil

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Hypothyroidism in pregnancy

Mum: more pre-eclampsia, miscarriages, stillbirths

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may get better in pregnancy but worse after.

no IFN in pregnancy

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Subseptate uterus

septum at fundus

more likely to have transverse lie, recurrent miscarriages, can’t have a IUD.

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SLE

better during preggers

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Venous stasis eczema

due to heavy baby

will get better after

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Cervical incompetence

early opening (before 34 weeks).
Cerclage between 12-14 weeks and remove 34 weeks.

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Cholecystasis bloods

High ALT and bile acids | normal ALP

Cholestasis

Oestrogen causes cholestasis Resolves after delivery May have still birth Need Vit K.

Gallstones

More common in preggers

Pre-eclampsia

AFter 20 weeks | High BP and proteinuria

Eclampsia

tonic-clonic general seizure during labour and after get placenta out!

Heterotrophic pregnancy

Half in and half out of uterus usually due to IVF like an ectopic

Hydatidiform mole

``` benign non-viable v. high bHCG Snowstorm on USS Bleeding Malignant potential Remove and methotrexate to kill ```

Hyperemesis gravidarum

due to bHCG 1st trimester urinary ketones give fluids and anti-emetics

Hyperstimulation syndrome

IVF complication Ascites, mild abdo distension, nausea, diarrhoea MASSIVE ovaries.

Placenta praevia

bleeding late Minor: side Major: over outlet

Placenta accreta

Inserted to myometrium

Placenta percreta

inserted into bladder

Placental abruption

Over 20 weeks | lead to APH and PPH, DIC, Hysterectomy

Spontaneous miscarriage

Before 24 weeks. Mifepristone and misoprostol Anti-D

Anencephaly

Due to: epileptics, T1DM, folic acid deficiency | 5mg/day for high risk.

Duodenal atresia

double bubble | treat with duodenoduodenostomy

IUGR

symmetrical: early asymmetrical: later

Oesophageal atresia

link with polyhydramnios (may have fistula)

Rubella in pregnancy

1st tri worst increase miscarriages, SN deafness, cataracts, congenital heart disease blueberry muffin rash

Premature labour

24-37 weeks.

Precipitate labour

under 3 hours | increased risk of trauma, PPH, infection, aspiration of baby

Bloody show

pink/white mucus | latent stage

cervix effaced

thinning

Rupture of membranes

If rupture and then nothing- will induce after 24 hours.

Artificial rupture

amniotomy

Foetal head above pelvic brim

not engaged. abdominally palpable

Foetal head below ischial spines

``` When gets to positive can use instruments Bishops score (at spines=0) ```

Bowel perforation

category 1 c-section=emergency

Cephalopelvic disproportion

Pelvis too small for baby

Transverse lie

preterm labour polyhydramnios multiple pregnancy

Breech

bum first extended (frank) flexed (complete) footling (undeliverable)

3rd degree tear

vagina to anal sphincter | due to obstruction, instruments, big baby, dystocia

Fitz- Hugh Curtis

Liver adhesions from chlamydia

Vaginal cancer

SCC | posterior wall upper third

Cervical cancer

SCC due to HPV

Endometrial cancer

unopposed oestrogen USS more than 5mm Hysterectomy and BSO

Ovarian cancer

most common serous cystadenoma

VIN

HPV pre cancer | Lichen sclerosis too

Hives

Can increase in pregnancy POPPP pruritic urticarial plaques and papules of pregnancy not dangerous

Allergies

can change in pregnancy | careful what you eat for baby too

Obs and Gynae Flashcards

(64 cards)