Obstetric Flashcards
(40 cards)
when is risk of rubella highest in pregnancy
in first 8-10 weeks risk of damage to fetus is as high as 90%
damage is rare after 16 weeks
features of congenital rubella syndrome
sensorineural deafness
congenital cataracts
congenital heart disease
learning difficulties
management of rubella exposure in pregnancy
should be discussed with local health protection unit
non-immune mothers should be vaccinated after giving birth
pre-eclampsia features a triad of what
hypertension
proteinuria
oedema
criteria for diagnosing pre-eclampsia
new hypertension of >140/90mmHg after 20 weeks AND 1 of the following:
proteinuria
end organ dysfunction e.g. raised creatinine, abnormal LFTs
features of severe pre-eclampsia
headache
visual changes/papilloedema
RUQ pain/epigastric pain
hyperreflexia
platelet count < 100 * 106/l, abnormal liver enzymes or HELLP syndrome
why can’t ACEi or ARBs be used in pregnancy
teratogenic
recommendation of folic acid during pregnancy
all women = 400mcg until 12th week of pregnancy
higher risk of conceiving a child with neural tube defects: 5mcg before conception until 12th week
higher risk includes:
either partner has NTD, FHx, or previous pregnancy
women is obese >30kg/m2
women takes anti-epileptic drugs, has coeliacs, diabetes, thalassaemia
what is obstetric cholestasis
seen in third trimester, occurs in around 1% of pregnancies
most common liver disease of pregnancy
raised bilirubin
pruritus, often of palms & soles
no rash, but might have excoriation marks
increased risk of stillbirth
management of obstetric cholestasis
ursodeoxycholic acid is used for symptomatic relief
weekly liver function tests
women are typically induced at 37 weeks
presentation of nipple candidiasis when breastfeeding
bilateral burning pain
itching
hypersensitivity of the niiple
what is a galactocele
occurs in women who have recently stopped breastfeeding, occurs due to occlusion of a lactiferous duct
** can be differentiated from an abscess by the fact that a galactocele is usually painless, with no local or systemic signs of infection
management of pre-eclampsia
NICE recommend emergency secondary care assessment for any women with suspected pre-eclampsia
>160/110mmHg likely to be admitted & monitored
oral labetalol = first line
delivery of the baby
most common cause of early onset severe infection in the neonatal period
group B streptococcus
risk factors for GBS infection
prolonged rupture of membranes
previous pregnancy with GBS infection
prematurity
maternal pyrexia e.g. due to chorioamnionitis
when should intrapartum antibiotic prophylaxis be given for GBS
preterm deliveries
maternal pyrexia during delivery >38
previous baby with early or late onset GBS disease
Hb cut offs to determine if a pregnant women should receive oral iron supplementation
first trimester: <110
second: <105
post-partum: <100
Complete hydatidiform mole presentation
painless vaginal bleeding in 1st or 2nd trimester
exaggerated symptoms of pregnancy
uterus large for dates
elevated levels of hCG (may cause hyperthyroidism symptoms)
management of complete hydatidiform mole
urgent referral to specialist centre - evacuation of the uterus is performed
effective contraception is recommended to avoid pregnancy in the next 12 months
management of mastitis
flucloxacillin for 14 days, continue breastfeeding
stages of post partum thyroiditis
thyrotoxicosis
hypothyroidism
normal thyroid function
diagnosis of post partum thyroiditis
within 12 months of giving birth
clinical manifestations of hypothyroidism
TFTs support diagnosis
management of post partum thyroiditis
propranolol used for symptomatic relief
thyroxine used in hypothyroidism stage
treatment of nipple candidiasis when breastfeeding
miconazole cream for the mother and nystatin suspension for the baby
