Obstetrics Flashcards
(186 cards)
1
Q
What percentage of deliveries are affected by shoulder dystocia?
A
0.65%
Source greentop guidelines 42
2
Q
What percentage of shoulder dystocia births have bracheal plexus injury?
A
2.3% to 16% of shoulder dystocia births have bracheal plexus injury?
3
Q
What percentage of shoulder dystocia births have permanent bracheal plexus injury?
A
< 10% of shoulder dystocia births have permanent bracheal plexus injury
4
Q
HYPEREMESIS GRAVIDARUM
A
HYPEREMESIS GRAVIDARUM
5
Q
According to the RCOG green top guidelines number 69 last updated 2024 what % of pregnancies are affected by nausea and vomiting?
A
90%
6
Q
According to NICE guidelines what % of pregnancies are affected by nausea and vomiting?
A
70%
7
Q
What is the physiology or cause of hyperemesis gravidarum?
A
Due to hypersensitivity to the hormone ‘growth differentiation factor 15’ which is produced by the placenta
Mnemonic remember JDF
8
Q
What are the two defining features in hyperemesis gravidarum?
A
Weight loss and metabolic disturbances
9
Q
What is the percentage weight loss that is seen in hyperemesis gravidarum?
A
Atleast 5% weight loss of pre-pregnancy weight
10
Q
What is the metabolic disturbances that are commonly seen in hyperemesis gravidarum?
A
- Hyponatremia
- Hypokalemia
- Hypochloremic metabolic alkalosis
11
Q
Explain the mechanism of metabolic alkalosis in hyperemesis gravidarum
A
Metabolic alkalosis is most commonly seen. Due to the lost of H+ ions in vomitus
12
Q
Explain the mechanism of metabolic acidosis in hyperemesis gravidarum
A
Metabolic acidosis is LESS commonly seen. Due to the accumulation of ketones due to depletion of glucose stores
13
Q
List two risk factors relating to the actual pregnancy that can lead to hyperemesis gravidarum
A
- Increased placental mass as seen in molar or multiple pregnancy
- FIRST pregnancy
14
Q
List one risk factors from past obstetric history that can lead to hyperemesis gravidarum
A
- history of hyperemesis gravidarum in previous pregnancy
15
Q
List THREE risk factors from past medical history that can lead to hyperemesis gravidarum
A
- H/O motion sickness
- H/O migraines
- Chronic H. pylori infection
16
Q
List ONE risk factors from the drug history that can predispose to hyperemesis gravidarum
A
History of nausea with estrogen containing oral contraceptive
17
Q
List one risk factors from family history that can lead to hyperemesis gravidarum
A
First degree relative with history of nausea and vomiting in pregnancy
18
Q
In the treatment of hyperemesis gravidarum, what age group should avoid metoclopramide?
A
Pregnant women under the age of 20years old
19
Q
In the treatment of hyperemesis gravidarum, why is metoclopramide avoided in the below 20 age group
A
Due to the increased risk of oculogyric crisis
20
Q
What is oculogyric crisis
A
This is an adverse reaction to dopamine antagonist drugs
Dystonia of the ocular muscles leading to fixed upward gaze
21
Q
How does administration of glucose solutions worsen wernicke encephalopathy?
A
In hyperemesis gravidarum patient may become thaimine deficient.
Thiamine is needed for the metabolism of glucose.
Therefore, if a patient is at risk of thiamine deficiency giving glucose will further deplete low thiamine stores causing / worsening wernicke
22
Q
Explain why a biochemical thyrotoxicosis occurs in hyperemesis gravidarum
?
A
HCG is structurally similar to TSH (thyroid stimulating hormone) leading to elevated free thyroxine levels
23
Q
True or False
Patients with hyperemesis gravidarum with elevated thyroxine levels, generally have thryoid antibodies.
A
FALSE
Patients rarely have thyroid antibodies and are euthyroid clinically
24
Q
True or False
Patients with hyperemesis gravidarum with elevated thyroxine levels, generally have symptoms of hyperthyroidism.
A
FALSE
Patients rarely have thyroid antibodies and are euthyroid clinically
25
What is the physiology of linear nigra?
This is due to increase production of melanocyte stimulating hormone by the placenta leading to darkening of the nipples and melasma
26
NEURAL TUBE DEFECTS
NEURAL TUBE DEFECTS
27
For what duration during pregnancy is folic acid recommended?
Atleast up to 12 weeks of gestation
28
What is the recommended dose of folic acid for pregnant women without any additional risk of neural tube defects?
units mcg
Folic acid 400mcg po od
0.4mg
29
What is the recommended dose of folic acid for pregnant women WITH risk of neural tube defects?
Folic acid 5mg daily
30
Why is folic acid given in pregnancy?
To reduce risk of neural tube defects
31
List THREE medical conditions can increase the risk of neural tube defects in pregnancy?
PMH
1. Sickle cell anemia
2. Celiac disease
3. Diabetes melitus
32
What medications can increase the risk of neural tube defects in pregnancy?
DH
1. Methotrexate
2. Antiepileptics sodium valproate
33
The UK food standard agency states folic acid recommended daily intake is _________ times higher in pregnancy
Repeat question also in physiology section
3 times
34
The UK food standard agency recommended daily intake for folic acid in pregnancy in the first trimester is?
Repeat question also in physiology section
600mcg
35
The UK food standard agency recommended daily intake for folic acid in non pregnancy in the first trimester is?
Repeat question also in physiology section
200mcg
36
POSTPARTUM HEMORRHAGE
POSTPARTUM HEMORRHAGE
37
What is primary post partum hemorrhage?
Loss of 500mls or more of blood from the genital tract within 24hours of birth of a baby
38
What is minor post partum hemorrhage
Loss of 500 to 1000mls of blood from the genital tract within 24hours of birth of a baby
39
What is major post partum hemorrhage?
Loss of > 1000mls of blood from the genital tract within 24hours of birth of a baby
40
What is major moderate post partum hemorrhage?
Loss of 1000 to 2000mls of blood from the genital tract within 24hours of birth of a baby
41
What is severe major post partum hemorrhage?
Loss of >2000mls of blood from the genital tract within 24hours of birth of a baby
42
What is secondary post partum hemorrhage?
Abnormal or excessive bleeding from the birth canal between 24hours and 3 months
43
When should prophylactic uterotonic be given to prevent PPH?
Immediately after the birth of the baby and before the cord is clamped and cut.
44
What % of post partum hemmorhage is due to uterine atony?
70%
45
What % of post partum hemorrhage is due trauma?
20%
46
What % of post partum hemorrhage is due to retained placental tissue or other products of conception?
10%
47
What % of post partum hemorrhage is due to coagulopathy?
< 1%
48
Maternal hemoglobin < _____ g/dl at the onset of labour is as risk factor of post partum hemmorhage
< 8.5 g/dl
49
Maternal BMI > _____ kg/m2 is as risk factor of post partum hemmorhage
BMI > 35kg/m2
50
According to RCOG list TWO measures to reduce the risk of PPH?
1. Routine prophylactic uterotonics in the 3rd stage of labour
2. Treatment of antenatal anemia
51
What are the three options for prophylactic uterotonics for active management after vaginal birth to decrease risk of PPH?
1. Oxytocin 10 units IM
2. Oxytocin 5 units IV
3. Oxytocin 5 units plus Ergometrine 0.5mg IM
52
In regards to uterine massage what does NICE say about this
Uterine massage can be done in ESTABLISHED PPH
53
In regards to uterine massage what does RCOG say about this
Uterine massage has no benefit as a prophylactic measure for PPH
54
In a patient with PPH post vaginal delivery who pharmacological treatment has not helped to stop PPH what is the next step in management?
Intrauterine balloon tamponade
This should be considered before other surgical options to control PPH
55
In the management of major primary PPH what amount of crystalloid can be given whilst awaiting blood products?
*blood loss > 1000 mls
Up to 2L crystalloid
56
In the management of major primary PPH what amount of colloid can be given whilst awaiting blood products?
*blood loss > 1000 mls
Up to 1.5 L of colloid
57
In the management of major primary PPH what blood type can be given while pending group specifc blood?
*blood loss > 1000 mls
Group O Rh D and K negative blood
58
In the management of major primary PPH when is FFP considered?
*blood loss > 1000 mls
FFP can be considered if hemostasis is not achieved after 4 units of blood
59
In the management of major primary PPH a patient has recieved 4 units of blood however hemostatsis has not been achieved and no hemostatic test is available.
How much FFP would you give?
*blood loss > 1000 mls
4 units of FFP can be given
60
In the management of major primary PPH a patient has prolonged aPTT and PT with ongoing hemorrhage.
How much FFP would you give?
12 - 15 mls / kg
61
In the management of major primary PPH a patient has prolonged aPTT and PT > 1.5 times normal with ongoing hemorrhage.
How much FFP would you give?
> 12 - 15 mls / kg
62
In the management of major primary PPH when is platelets given?
Platelets ≤ 75
63
In the management of major primary PPH if platelets levels are ≤ 75, what is done?
Give 1 pool platelet transfusion
64
In the management of major primary PPH if fibrinogen levels are ≤ 2g/l, what is done?
Give 2 pool of cryoprecipitate
Mnemonic 2 eyes to CRYoprecipitate
65
In the management of major primary PPH when is cryoprecipitate given?
Fibrinogen ≤ 2g/l
66
ADDITIONAL QUESTIONS POST PARTUM HEMORRHAGE GREEN TOP #52
ADDITIONAL QUESTIONS POST PARTUM HEMORRHAGE GREEN TOP #52
67
What is the agent of choice for PPH prophylaxis in the 3rd stage of labour?
Oxytocin 10 units IM
68
What is the active management of the 3rd stage of labour?
Use of interventions to expedite delivery of the placenta with the aim of reducing blood loss
69
What are the interventions used to expedite delivery of the placenta with the aim of reducing blood loss or active management of the third stage of labour
1. Use of prophylactic uterotonics
2. Early cord clamping
3. Controlled cord traction
70
State the effect(s) of early cord clamping on the newborn
Reults in low birth weight.
Reflecting a lower blood volume
71
Comment on NICE guidelines re cord clamping
Umbilical cord should NOT be clamped earlier than 1 minute from delivery of the baby if there are no concerns over cord integrity or the baby's well being.
72
IM Oxytocin is the agent for choice for PPH prophylaxis, when should it be given?
1. With birth of the anterior shoulder
or
2. Immediately after the birth of the baby - before the cord is cut and clamped
Endorsed by NICE as well
73
Comment on visual estimation of blood loss for PPH
This is inaccurate
Usually underestimate blood loss
74
Name 2 accurate methods that can be used to assess blood loss in PPH
1. Blood collection drapes for vaginal deliveries
2. Weighing of swabs
75
True of False
Physiological increase in circulating blood volume during pregnancy signs of hypovolemic shock become less sensitive in pregnancy.
True
76
In pregnancy pulse amd blood pressure are usually maintained in the normal range until blood loss exceeds _________ ml
1000ml
77
PUERPERAL SEPSIS
PUERPERAL SEPSIS
78
In terms of suspected sepsis what serum lactate level is indicative of tissue hypo perfusion?
> 4 mmol/l
79
If severe sepsis is suspected what is the recommended timeline that serum lactate should be measured?
Within 6 hours of suspicion of severe sepsis
80
What organism is the most common cause of puerperal sepsis?
Group A streptococcus
Streptococcus pyogenes
81
What is puerperal sepsis?
Sepsis occuring after birth until 6 weeks postnatally
82
What infection typically cause puerperal sepsis?
Endometritis
83
How many deaths per year is puerperal sepsis responsible for in the UK?
10 (ten)
84
In the management of puerperal sepsis when should blood cultures be done in comparsion to antibiotic administration?
Blood cultures should be taken before antibotics are given
85
In regards to the management of severe puerperal sepsis when should broad spectrum antibiotic be given?
Antibiotic should be given within ONE hour of recognition of severe sepsis
86
In regards to the management of severe puerperal sepsis, according to RCOG which antibotics can be given?
Piperacillin + Tozobactam
Zosyn, tozobactam is a beta lactamase inhibitor and piperacillin is a penincillin
87
In regards to the management of severe puerperal sepsis, according to RCOG which antibotics can be given?
Apart from a penincillin
Carbapenem with clindamycin
Carbapenems are beta lactams which as similar in structure to penicillins and cephalosporins
88
In regards to the management of severe puerperal sepsis, what is the first line treatment for hypotension and hypoperfusion indicated by serum lactate > 4mmol/l?
Fluid resuscitation Initial minimum 20mls/kg of crystalloid
89
In regards to the management of severe puerperal sepsis, what is the SECOND line treatment for hypotension and hypoperfusion indicated by serum lactate > 4mmol/l?
Vasopressors to keep MAP > 65
90
In regards to the management of severe puerperal sepsis, what value of MAP is aim for when vasopressors are given.
MAP > 65 mmHG
91
In regards to the management of Puerperal sepsis with septic shock what central venous pressure is aimed for?
central venous pressure of 8mmHg
92
In regards to the management of Puerperal sepsis with septic shock what central venous oxygen saturation is aimed for?
central venous oxygen saturation of 70%
93
With regards to postpartum endometritis List THREE indications for admission for intravenous antibiotic as by patient.info
1. Fever >38 degrees
2. Sustained tacycardia > 90bpm
3. Abdominal pain
94
List RED FLAG signs that would indicate puerperal sepsis from the vital signs
1. Temp > 38 degrees
2. RR > 20 breaths per minute
3. Pulse > 90 bpm
95
List RED FLAG signs that would indicate puerperal sepsis
1. Abdominal or chest pain
2. Vomiting or diarrhoea
3. Uterine or renal angle pain
4. Uterine or renal angle tenderness
5. Generally unwell or seem unduly anxious or stressed
96
List FIVE risk factors from the past medical history that predisposes to puerperal sepsis
1. Obesity
2. Diabetes
3. Anemia
4. H/O pelvic infection
5. Vaginal discharge
97
List THREE risk factors from the antenatal period that predisposes to puerperal sepsis
1. Amniocentesis and other invasive procedures
2. cervical cerclage
3. PROM
98
List FOUR risk factors from the intrapartum period that predisposes to puerperal sepsis
1. Vaginal trauma
2. Caesarean
3. Wound hematoma
4. Retained products of conception
99
What is lactogenesis
Lactogenesis is the initiation of milk production
Genesis refers to the beginning / creation
100
What is galactopoiesis
Galactopoiesis is the maintenance of milk production once it has been established.
101
Which hormone causes the milk ejection reflex or let down in response to suckling?
Oxytocin
102
REDUCED FETAL MOVEMENT
REDUCED FETAL MOVEMENT
103
At what gestational age does fetal movement become apparent?
18 to 20 weeks
104
When does fetal movement plateau?
32 weeks
Fetal movements plateau at 32 weeks but do not decrease
105
When does fetal movements decrease?
Fetal movements plateau at 32 weeks but DONOT decrease
106
What is the average number of generalized fetal movement per hour at term.
31 (thirty -one)
Mnemonic the baby is active like Johns Road people at #31
107
Why is ascultation done with hand held dopper when a woman presents with reduced fetal movement?
To exclude fetal death
108
At what gestation is CTG done when a woman presents with reduced fetal movement?
Above 28 weeks
109
What % of women presenting with a single episode of reduced fetal movement will have uncomplicated / healthy pregnancies?
70%
More than half of women with single episode of reduced fetal movement will progress and have healthy pregnancies
Source greentop guidelines #57
110
List TWO protective factors for developing gestational diabetes?
1. High polyunsaturated fat diet
2. Physical exercise
111
List TWO non modifiable patient factors that increases the risk of developing gestational diabetes
1. Increasing age
2. Certain ethnic groups such as Asians, Africans, Latinas and Pima Indians
112
List TWO modifiable patient factors that increases the risk of developing gestational diabetes
1. Smoking double the risk
2. High BMI before pregnancy 3 fold risk for obese women compared to non obese
113
List THREE factors from the past obstetric history that increases the risk of gestational diabetes
1. short interval between pregnancies
2. Previous unexplained still birth
3. Previous macrosomia
114
At what gestation should pregnant women with PCOS be screened for gestational diabetes?
24 to 28 weeks
115
With regards to pregnant women with PCOS how is gestational diabetes screened for?
blood test after 75grams of oral glucose tolerance test
116
In the diagnosis of gestational diabetes according to the WHO what fasting glucose is diagnostic
Fasting glucose of 5.1 to 6.9
unit mmol/l
this is diagnostic for GDM
117
In the diagnosis of gestational diabetes according to WHO what value of plasma glucose one hour after 75g oral glucose load is diagnostic?
≥10
unit mmol/l
one hour plasma glucose ≥ 10 mmol/l following a 75gram oral glucose load is diagnostic of GDM
118
In the diagnosis of gestational diabetes according to WHO what value of plasma glucose TWO hour after 75g oral glucose load is diagnostic?
8.5 to 11
unit mmol/l
two hours plasma glucose 8.5 to 11 mmol/l following a 75gran oral glucose load is diagnostic of GDM
119
In the diagnosis of diabetes in pregnancy according to WHO what value of plasma glucose TWO hour after 75g oral glucose load is diagnostic?
≥11.1
unit mmol/l
two hours plasma glucose ≥11.1 mmol/l following a 75grams oral glucose load is diagnostic of diabetes in pregnancy
120
In the diagnosis of diabetes in pregnancy according to WHO what value random plasma glucose is diagnostic?
≥11.1 plus diabetes symptoms
unit mmol/l
121
In the diagnosis of diabetes in pregnancy according to the WHO what fasting glucose is diagnostic?
≥7.0
units mmol/l
122
True or False
Early self monitoring of blood glucose can be done for testing for gestational diabetes in women who had it in a previous pregnancy
True
source mrcog
123
True or False
A 75gram glucose, two hour OGTT as soon as possible whether in the first or second trimester can be done for testing for gestational diabetes in women who had it in a previous pregnancy
True
124
True or False
Early self monitoring of blood glucose CANNOT be done for testing for gestational diabetes in women who had it in a previous pregnancy
False
125
True or False
Following early OGTT a repeat test should be done at 24 to 28 weeks if the previous was normal for testing for gestational diabetes in women who had it in a previous pregnancy
* 75g glucose with 2 hour OGTT
True
126
When is OGTT done in women with risk factors of gestational diabetes
24 to 28 weeks
127
At what gestation does the amniotic fluid reach its maximum volume?
At 35 weeks gestation
The amniotic fluid volume increases up to 35 weeks and then decrease from then to term
128
When does the fetus start producing urine?
8 - 11 weeks gestation
Mnemonic beyonce in 7 /11
129
By term how much urine is produced by the fetus each day?
800mls of urine per day
Mnemonic 8 for 8
Urine produced at 8weeks to 11weeks
Then 800mls produced
130
When does the fetus start swallowing?
At 12 weeks gestation
131
How much amniotic fluid does the fetus swallows each day?
250mls per day
132
How much fetal lung secretions are produced each day?
300mls per day in the second trimester
133
With regards to prelabour rupture of members when should induction be offered?
If labour hasnot started within 24hours of PROM
134
In the first trimester anemia is defined as by British Committee for standards in hematology as ?
Hb < 11 g/dl
135
In the second trimester anemia is defined as by the British Committee for standards in hematology as ?
Hb < 10.5 g/dl
136
In the third trimester anemia is defined as by British Committee for standards in hematology as ?
Hb < 10.5 g/dl
137
In the post partum anemia is defined as by British Committee for standards in hematology as ?
Hb < 10 g/dl
138
List the THREE infections that are screened for as by the UK National Screening Committee
1. HIV
2. Hepatitis B
3. Syphillis
139
Hyperpigmentation of the face may occur in pregnancy due to increase production of melanin.
List the THREE names for this
1. Mask of pregnancy
2. Melasma gravidarum
3. Chloasma
140
In the postpartum following vaginal delivery when does cervical constriction occurs
takes up to 7 days
141
In the postpartum following vaginal delivery how long does afterpains last for?
for 2 to 3 days
142
In the postpartum following vaginal delivery how long does uterine involution takes?
up to 4 to 6 weeks
143
In the postpartum following vaginal delivery when does vaginal contraction and return of tone occurs?
at 4 to 6 weeks
144
In the postpartum following vaginal delivery how long does lochia flow for?
up to 3 to 6 weeks
145
DERMATOLOGY IN OBSTETRICS
DERMATOLOGY IN OBSTETRICS
146
What is another name for obstetric cholestasis
Intrahepatic cholestasis of pregnancy
147
0.7% of pregnancies are affected by obstetric cholestasis or intrahepatic cholestasis of pregnancy.
What other name is this know by
Prurigo gravidarum
148
What % of pregnancies are affected by obstetric cholestasis in the UK?
0.7%
149
True or False
Obstetric cholestasis is associated with a rash
FALSE!
No rash present, itching without a rash
150
With regards to obstetric cholestasis, how often during pregnancy should LFTs be done?
every 1 to 2 weeks during pregnancy
151
With regards to obstetric cholestasis,when postnatally should LFTs be done?
At day 10 (ten) or later
152
With regards to obstetric cholestasis, what treatment may improve pruritus and liver function?
ursodeoxycholic acid
153
With regards to obstetric cholestasis, where is the itchying?
Intense itching of the hands and feet WITHOUT a rash
154
With regards to obstetric cholestasis, when does the itching worsen?
At nights
155
With regards to obstetric cholestasis, comment on the effect of antihistamine for itching.
NOT effective
Treat with ursodeoxycholic acid
156
According to NICE 2023 updated definitions how can the first stage of labour be subdivided
Latent vs Established
Latent first stage of labour
Established first stage of labour
157
According to NICE 2023 updated definitions how can the second stage of labour be subdivided
Passive vs Active
Passive second stage of labour
Active second stage of labour
158
According to NICE 2023 updated definitions what is latent first stage of labour
There are contractions AND cervical changes
Cervical changes include changes to cervical position, consistency, effacement and dilation up to 4cm
159
According to NICE 2023 updated definitions what is established first stage of labour
There are regular contractions and progressive dilation from 4cm
160
According to NICE 2023 updated definitions what is passive second stage of labour
Full dilation of the cervix BEFORE active pushing
or
Full dilation of the cervix in the absence of active pushing
active or involuntary pushing
161
According to NICE 2023 updated definitions what is active second stage of labour
The baby is visible
OR
Full dilation of the cervix with active pushing
active or involuntary pushing
162
According to NICE 2023 updated definitions what is third stage of labour
The time from the delivery of the baby to expulsion of placenta and membranes
163
In multiparous women, birth would be expected to take place within ___________ hours of the start of the active second stage of labour
TWO hours
In multiparous women, birth would be expected to take place within 2 (two) hours of the start of the active second stage of labour
164
In nulliparous women, birth would be expected to take place within ___________ hours of the start of the active second stage of labour
THREE hours
In multiparous women, birth would be expected to take place within 3 (three) hours of the start of the active second stage of labour
165
In nulliparous women, if no progress within ___________ of the start of the active second stage of labour offer vaginal exam and consider amniotomy
1 (one ) hour
In nulliparous women, if no progress within ONE hour of the start of the active second stage of labour offer vaginal exam and consider amniotomy
166
In multiparous women, if no progress within ___________ of the start of the active second stage of labour offer vaginal exam and consider amniotomy
1/2 hour
In multiparous women, if no progress within HALF hour of the start of the active second stage of labour offer vaginal exam and consider amniotomy
167
PROM
PRELABOUR RUPTURE OF MEMBRANES
PROM
PRELABOUR RUPTURE OF MEMBRANES
168
When is induction of labour appropriate after Prelabour rupture of membrane (PROM)
24 hours after prelabour rupture of mebranes
Patient is > 34 weeks pregnant
169
__________ % of women will go into labour within 24hours of prelabour rupture of membranes
60%
60% of women will go into labour within 24hours of prelabour rupture of membranes
170
What is the % risk of serious neotal infection with PROM
1%
soure passmrcog
171
What is the % risk of serious neotal infection in women with intact membranes?
0.5%
soure passmrcog
172
The risk of serious neontal infection ________ in women with prelabour rupture of membrane compared to women with intact membranes
doubles
The risk of serious neontal infection doubles in women with prelabour rupture of membrane compared to women with intact membranes
soure passmrcog
173
What is the luteoplacental shift?
This refers to the placenta taking over from the corpus luteum as the main producer of estrogen and progesterone
174
When does the luteoplacental shift occurs?
6 to 8 weeks
175
CHORIONIC VILLUS SAMPLING
AMNIOCENTESIS
CHORIONIC VILLUS SAMPLING
AMNIOCENTESIS
176
According to the RCOG greentop guidelines # 8, at what gestation is it inappropriate to carry out chorionic villus sampling
Prior to 10 + 0 weeks
Chorionic villus sampling SHOULD NOT be done prior to 10 + 0 weeks
177
According to the RCOG greentop guidelines # 8 why is it inappropriate to carry out a chorionic villus sampling prior to gestational age 10 + 0
Possible association with oromandibular and limb defects
178
According to the RCOG greentop guidelines # 8 at what gestational age is it appropriate to carry out chorionic villus sampling?
Gestation 11 + 0 weeks and onwards
179
According to the RCOG greentop guidelines # 8 BETWEEN which gestational age is it appropriate to carry out chorionic villus sampling?
Gestation 11+0 to 13+6 weeks
180
The RCOG greentop guidelines number 8 recommends chorionic villus sampling between 11+0 to 13+6 weeks gestation, can this be done at any other time?
Gestation 14+0 to 14+6 weeks
181
According to the RCOG greentop guidelines # 8 at what gestational age is it appropriate to carry out amniocentesis?
Gestation 15 + 0 weeks
182
According to the RCOG greentop guidelines # 8 what is the % risk of miscarriage following amniocentesis or cvs
< 0.5 %
183
According to the RCOG greentop guidelines # 8 what is the % risk of miscarriage following amniocentesis or cvs in a multiple pregnancy?
1%
184
PREPREGNANCY CONCERNS
PRE PREGNANCY
CONCERNS
185
With regards to women living with diabetes what is the recommended HBA1C preconception.
units % or mmol/mol
HbA1C
< 6.5%
< 46 mmol/mol
186
With regards to women living with diabetes what is the HBA1C value that pregnancy is STRONGLY discouraged due to risk of teratogenicity
HbA1C
> 10%
>86 mmol/mol
