Obstetrics

Question 1

Signs of placental previa

Answer 1

Shock in proportion to bleeding
No pain
Uterus not tender
Lie and presentation may be abnormal
Fetal heart usually normal
Small bleeds before large

Question 2

Investigation of placental previa

Answer 2

Do not perform DRE before uss

Transvaginal uss

Question 3

Hyperemisis gravidium

Answer 3

Investigations:
Obs
Urinalysis
ECG - hypocalemia

Bloods: FBC, u&es, vbg, HCG - elevated

Question 4

What is the management for hyperemesis gravidum

Answer 4

Simple measures: rest and avoid triggers, bland food

First-line: antihistamines- oral cyclizine

Second line: oral ondansetron

Admission for IV hydration may be needed

Question 5

Investigation for PROM

Answer 5

Sterile speculum - don’t do digital vaginal exam

USS

Question 6

Features of postpartum sepsis/ endometritis

Answer 6

Post partum , presents with fever
Foul smelling discharge
Lower abdominal pain

Question 7

Management of PROM

Answer 7

Admission for observation - monitor for signs of infetion, regular observation

Oral erythromycin - for 10 days
Antenatal corticosteroids (dexamethoasone)

Consider iv magnesium sulphate if <30 weeks and birth is imminent

Delivery recommended at 37 weeks