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Flashcards in Obstetrics Deck (26):
1

management of gestational cholestasis

ursodeoxycholic acid. Induce at 37/40

2

features suggestive of acute fatty liver of pregnancy

RUQ pain, nausea, jaundice. High transferases.

3

Management of acute fatty liver of pregnancy

Supportive
Induce once stable

4

HELLP

haemolysis, elevated liver enzymes, low platelets

5

follow-up for GDM patient post-delivery?

Continue therapy immediately after birth
Check bloods before sending home
remind them of hyperglycaemia symptoms and lifestyle management
Postnatal GTT at 6-13 weeks

6

A 27 year-old lady is day 1 post emergency caesarean section for failure to progress in the first stage. She has been complaining of pain and heavy vaginal bleeding since delivery and in the morning was noted to have heavy, offensive lochia and a boggy poorly contracted uterus above the umbilicus.

Retained products of conception.
Management is EUA

7

Management of pregnant woman with negative Rubella IgG

Advise to avoid anyone with rubella. Offer MMR postnatally

8

management of primary genital herpes in pregnancy after in third trimester

oral aciclovir 400mg tds until delivery. Particularly if after 34 weeks (6 weeks to delivery)
Delivery by caesarean
Assume primary if patient has not had similar symptoms in the past

9

Management of primary genital herpes in first or second trimester

5 days of oral aciclovir 400mg tds
Give daily oral suppressive aciclovir (tds) from 36 weeks until delivery to reduce genital lesions
Deliver vaginally

10

Management of reccurence of genital herpes in pregnancy

supportive -warm saline wash, paracetamol
consider oral aciclovir if after 36/40
risk of tranmission is low, even if vesicles present at delivery.
Deliver vaginally

11

NSAIDs in pregnancy

Should be avoided after 32 weeks

12

Management of TTTS?

Stage using Quintero scoring

Medical:
Indomethacin - reduces fetal urine output

Surgical:
laser obliteration of communicating placental vessels
Selective foetal reduction is an option, esp if there is hydrops or evidence of cerebral damage

13

When should you deliver MCDA twins?

36-37 weeks

14

When should DCDA twins be delivered?

37-38 weeks

15

What abnormalities are associated with increased NT?

Downs
Cardiac defects
Bowel wall defects

16

Management of pregnant woman with chickenpox rash

Oral aciclovir. VZIG has no benefit after onset of rash

17

What type of miscarriage is this?

Cervical os - closed
Bleeding - light

Threatened

18

What type of miscarriage is this?

Cervical os - open
Bleeding - starting

Inevitable

19

What type of miscarriage is this?

Cervical os - open
Bleeding - ongoing

Incomplete

20

What type of miscarriage is this?

Cervical os - closed
Bleeding - stopped

Complete

21

What type of miscarriage is this?

Cervical os - closed
Bleeding - not experienced

Missed

22

What results would you expect on antenatal screening of a baby with down syndrome

Low alpha fetoprotein (AFP)
Low oestriol
High BhCG
Low pregnancy-associated plasma protein A (PAPP-A)
Thickened nuchal translucency

23

McRoberts manoeuvre

hips fully flexed and abducted

24

Rubin manoeuvre

suprapubic pressure

25

Woodscrew manoeuvre

put hand in vagina and rotate fetal head 180 degrees

26

treatment of endometritis?

IV clindamycin and gentamicin