obstetrics wrong answers Flashcards
definition of APH
bleeding from the genital tract after 24 weeks of gestation
why shouldn’t you examine the genital tract in suspected APH
can provoke massive bleed
what is the lie of the fetus in placental abruption
normal , longitudinal lie and cephalic presentation
why is shock not proportional to visual loss in placental abruption
This is because the blood is not escaping the uterus and is concealed as the bleed is retroplacental
what is the definition of vasa praevia
foetal blood vessels running in front of the presenting part
What would you expect to see on clotting studies after a major
abruption?
afibrinogenemia due to placental damage causing the release of thromboplastin into the circulation causing DIC because clotting factors and fibrinogen have been used up
management of placental abruption
Fetus alive and < 36 weeks
fetal distress: immediate caesarean
no fetal distress: observe closely, steroids, no tocolysis, threshold to deliver depends on gestation
Fetus alive and > 36 weeks
fetal distress: immediate caesarean
no fetal distress: deliver vaginally
what blood tests are performed at the booking test
FBC, Blood group, rhesus, red cell alloantibodies, Hep B, Syphilis, HIV , urine dip
mechanism of GDM impacting foetus
An increase in foetal blood glucose brings about a
hyperinsulinemia in the foetus, leading to increased fat
deposition.
is a women who develops gestational diabetes likely to develop normal diabetes
yes , and increased risk in future pregnancies
Wbat medical diagnosis should be considered in women
presenting with depressive symptoms post-partum?
post partum thyroiditis
what % of women does post-partum depression affect
5-15%
HELLP
haemolysis, elevated liver enzymes ( ALT, AST) low platelets
method of monitoring magnesium sulphate
checking reflexes
why is DVT more common in the left leg rather than the right leg
T h e gravid uterus puts greater pressure on the left iliac vein at the
p o in t it crosses the left iliac artery, slow ing venous retu rn to the
heart.
