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1

Which is the cause of increased incidence of multiple pregnancies in the last 25 years?

Change in the use of ovulation induction agents and assisted reproductive technologies

2

Minimum criteria for preeclampsia

Blood pressure is over 140/90 after 20 gw and proteinuria over 300 mg/24 hrs

3

When screening for gestational diabetes, average risk pregnant women should undergo OGTT?

At 24-28 gw. Blood glucose should be lower than 7,8 mmol/l 2 hours after ingesting a 75 g glucose

4

Which US examination is used to screen intrauterine growth retardation

3rd screening

5

Which hormone is responsible for milk ejection (letting down)?

Oxytocin
(Production: prolactin)

6

Causes of immediate postpartum hemorrhage

- Retained placental tissue
- Trauma to the genital tract
- Coagulation defects
- Uterine atony
All are correct (4 T´s: tone, trauma, tissue, thrombin)

7

When there is uterine bleeding in the third trimester, to diagnose placental abruption, the first step is

To check with outer examinations whether there is a persistent uterine hypertonus

8

The most common type of anaesthesia in c-section is

Spinal anesthesia
(Emergency: intratracheal, Vaginal: epidural)

9

Preterm delivery is when?

Before week 37 gw

10

Select the only one right anwer

In case of anti-TPO positivity the risk of having postpartum thyroiditis is about 40-50%

11

Pituitary hyperplasia of lactotroph cells is due to:

Estrogen

12

Progesterone functions and production

- Inhibit lactation and uterine contraction
- Produced by ovaries and placenta

13

Indications of induced abortion

A) Social: up to week 12

B) Medical: up to week 20, or 24 if lab delay. Indications:
- Fetal
- Maternal
- Feto-maternal

14

Methods of prenatal diagnosis

A) Invasive
- Genetic amniocentesis (GAC)
- Chorionic villus sampling (CVS)
- Chordocentesis (percutan umbilical blood sampling - PUBS)

B) Non-invasive
- US
- Cell-free fetal DNA in maternal blood (NIPT)

15

Differential diagnosis vaginal bleeding in gw 30

- Placental abruption: hard
- Placenta previa: soft

16

Presumptive signs of pregnancy

Nausea, vomit (can also be in men)

17

Probable pregnancy

- Vulvar changes
- Pregnancy test etc

18

Definite pregnancy

- US
- CTG

19

Stages of partution

Phase 0: uterine quiescence
Phase 1: Preparation of labour
Phase 2: the process of labor (1st, 2nd, 3rd)
Phase 3: recovery

20

Criteria for normal labour

Spontaneous expulsion
Of a single (twins/triplets «not normal» labour)
Mature fetus (gw 37 - 42)
Presented by vertex
Through the birth canal
Within reasonable time (more than 3, less than 18 hours)
Without complications to the mother
Without complications to the fetus

21

3 P´s in progress of labour

Power: uterus (myometrium)
Passenger: fetus (head mostly)
Passage: pelvis of the mother

22

Stages of delivery

First stage:
- Starts with onset of true labor contractions
- Ends when cervix is fully dilated (10 cm)
- Longest stage of labor

Second stage: birth
- Begin with complete dilation of cervix
- Ends with borth of baby
- Duration between 60-90 minutes

Third stage: placental stage
- Separation and expulsion of placenta and membranes
- Duration between 5-30 minutes
- Shortest stage of labour

Fourth stage: postplacental stage
- First 2 hours of monitoring after expulsion of placenta
- Increased risk for bleeding

23

Phases of cervical dilation - 2 phases

- Latent phase: slow, first 3 cm (8 hrs at nulliparous, 3 hrs at multiparous), onset: regular contractions

- Active phase: faster (stronger and more frequent contractions), from 3-10 cm, onset - protraction - arrest

24

Second stage: birth

- Propulsive phase (full dilation - presenting part in pelvic floor)

- Expulsive phase (delivery of fetus)

25

Placental stage - phases + blood loss

Separation + Expulsion

Blood loss: 150 - 250 ml (average)

26

Fetal lie

- Longitudinal
- Transverse
- Oblique

27

Fetal presentation

- Vertex - 96,8 %
- Breech
- Transverse
- Face, brow, shoulder etc.

28

Fetal attitude or posture

Ovoid mass

29

Fetal position

Left or right

30

Fetal head bones compressed during delivery - is called:

Molding