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Pregnancy Flashcards

1
Q

what are the signs of pre-eclampsia

A

increased BP
proteinuria
+/- derranged renal and hepatic function
eclampsia (seizures)

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2
Q

define a preterm labour

A

unset of labour after age of foetal viability before 37wks

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3
Q

what are the increased risks of a primigravida labour

A

inefficient uterine contraction
risk of cephalopelvic disproportion
foetal trauma

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4
Q

what causes anaemia in pregnancy

A

50% increase in plasma volume
2-3x iron requirement
10-20x folate requirement

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5
Q

from the pelvic brim to pelvic floor which direction does the head rotate to and from

A

pelvic brim –> LOL

pelvic floor –> DOA

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6
Q

what is obstetric cholestasis

A

the build up of bile salts in blood which as a result flow through the bile duct

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7
Q

what is gestational trophoblastic disease

A

chorionic villi abnormally expand and develop vesicles

may cause haemorrhage, clotting abnormalities, hypertension and later cancer development

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8
Q

define caput

A

oedema of baby’s scalp caused by pressure of head on cervix

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9
Q

what increases the risk of hyperemesis gravidarum

A

UTI
viral herpes
multiple pregnancy
molar pregnancy

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10
Q

define head engagement

A

descent of the foetal head through the pelvic brim

if the head is at the level of the ischeal spine it is engaged unless there is caput

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11
Q

at which diameter should the baby’s head present in delivery

A

suboccipito bregmatic

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12
Q

what classes as a positive screen in the triple test

A

> 1 in 150 risk of Down’s syndrome

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13
Q

how would you diagnose an ectopic pregnancy

A

USS
HCG
laparoscopy

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14
Q

who is gestational trophoblastic disease most likely to occur in

A

very young/old mothers

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15
Q

define foetal presentation

A

part of the foetus at the lower pole of the uterus

cephalic vertex breach

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16
Q

define the foetal lie

A

relationship of the longitudinal axis of the baby in relation to the mother’s spine
longitudinal, oblique, transverse

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17
Q

define liquor

A

amniotic fluid

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18
Q

what is the third stage of labour

A

delivery of the baby –> expulsion of the placenta and membrances
the cord lengthens, gush of blood and the fundus of the uterus rises

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19
Q

how do you manage obstetric cholestasis

A 
Emollients
antihistamines
ursodeoxycholic acid
vitamin K
deliver at 37-38 weeks
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20
Q

what is carboprost used for

A

post partum haemorrhage

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21
Q

define crowning

A

when the foetal head is +4

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22
Q

why are pregnant women more susceptible to developing a UTI

A

dilation of urinary collection system
relaxation of smooth muscle
compression from the uterus

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23
Q

how do you manage pregnancy induced hypertension

A

anti-hypertensives
regular monitoring
baby delivered at term

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24
Q

what does syntocin do?

A

synthetic oxytocin
acts in 2 mins when given IM
causes rhythmical uterine contractions

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25
Q

define operculum/show

A

blood stained mucous discharge occuring in 2/3 of women before the onset of labour

26
Q

what connective tissue disorders may present with PUO

A 
RA/polyarteritis nodosa
temporal arteritis/polymyalgia rheumatica
SLE
Stills disease
Rheumatic fever
27
Q

what are the increased risks of multigravida labour

A

risk of uterine rupture

disporpotion and dystocia are rare

28
Q

what test does the NHS use for risk screening of Down’s

A

triple test
conducted between 15-20wks
uses alpha-feto protein, beta HCG and unconjugated oestrial

29
Q

how do you manage pre-eclampsia

A

close monitoring
anti-hypertensises/ magnesium sulphate
early delivery

30
Q

what occurs in the first stage of labour

A

onset –> full dilation of the cervix
latent –> effacement
active –> cervical dilatation

31
Q

what is an APGAR score

A

assessment system for newborn baby

32
Q

what malignancies may present with PUO

A

lymphoma/myeloma
leukaemia
solid tumours (renal/colon)

33
Q

how much of the foetal head can be felt abdominally if the head is engaged

A

no more than 2/5ths

34
Q

what occurs in cervical effacement

A

cervix flatterns and becomes part of the inferior uterine wall, the mucous plug from pregnancy is lost

effacement and dilatation are the cardinal signs of labour

35
Q

what occurs during the second stage of labour

A

full dilation –> delivery of the baby
propulsive phase in full dilatation with head down to level of ischeal spines
expulsive phase irresistable desire to bear down/push

36
Q

what does ergotamine do

A

causes sustained contractions of the uterus and reduces uterine bleeding
used to reduce post partum haemorrhage

CONTRAINDICATION in HTN and cardiac disease

37
Q

what is syntometrine

A

combination of syntocin(rhythmic) and ergmetrine (sustained)
used in the active management of stage 3
given as anterior shoulder appears under PS

38
Q

what is carboprost used for

A

post partum haemorrhage

39
Q

what does prostin do

A

causes tetenic contractions

40
Q

what are the subtypes of miscarriage

A 
threatened 
inevitable
incomplete
complete
silent
41
Q

how does an ectopic pregnancy present

A

pain
vaginal bleeding
pelvic tenderness
cervical excitation

42
Q

what are the causes of preterm labour

A 
unknown
infection
multiple pregnancy
polyhydramnios
cervical incompetency
iatrogenic causes
43
Q

what are the placental causes of ante partum haemorrhage

A

abruptio placentae (separation fo the placenta from the uterus)

placenta praevia (placenta partially covers the cervix)

44
Q

what are the local causes of antepartum haemorrhage

A 
cervicitis
cervical erosion
cervical carcinoma
vaginal trauma/infection
cervical polyps
45
Q

what factors increase your risk of a thromboembolism in pregnancy

A 
age
obesity
thrombophillia
immobilisation
VT
46
Q

what are the risks of obstetric cholestasis

A

spontaneous prematurity
iatrogenic prematurity
intra-uterine death
increased meconium stained liquor

47
Q

define macrosomia

A

large baby

48
Q

define crowning

A

when fetal head is at +4

49
Q

define foetal attitude

A

posture of the foetus
usually flexion in vertex pres
can be : flexion deflexion or extension

50
Q

what does a cardiotocograph measure

A

baby’s stress levels

51
Q

which cardiac abnormalities are associated with Down’s

A 
ASD
VSD
PDA
tetralogy of fallot: 
1) pulmonary infundibular stenosis
2) overriding aorta
3) VSD
4) right ventricular hypertrophy
52
Q

which GI defects are associated with Down’s

A

oesophageal atresia

duodenal atresia

53
Q

when do you perform an amniocentesis and how accurate is it

A

12-18wks
>99% accuracy
<1% miscarriage risk

54
Q

what monitoring should be in place during the first stage of delivery

A 
vaginal exam - 4hrly
maternal urine 4hrly (for ketones-> give 10% dextrose if found)
maternal BP and temp -half hourly
contractions -15mins
foetal hr - 15mins
55
Q

what is the normal rate of dilatation

A

1-3cm/hour

56
Q

what is the normal time to achieve full dilatation

A

12h primip

7h multi

57
Q

what is the normal duration of the second stage of labour

A

40-120min pri

15-45 min multi

58
Q

what 4 Ts are the causes of postpartum haemorrhage

A

Trauma
Tissue
Thrombin
Tone

59
Q

which renal pathology is unique to pre-eclampsia

A

glomerular endotheliosis

60
Q

which LFT is normally raised in pregnancy

A

ALP

61
Q

which antihypertensive medications are contraindicated in pregnancy

A

ACEI

62
Q

which antihypertensive is least associated with intra-uterine growth retardation

A

labetalol (beta blocker)

also used: nifedipine (Ca blocker) and hydralazine (vasodilator

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