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Pregnancy Flashcards

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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
define operculum/show
blood stained mucous discharge occuring in 2/3 of women before the onset of labour
26
what connective tissue disorders may present with PUO
``` RA/polyarteritis nodosa temporal arteritis/polymyalgia rheumatica SLE Stills disease Rheumatic fever ```
27
what are the increased risks of multigravida labour
risk of uterine rupture | disporpotion and dystocia are rare
28
what test does the NHS use for risk screening of Down's
triple test conducted between 15-20wks uses alpha-feto protein, beta HCG and unconjugated oestrial
29
how do you manage pre-eclampsia
close monitoring anti-hypertensises/ magnesium sulphate early delivery
30
what occurs in the first stage of labour
onset --> full dilation of the cervix latent --> effacement active --> cervical dilatation
31
what is an APGAR score
assessment system for newborn baby
32
what malignancies may present with PUO
lymphoma/myeloma leukaemia solid tumours (renal/colon)
33
how much of the foetal head can be felt abdominally if the head is engaged
no more than 2/5ths
34
what occurs in cervical effacement
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
what occurs during the second stage of labour
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
what does ergotamine do
causes sustained contractions of the uterus and reduces uterine bleeding used to reduce post partum haemorrhage CONTRAINDICATION in HTN and cardiac disease
37
what is syntometrine
combination of syntocin(rhythmic) and ergmetrine (sustained) used in the active management of stage 3 given as anterior shoulder appears under PS
38
what is carboprost used for
post partum haemorrhage
39
what does prostin do
causes tetenic contractions
40
what are the subtypes of miscarriage
``` threatened inevitable incomplete complete silent ```
41
how does an ectopic pregnancy present
pain vaginal bleeding pelvic tenderness cervical excitation
42
what are the causes of preterm labour
``` unknown infection multiple pregnancy polyhydramnios cervical incompetency iatrogenic causes ```
43
what are the placental causes of ante partum haemorrhage
abruptio placentae (separation fo the placenta from the uterus) placenta praevia (placenta partially covers the cervix)
44
what are the local causes of antepartum haemorrhage
``` cervicitis cervical erosion cervical carcinoma vaginal trauma/infection cervical polyps ```
45
what factors increase your risk of a thromboembolism in pregnancy
``` age obesity thrombophillia immobilisation VT ```
46
what are the risks of obstetric cholestasis
spontaneous prematurity iatrogenic prematurity intra-uterine death increased meconium stained liquor
47
define macrosomia
large baby
48
define crowning
when fetal head is at +4
49
define foetal attitude
posture of the foetus usually flexion in vertex pres can be : flexion deflexion or extension
50
what does a cardiotocograph measure
baby's stress levels
51
which cardiac abnormalities are associated with Down's
``` ASD VSD PDA tetralogy of fallot: 1) pulmonary infundibular stenosis 2) overriding aorta 3) VSD 4) right ventricular hypertrophy ```
52
which GI defects are associated with Down's
oesophageal atresia | duodenal atresia
53
when do you perform an amniocentesis and how accurate is it
12-18wks >99% accuracy <1% miscarriage risk
54
what monitoring should be in place during the first stage of delivery
``` 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
what is the normal rate of dilatation
1-3cm/hour
56
what is the normal time to achieve full dilatation
12h primip | 7h multi
57
what is the normal duration of the second stage of labour
40-120min pri | 15-45 min multi
58
what 4 Ts are the causes of postpartum haemorrhage
Trauma Tissue Thrombin Tone
59
which renal pathology is unique to pre-eclampsia
glomerular endotheliosis
60
which LFT is normally raised in pregnancy
ALP
61
which antihypertensive medications are contraindicated in pregnancy
ACEI
62
which antihypertensive is least associated with intra-uterine growth retardation
labetalol (beta blocker) also used: nifedipine (Ca blocker) and hydralazine (vasodilator

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