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Obs & Gynae 01.15 > Pregnancy > Flashcards

Pregnancy Flashcards

(50 cards)

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1
Q

What level does the baby head move to in the propulsive phase

A

Pelvic floor - ischial spines

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2
Q

What happens in the expulsive phase

A

Baby pushed out

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3
Q

Cervix is “fully dilated” at what size?

A

10cm

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4
Q

What is effacement of the cervix

A

Cervical canal draws into uterine body - and dilation of external os.

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5
Q

On a partogram, if the Liquor is “C” what does this mean

A

The amniotic fluid is clear so does not show contamination by meconium from the baby (a sign of foetal distress)

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6
Q

What is meconium

A

Foetus poo

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7
Q

The “lie” of the baby can be in 3 ways

A 
Longitudinal
Transverse (across the abdomen)
Oblique (diag across abdomen)
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8
Q

What is cephalic and breech presentation

A

Breech - feet first

Cephalic - normal head first

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9
Q

What is moulding

A

Overlap of skull bones

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10
Q

What is the definition of “engaged” for the baby

A

2/5 or less palpable per abdomen

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11
Q

What is “caput”

A

Scalp oedema

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12
Q

This drug is used to induce labour - causes rythmical contractions (Avoid if NOT first preg – chance of uterine rupture)

A

Oxytocin / Syntocinon

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13
Q

This drug causes prolonged tetanic contractions / spasm – for post partum haemorrhage (Contraindication = high BP)

A

Ergometrine

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14
Q

This drug is a combination of ergometrine and oxytocin – used in 3rd stage to speed placental expul.

A

Synometrine

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15
Q

What does DOA in relation to the baby position mean

A

Direct occipito anterior “face to arse” - normal position prior to final expulsion

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16
Q

What does DOP mean in relation to baby position

A

Direct occipito posterior - “face to pubes” more difficult delivery as diameter of skull is wider through the pelvis

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17
Q

This complication of pregnancy presents with hypertension, proteinurea +/- oedema. There is deranged renal functio and CNS/PNS effects

A

Pre-Eclampsia

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18
Q

What is the consequence of uncontrolled gestational diabetes on baby

A

Baby produces insulin in response to raised glucose - Insulin is a growth factor - can cause macrosomia (big baby)

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19
Q

Preg woman complains of sore hot calf and SOB - problem?

A

DVT /PE - increased risk of thromboembolism

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20
Q

The ovary produces what 3 hormones

A

Oestrogen
Progesterone
Testosterone

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21
Q

What is contained within the medulla of the ovary (the deep tissue)

Study These Flashcards
A

Lymphatics and blood vessels

22
Q

Where are follicles produced in the ovary

Study These Flashcards
A

Cortex - contain follicles each containing oocyte (Graffian follicle)

23
Q

What is the stroma of the ovary

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A

Soft tissue on surface - forms Tunica Albuginea

24
Q

What is the function of a bartholin’s gland

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A

Lubrication of vagina

25
What is another name for the recto-uterine pouch
Pouch of douglas
26
What is the "quadruple test" for Downs syndrome and when would it happen - what will the levels of the 4 things be?
approx 15/16 weeks 1. AFP - Alpha fetoprotein (HIGH) 2. HE3 - Oestrodial (LOW) 3. bHCG - Human chorionic gonadotropin (HIGH) 4. Inhibin A (LOW)
27
What is the threshold for LOW / HIGH risk of Down's as a number
1/150
28
What can be carried out to confirm if a baby is carrying Down's
Amniocentesis
29
What is the risk of miscarriage in amniocentesis
1%
30
At what stage of pregnancy is pre-eclampsia most common
3rd trimester
31
Key 3 features of pre-eclampsia
HTN Proteinurea Oedema
32
HELLP is associated with pre-eclampsia what 3 key things are it referring to
Haemolysis Elevated liver enzymes Low platelets
33
What liver enzyme is raised during normal pregnancy
Alk Phosphatase
34
Bp 140 - 159mmhg and proteinurea - mild, mod or severe pre-eclampsia?
Mild
35
BP >160mmHg, and proteinurea is mod pre-eclampsia. | Severe is this plus one of a number of other features (6+)
``` Visual disturb Clonus Headaches Epigastric pain Papilloedema HELLP - Liver tenderness, ALT >70, platelets ```
36
What is the underlying cause of pre-eclampsia (ie what is happening in terms of cytotrophoblast attachment to endometrium etc)
Poor attachment - reduced development of spiral artery formation in endometrium - small diam and low NO = high BP
37
Scans are usually performed at 12 and 18-20 weeks - why
1st - routine | 2nd - Anomaly scan
38
What is placenta previa - what are the 2 main types
Obstruction of the cervical os by placenta establishing in "wrong place" - Types: 1. Minor (partial obstruction of os) 2. Major - total obstruction of os
39
What is placental abruption - 2 main types
Bleed of placenta - hidden (bleeding behind placenta) and obvious (from uterus)
40
Sign of placental abruption on examination of abodomen
Hard woody uterus
41
Assisted contraception, previous terminations, defective endometrium are all risk factors for what
Placenta previa
42
Pre-eclampsia, multi-parity, blunt trauma are all risk factors for what
Placental abruption
43
How might oxytocin help in management of post partum haemorrhage
It stimulates contractions - uterus contracts so helps stem bleeding
44
What is given in sever pre-eclampsia if delivery is due to occur
Magnesium sulfate - is also protective to neonatal brain development
45
Why must magnesium sulfate be given slowly
To avoid cardio pulmonary arrest in mother
46
What is the only "cure" for pre-eclampsia or eclampsia
Delivery of baby
47
What is the name for the classic c-section incision
Pfannenstiel
48
Twins are described in relation to whether they have their own placenta / amniotic sac. What does the following mean: Monoamniotic monochorionic
Both in one amniotic sac - sharing one placenta
49
What is the issue with monochorionicity
Complications from only having 1 placenta - miscarriage, developmental problems, various issues to mother also
50
Twins are described in relation to whether they have their own placenta / amniotic sac. What are di-zygotic (non-identical) twins always?
Diamniotic and dichorionic - they each have their own amniot. and placenta

Obs & Gynae 01.15 (4 decks)

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