Women's Health Flashcards
(20 cards)
What is ‘recurrent miscarriage’?
> 3 with the same partner
Who gets 5mg of folic acid?
past neural tube defect, AEDs, BMI >30, HIV +ve, diabetes, sickle cell
What should HbA1c be under before suggesting getting pregnant?
<48. If >86 DO NOT
What will a diabetic woman have screening wise when she becomes pregnant
advice about getting HbA1c low BMI <27 retinopathy and neprhopathy screening risks of hypos and impaired awareness complications 5mg folic acid 75mg of aspirin
Which diabetic medications are ok?
Metformin and insulin
No others are ok
How often do diabetic mothers get growth scans?
Every 4 weeks for 28 weeks
What are the complications of GDM?
VTE pre-eclampsia future GDM and T2DM macrosomia and shoulder dystocia congenital problems still birth childhood obesity PTL and breech neonatal hyperglycaemia and time in ITU
Can diabetic women have a home birth?
no
When can you have the: Combined test Quadruple test Chorionic villous sampling Amniocentesis
Combined test 11 to 13+6 weeks NT + hCG + PAPP-A + age
Quadruple test dating scan 15-20 weeks AFP + estiol + beta hCG + inhibit A
Chorionic villous sampling 10-13 weeks (1-2% miscarriage)
Amniocentesis 16 weeks onwards
What increases the risk of hyperemesis gravidarum?
Molar pregnancy
twins
previous hyperemesis
How do you treat?
Admit if can’t keep anything down or ketones ++ on dipstick suggestive of dehydration
Fluids
cyclising or metoclopramide
if still vomiting consider prednisilone
high dose folic acid and thiamine to prevent Wernickes
High risk for VTE (dehydration) so prophylaxis
What are the differentials for antepartum haemorrhage?
placenta praaevia placental abruption (revealed) ectropion polyps cervical cancer vaginits
What are the different grades of placenta praevia?
1 is clear of the os
2 is just at the edge
3 is overlying
4 is the os is in the middle of the overlying placenta
How many women will have a low lying placenta at 16-10 weeks and how many will have one at delivery?
5% at 16-20 weeks and only 0.5% or 1 in 200 at delivery
Placenta praevia - can you speculum? can you bimanual?
You can speculum but not bimanual
What might you need to give if there has been a bleed during pregnancy?
Anti-D immunoglobulin
Kelihauer test to see if anti-D needs to be increased
Causes of abdominal pain in pregnancy?
Ectopic miscarriage labour/ Braxton Hicks abruption symphysis pubis dysfunction HELLP uterine rupture appendicitis UTI endometriosis rib pain - pre-eclampsia
What are the types of miscarriage?
threatened - painless bleeding with os closed
missed (delay) - gestational sac with dead foetus <20 weeks and light bleeding
inevitable - heavy bleeding with open os
incomplete - not all products expelled with thickened endometrium
When can you do a pregnant abdomen exam and when can you measure?
from 20 weeks onwards as the uterus is at the umbilicus and then measure from 24 weeks onwards
How do you treat/prevent rhesus disease?
Anti-D if mum is negative in the third trimester (28-30 weeks)
extra if you’ve had amniocentesis/bump. Extra worked out with Kleihauer test.
At birth, blood sample is taken. If the baby is positive (positive Coomb’s test) then you’ll have another injection within 72 hours to destroy any positive cells. Can give you a rash or flu like symptoms.
