O&G

  1. Causes of abnormal bleeding in early pregnancy?
    • implantation bleeding
    • spontaneous abortion
    • ectopic pregnancy
    • molar pregnancy
  2. Differentiate between an ectopic and IUP
    TV scan to locate gestation sac in uterus. Sac usually visible after 5-6 weeks, if uncertain perform laparoscopy.
  3. What are the causes of PPH?
    4 T's

    • Tone (70%)
    • -placenta previa
    • -overs distention of the uterus (polyhydramnios, macrosomia, multiple pregnancy)
    • -uterine relaxants
    • -previous PPH

    • Trauma (20%)
    • -c section
    • -episiotomy

    • Tissue (10%)
    • -retain POC
    • -placenta accreta
    • -retained placenta

    • Thrombin (1%)
    • -bleeding disorders
    • -placental abruption
    • -pre-eclampsia
  4. Manoeuvres for shoulder distocia?
    Image Upload 1
  5. Assessment of amenorrhoea
    Image Upload 2
  6. Assessment of AUB
    Image Upload 3
  7. Risk factors for abnormal lie
    • multiparous lax uterus 
    • inc or dec fetal activity 
    • inc or dec liqour
    • fetal malformation
    • placenta previa 
    • uterine malformation
    • prematurity
  8. Clinical Signs of placenta previa
    • Painless bleeding
    • abnormal liw/high presenting fetal part
    • soft non tender uterus
    • normal FHR
    • depening on bleeding > tachycardia + hypotension
  9. Risk factors for placenta previa
    • multiparity
    • previous c-sections
    • submucosal fibroid
    • previous placenta previa
    • increasing age
    • smoking
    • previous D+C
    • multiparous
  10. define preterm labour/name a tocolytic/when should steroid therapy be commenced? (gestation)
    • Labour prior to 37 completed weeks
    • nifedipine, terbutaline
    • 24-34 wk gestation 
    • previous preterm is r/f
  11. Should CTG be done routinely?
    No proven benefit and may increase the intervention rate in low risk patients

    • indications:
    • Abnormal antenatal scans/doppler/CTG
    • suspected IUGR
    • any hydramnios
    • prolonged pregnancy 
    • multiple pregnancy 
    • breech 
    • antepartum haemorrhage 
    • prior uterine scar/c-section
    • meconium or blood stained liqour
  12. PPH immediate management
    • assess need for resuscitation 
    • call for help
    • lie woman slat and reassure
    • massage fundus 
    • administer O2 via FM
    • insert large bore cannulas + take bloods crossmatch 
    • check placenta > ensure 3rd stage oxytocin
    • check 4T's
  13. increased nuchal translucency is associated with:
    • chromosomal abnormalities
    • cardiac abnormalities
    • diaphragmatic hernias
    • skeletal dysplasias
    • noonans syndrome
    • CAD
  14. signs of shoulder dystocia
    • turtling
    • protracted late active stage of labour
    • prolonged second stage
    • delay in decent of the head in second stage
  15. which is not associated with macrosomia 
    obesity
    GDM T2DM
    Post term
    multiparity
    large size of parents
    advanced maternal age
    previous macrosmic baby
    multiparity
  16. Risk factors for preeclampsia
    • Nulliparity
    • Preeclampsia in a previous pregnancy
    • Age >40 years or <18 years
    • Family history of preeclampsia
    • Chronic hypertension
    • Chronic renal disease
    • Autoimmune disease (eg, antiphospholipid syndrome, systemic lupus erythematosus) 
    • Vascular disease
    • Diabetes mellitus (pregestational and gestational)
    • Multifetal gestation
    • Obesity
    • Black race
    • Hydrops fetalis
    • Woman herself was small for gestational age
    • Fetal growth restriction, abruptio placentae, or fetal demise in a previous pregnancy
    • Prolonged interpregnancy interval if the previous pregnancy was normotensive. If the previous pregnancy was preeclamptic, a short interpregnancy interval increases the risk of recurrence.
    • Partner-related factors (new partner, limited sperm exposure [eg, previous use of barrier contraception])
    • In vitro fertilization
Author
TLam89
ID
320314
Card Set
O&G
Description
O&G R3
Updated