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 






    F) 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