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34 Cards in this Set
- Front
- Back
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What are some RF for endometrial cancer
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diabetes
hypertension obesity unopposed oestrogen |
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What is Ashermann's syndrome
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Intrauterine scarring usually secondary to instrumentation or infection which can cause infertility
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Contraindications for OCP
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Venous thromboembolism
CAD Cerebrovascular disease Uncontrolled HTN Severely impaired LFT Malignancy of breast of genital tract Migraine with aura (not migraine alone) |
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How do you make a diagnosis of placental abruption?
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History and clinical features of bleeding
NB: 30% are small and are diagnosed after delivery Most are not diagnosed on US |
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What are the indications for delivery with preeclampsia
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> 37 GA
Progression to eclampsia (persistent headaches or visual changes) Thrombocytopenia Deteriorating LFTs Persistent severe epigastric pain, N/V Severe IUGR Non-reassuring fetal heart Oligohydramnios |
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RF for preterm labour
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Prior preterm labour
PROM polyhydramnios bacterial vaginosis placental abruption preeclampsia chorioamnionitis |
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What medical management is used for fibroids
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Antiprostaglandins (ibuprofen)
Tranexamic acid OCP/Depoprovera GnRH agonist - short term only - often used pre sugery as reduces fibroid size |
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What are the signs of chorioamnionitis?
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Maternal fever
Maternal or fetal tachycardia UTerine tenderness Foul and purulent cervical discharge |
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Medical treatment for endometriosis
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Drug treatment to halt or regress the growth of endometriotic deposits
Medroxyprogesterone acetate (bloating, mood changes, weight gain) OR Goserelin (GnRH analogue to reduce the HPA axis) SE: oestrogen deficiency OCP can be used with mild disease Can use synthetic steroids - danazol and gentirnone - but big SE with these |
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What is given if magnesium sulfate toxicity is apparent
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calcium gluconate
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What should be discussed with a women with type 1 diabetes thinking about trying to conceive
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HBA1C ideally needs to be < 7 (associated with congenital abnormalities - esp. sacralogenesis spec to type 1)
Folic acid Diabetic complications can get worse during pregnancy so get baselines for these - renal fxn; ophthal; cholesterol etc. |
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What shoudl be discussed with a women with type 2 diabetes thinking about trying to conceive
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HBA1C ideally needs to be < 7 (associated with congenital abnormalities)
Folic acid Diabetic complications can get worse during pregnancy so get baselines for these - renal fxn; ophthal; cholesterol etc. + can stay on metformin Try to lose some weight |
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Are there any special considerations for delivery of type 1 or type 2 DM
i.e. timing and mode of delivery |
Induction at 38-39 weeks if everything else is ok - no complications
Most have CS but guidelines say to offer NVD |
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Are there any special considerations for delivery of gestational DM
i.e. timing and mode of delivery |
Diet - 41 weeks
Insulin - 40 weeks Most have CS but guidelines say to offer NVD |
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Who should be involved int he care of a diabetic woman who is pregnant?
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Obstetrician
Endocrinologits Diabetic educator Dietician |
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What kind of screening should be offered to pregnant woman wtih diabetes
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Morphology scan 18-20 weeks
Follow-up with cardiac scan at 22 weeks Serial growth scans once per month after 28 weeks + CTG monitoring + Regular monitoring of HBA1c, glucose control and diabetic complications |
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If a woman has a history of GDM in her previous pregnancy when should she be offered GDM testing? and What should be done
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Jump straight to GTT 75 g
at 12 weeks IF negative re test at 28 weeks |
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What fetal complications are associated with diabetes
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macrosomia
Prematurity due to polyhydramnios (baby is peeing more due to hyperglycaemia) Can get IUGR due to poor placental function due to vascular disease Still birth x 5 risk Hypoglycaemia Congenital anomalies - CNS, CVS, neural tube defects |
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What requirements do diabetic Type 1 and 2 Mum's need during delivery?
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insulin infusion - NB insulin requirements are often less during delivery and often type 2 will need insulin during deliver
hourly BSL measurements Continuous CTG |
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What requirements do GDM mums need during delivery
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fetal monitoring
BSLs every 2 hours |
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RF for uterine atony
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multiple gestation
chorioamnionitis prolonged labour exposure to oxytocin for induction multiparity |
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What are the symptoms of molar pregnancy
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Very high B-HCG - in the 100 000
Sx of really bad morning sickness |
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What is the greasy white material that covers the body of infants usually between 35-38 weeks called?
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Vernix caseosa
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What are the normal blotches on skin of a neonate called
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livedo reticularis
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What is lanugo?
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Fine facial and body hair
Seen mostly in preterm babies Lost during the first month of life |
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What is the most common vascular birth mark in newborns
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Naevus flammeus (stork marks)
50% of newborns Blanches with pressure |
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What are the tiny raised white dots on the tip of babies nose and chin called
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Milia
40% of newborns Usually occur on the face and scalp When found on mouth = Epstein's pearls |
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What is erythema toxicum
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Benign
Small white/yellow papules with an erythematous base any part of the body Peak incidence 24-48 hours |
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When one side of the newborn is red and the other side is blanched what is this called
How long does it last for when does it occur |
Harlequin phenomenon
Seconds to minutes First few days of life Immature autonomic system |
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What are the tiny white dots around the head
What are they due to? |
Miliaria
Due to obstruction of sweat and rupture of the exocrine sweat duct - commonly seen secondary to thermal stress 2 types Crystallina - superficial vesciles - skin not inflammed Rubra - "prickly heat" - papules and pustules from obstruction of mid-epidermis |
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What is the oedematous thickening of the sclalp where the baby's head presented during labour called
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caput succedaneum
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Cephalhaematoma - what is it due to?
Complications from it |
bleeding between periosteum and cranium
due to shearing or tearing of communication veins during delivery Foten appears on 2nd day of life and has hard irregular bony margin surrounding it Complications: jaundice secondary to reansorption, linear skull fracture, calcification |
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What is fusion of fingers or toes called?
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synactyly
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How do you tell the difference between Napkin dermatitis and genital thrush?
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Thrush is inside the skin folds and creases whereas napkin dermatitis isn't
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