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NAUSEA AND VOMITING
Morning sickness 50%Hyperemesis gravidarum 1%
Treatment Diclectin (10 mg doxylamine with vit B12)
RestAvoid triggersAdmit if severeLFTs, iv feeding
DIABETES
Incidence 1 %Abnormal GTT 3 - 5 % in PREGNANCY
PREVIOUS STILL BIRTH PREVIOUS LGAFAMILY HISTORYPERSISTENT GLYCOSURIA
poor predictorsSCREENING
Random B.S.50 g load > 7.8 at 1 hr, do OGTT
> 10.3 = GDM
ORAL GLUCOSE TOLERANCE TEST OGTT
fasting >5.31 hour >10.62 hour 8.92 of the 3 values met or exceeded = GDM
risk of anomalies infection pre - eclampsia macrosomia polyhydramnios late fetal death shoulder dystocia
A pregnant woman with a sickle cell trait is at risk for increased incidence of:
a) perinatal mortality
b) a low birth weight infant
c) pregnancy induced hypertension
d) anemia
e) spontaneous abortion
ANTE - PARTUM HEMORRHAGE> 20 / 40
ABRUPTION CONCEALEDREVEALED
PET DICCOCAINESMOKING PAINSLE BLEEDINGTRAUMA + FETAL DISTRESSPREVIOUS ABRUPTION
PLACENTA PREVIA diagnosed by TVSTOTAL (COMPLETE)PARTIALMARGINALLOW LYING PAINLESS BLEEDING
TRANSVERSE LIEVASA PREVIA
RHESUS ISOIMMUNIZATION
7 % BLACK RACES13 % WHITE RACES
IgG anti - D in rhesus negative sensitized women
Causes fetal anemia , heart failurehydrops fetalis. Born with jaundice
In- Utero Dx. Amniocentesis, Cordo, Doppler
PROPHYLAXIS RHOGAM AT 28 WEEKSKLEIHAUER AT
DELIVERY
B ILL ED
PREMATURE LABOURIncidence 7 % < 37 weeksMAJOR CAUSE OF P.N.M.R.OVERALL RECURRENCE RISK 30 %RISK FACTORS
Previous Prem. LabourLow incomesmokingcervical surgeryuterine anomalymultiple gestation
TREATMENT: BED RESTTOCOLYTICSSTEROIDS
PROM ERYTHROMYCIN
PREDICTING PTL TVS / FIBRONECTIN
CONGENITAL INFECTION
Toxoplasmosis
Other - Parvovirus , syphilis, listeria,
Rubella
Cytomegalovirus
Herpes simplex
Chickenpox
Hepatitis B, Grp B Strep
HIV - fetal transmission risk
The most common cause of vaginal bleedingcomplicating premature labour is :
a) a vaginal laceration
b) an endocervical polyp
c) cervical dilation
d) placenta previa
e) placental abruption
PPH
Causes 1° Uterine atony - twins - long labour - oxytocin
Tears Coug. Disorders - APH 2° Retained products Infection
PPHRx Deliver placenta
Repair tears
Bimanual compression
Get help → Blood Bank
X match
platelets
FFP
comp ppt.
Ergotamine
Hemabate
Oxytocin
Explore uterus
Ligate internal ilicecis
Hysterectomy