100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
Summary Obstetric summaries CA$15.56   Add to cart
Quickly navigate to
Preview
  2.  
  3. The University Of Edinburgh (ED)

Summary

Summary Obstetric summaries

 5 views  0 purchase
  • Course
  • Institution
  • The University Of Edinburgh (ED)
  • Book
  • Zero to Finals Medicine

Summary of obstetric conditions and complications as covered in zero to finals. Contains information about clinical features of each condition, as well as relevant diagnostic tests and investigations, risk factors, causes and management guidelines. Everything has been cross referenced with passme...

[Show more]

Preview 4 out of 50  pages

Document information

  • No
  • Obstetrics
  • November 20, 2023
  • 50
  • 2022/2023
  • Summary

Subjects

  • obstetrics
  • gynaecology
  • medicine
  • surgery
  • clinical medicine
  • obs and gynae

Connected book

book image

Book Title:

Author(s):

  • Edition:
  • ISBN:
  • Edition:

More summaries for

  • Neonatal medicine summary
  • Paediatric Summaries
  • Gynaecology summaries
All for this textbook (5)

Written for

  • The University of Edinburgh (ED)
  • Unknown
  • Unknown

Seller

avatar-seller
saskiahogan

Content preview

OBSTETRIC CONDITIONS




Microsoft Office User
[COMPANY NAME] [Company address]

,Contents


Early pregnancy
1. Ectopic pregnancy
2. Miscarriage
3. Molar pregnancies
4. Nausea and vomiting
5. Recurrent miscarriage
6. TOP
Antenatal care
1. Pregnancy timeline and booking clinic
2. Trisomy 21 screening
3. Chronic conditions in pregnancy
4. Infections in pregnancy
5. Medications in pregnancy
6. Acute fatty liver of pregnancy
7. Anaemia
8. Breech presentation
9. Cardiac arrest in pregnancy
10. Gestational diabetes
11. Large for gestational age
12. Multiple pregnancy
13. Obstetric cholestasis
14. Placental abruption
15. Placenta accrete
16. Placenta praevia
17. Pre-eclampsia
18. Rashes of pregnancy
19. Small for gestational age
20. Stillbirth
21. UTIs in pregnancy
22. Vasa praevia
23. VTE in pregnancy
Labour and Delivery
1. Labour
2. Cardiotocography
3. Drugs in labour
4. Failure to progress
5. Induction of labour
6. Pain relief
7. Premature labour
8. Umbilical cord prolapse

,ECTOPIC PREGNANCY



CLINICAL SIGNS PATHOPHYSIOLOGY
Presents around 6-8 weeks gestation – should Pregnancy implanted outside the uterus – most
have low threshold for suspicion commonly in the Fallopian tube
- Missed period Other locations: entrance to the fallopian tube, ovary,
- Constant lower abdo pain in RIF/LIF cervix, abdomen
- PV bleed Incidence 11/1000
- Lower abdo or pelvic tenderness
- Cervical motion tenderness
May have
- Dizziness or syncope (blood loss) RISK FACTORS
- Shoulder tip pain (peritonitis)  Previous ectopic
 Previous PID
 Previous surgery to fallopian tubes
 IUD
INVESTIGATIONS
 Older age
Transvaginal USS  IVF
- May see gestational sac in fallopian tube  Endometriosis
- ‘blob sign’ or ‘bagel sign’  Smoking
- Tubal ectopic pregnancy moves separately
to the ovary (in contrast to corpus luteum)
- Empty uterus
- ‘Pseudogestational sac’ CRITERIA FOR EXPECTANT MANAGEMENT
Positive pregnancy test + no evidence of  Follow-up possible to ensure successful
pregnancy on USS termination
 Ectopic must be unruptured
- Serial hCG: Rise < 63% after 48 hours  Adnexal mass < 35mm
likely to indicate ectopic pregnancy (needs  No visible heartbeat
close monitoring)  No significant pain
- Fall > 50% likely to indicate miscarriage  HCG < 1500IU/L
(urine pregnancy test 2/52 to confirm
complete)


MANAGEMENT
1. Expectant management
2. Methotrexate
3. Surgical management
Methotrexate - criteria same as expectant management + HCG < 5000IU/L, confirmed absence of
intrauterine pregnancy on USS
Highly teratogenic – given as IM injection. Women advised to not get pregnant for 3/12 following
treatment
Common AEs: PV bleed, N+V, Abdo pain, stomatitis (inflammation of mouth)
Surgical – salpingectomy (1st line), salpingotomy
Indications: pain, adnexal mass > 35mm, visible heartbeat, HCG > 5000IU/L
Salpingotomy may be used in women at increased risk of infertility due to damage to the other tube.
Increased risk of failure compared to salpingectomy – may need further treatment with methotrexate
Anti-D prophylaxis given to rhesus negative wome having surgical management

, MISCARRIAGE



SUMMARY DEFINITIONS
Occurs in ~20% of pregnancies – highest early in Early miscarriage < 12 weeks
pregnancy Late miscarriage 12-24 weeks
Incidence increases with maternal age - Missed miscarriage – fetus no longer alive, no
symptoms have occurred
- Threatened miscarriage – PV bleed with closed
PRESENTATION cervix and fetus is alive
 Usually hx of PV bleed and lower abdomen - Inevitable miscarriage – PV bleed with open
pain cervix
 Passage of tissue may be reported - Incomplete miscarriage – retained POC in
 Bleed can vary from life-threatening to utero
spotting - Complete miscarriage – full miscarriage has
occurred, no POC left in uterus
- Anembryonic pregnancy – gestational sac
present but no embryo
INVESTIGATIONS
Transvaginal USS MANAGEMENT < 6 WEEKS GESTATION
Mean gestational sac diameter Expectant given no pain or other complications
- Fetal pole is expected once gestational sac including risk factors (e.g. previous ectopic)
is > 25mm Repeat urine pregnancy test is performed after 7-10
- If > 25mm and no fetal pole the scan is days and if negative a miscarriage can be confirmed
repeated after 1 week before confirming
anembryonic pregnancy If bleeding continues or pain occurs referral and
further investigation may be indicated
Fetal pole and crown-rump length
- CR length < 7mm without fetal heartbeat
the scan is repeated after at least 1/52 to
INCOMPLETE MSICARRIAGE
ensure heartbeat develops
- CR length > 7mm without fetal heartbeat Retained POC create risk of infection
scan is repeated after 1/52 to confirm non- - Medical management – misoprostol
viable pregnancy - Surgical (GA)
Fetal heartbeat o Retained POC removed using vacuum
aspiration and curettage
- Visible = viable
o Key complication = endometritis
- Expected once CR length is > 7mm
Remember to exclude ectopic pregnancy – serial
HCG may be helpful




MANAGEMENT
Transvaginal USS to confirm location and viability
Expectant (1st line for women without risk factors for heavy bleeding or infection). 1-2/52 to allow
miscarriage to occur spontaneously
Repeat urine pregnancy test after 3/52 to confirm miscarriage complete
Misoprostol – PG analogue to soften cervix and stimulate uterine contractions. It is taken as oral dose or
vaginal suppository
AEs: heavier bleeding, pain, vomiting, diarrhoea
Surgical management
- Manual vacuum aspiration under LA
o < 10 weeks gestation
o More appropriate for parous women
o Syringe inserted into uterus and contents manually aspirated
- Electric vacuum aspiration under GA
o Cervix gradually widened using dilators and POC removed using electric-powered vacuum
- Misoprostol given prior to surgery
- Anti-rhesus D prophylaxis given to rhesus negative women having surgical management

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller saskiahogan. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for CA$15.56. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

78637 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
CA$15.56
  • (0)
  Add to cart