amniocentesis. This is usually performed between weeks 15-20 due to its risks being higher if done earlier
Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency
quadruple test: alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin and inhibin A
Cervical cancer screening: if sample is hrHPV +ve + cytologically normal → repeat smear at 12 months
NICE guidelines advise that menopausal women suffering from vasomotor symptoms can be given a selective serotonin uptake inhibitor (SSRI) such as fluoxetine. Clonidine is also licensed for the treatment of vasomotor symptoms in menopause
Gestational diabetes - insulin should be commenced if fasting glucose level is >= 7 mmol/l insulin at the time of diagnosis
A woman at moderate or high risk of pre-eclampsia should take aspirin 75-150mg daily from 12 weeks gestation until the birth
Antenatal cytomegalovirus infection can cause cerebral calcification, microcephaly and sensorineural deafness
women at higher risk of conceiving a child with a NTD should take 5mg of folic acid from before conception until the 12th week of pregnancy
Cephalic presentation, nulliparity and prolonged pregnancy all reduce the likelihood of umbilical cord prolapse. Prostaglandins have no major effect on risk of cord prolapse
. Artificial amniotomy (artificial rupture of membranes) is the biggest risk factor for cord prolapse.
The following results would be expected in a trisomy 21 (Down’s syndrome) pregnancy:
Low alpha fetoprotein (AFP)
Low oestriol
High human chorionic gonadotrophin beta-subunit (-HCG)
Low pregnancy-associated plasma protein A (PAPP-A)
Thickened nuchal translucency
The Mirena coil is licensed to provide the progesterone component of hormone replacement therapy
Women who are HIV positive should be offered annual cervical cancer screening
Ovarian hyperstimulation syndrome (OHSS) is a complication that can occur in women undergoing in vitro fertilisation (IVF). It results from an excessive response to taking the medicines (gonadotropins) to stimulate the development of eggs in the ovaries.
Combined oral contraceptive pill
increased risk of breast and cervical cancer
protective against ovarian and endometrial cancer
The first-line treatment for nausea and vomiting of pregnancy or hyperemesis gravidarum are antihistamines. Promethazine is a type of antihistamine and so this is the correct answer.
Low-level gonadotrophins indicate a hypothalamic cause.
Premature ovarian failure would have high gonadotrophins.
Polycystic ovarian syndrome would have high LH and androgens.
Oestrogen-containing contraceptives should preferably be discontinued 4 weeks before major elective surgery and all surgery to the legs or surgery which involves prolonged immobilisation of a lower limb.
Maternal intravenous antibiotic prophylaxis should be offered to women with a previous baby with early- or late-onset GBS disease ( Group B streptococcus)
intrapartum intravenous benzylpenicillin is required to reduce neonatal transmission. An alternative would be clindamycin
congenital rubella syndrome with the classic triad of sensorineural deafness, eye abnormalities and congenital heart disease.
Most of the contraceptive effect of the LNG-IUS is mediated via its progestogenic effect on the endometrium which prevents implantation.
Progestogen-only injectable contraception works primarily by inhibiting ovulation.
POPs alter cervical mucus to prevent sperm penetration into the upper reproductive tract. In addition, traditional POPs inhibit ovulation but this can be variable.
A history of sudden collapse occurring soon after a rupture of membranes is suggestive of amniotic fluid embolism.
