Obgyn RF

Question 1

Rf for cerebral palsy

Answer 1

• Birth complications
• Maternal infection
• Maternal thyroid dysfunction
• Prematurity
• Small baby

Question 2

Rf for ectopic pregnancy

Answer 2

• Previous ectopic
• Previous PID
• Previous surgery to fallopian tubes
• IVF
• IUD
• Smoking
• Also anything that slows passage of ovum e.g. POP

Question 3

Rf for endometriosis

Answer 3

• FHx
• White ethnicity
• Low BMI
• Autoimmune disease
• Anything that prolongs the amount of bleeding woman has in life:
  + early menarche
  + late menopause
  + delayed childbearing
  + nulliparity

Question 4

High rf for pre-eclampsia

Answer 4

• Pre-existing HTN
• Previous HTN in pregnancy
• Existing autoimmune conditions e.g. SLE
• Diabetes
• Chronic kidney disease

Question 5

Moderate rf for pre-eclampsia

Answer 5

• Older than 40
• BMI > 35
• Multiple pregnancy (twins)
• First pregnancy
• More than 10 years since previous pregnancy
• FHx of pre-eclampsia

Question 6

Rf for shoulder dystocia

Answer 6

• Previous shoulder dystocia
• Macrosomia
• High BMI
• Gestational diabetes
• Induction of labour
• Long labour
• Instrumental delivery

Question 7

Rf for VTE in pregnancy

Answer 7

Rf relating to mum:
- Smoking
- Age > 35 years
- BMI > 30
- Parity ≥ 3
- Gross varicose veins
- Thrombophilia
- Family history of VTE

Rf relating to pregnancy:
- Reduced mobility
- Multiple pregnancy
- Pre-eclampsia
- IVF pregnancy

Question 8

Rf for cervical cancer

Answer 8

Increased risk of catching HPV:
- Early sexual activity
- More sexual partners
- Sexual partners who have had more partners
- No condoms

Other:
- Poor engagement with screening
- Smoking
- HIV (get yearly smear tests)
- > 5 yrs COCP
- Increased number of full term pregancies
- FHx
- Exposure to diethylstilbestrol during fetal development

Question 9

Rf for endometrial cancer

Answer 9

Relating to unopposed oestrogen:
- Increased age
- Earlier onset of menstruation
- Late menopause
- Oestrogen only HRT
- No or fewer pregnancies
- Obesity
- Polycystic ovarian syndrome
- Tamoxifen

Not relating to unopposed oestrogen:
- T2DM
- Lynch syndrome

Question 10

Rf for ovarian cancer

Answer 10

• Age (peaks age 60)
• BRCA1 and BRCA2 genes
• Obesity
• Smoking
• Recurrent use of clomifene
• Increased number of ovulations
  + early periods
  + late menopause
  + no pregnancies

Question 11

Rf for placental abruption

Answer 11

Relating to mum:
- Increased maternal age
- Smoking
- Cocaine/amphetamine use
- Multigravida

Relating to pregnancy:
- Previous placental abruption
- Bleeding early in pregnancy
- Trauma
- Pre-eclampsia
- Fetal growth restriction
- Multiple pregnancy

Question 12

Rf for placenta praevia

Answer 12

• Older maternal age
• Smoking
• Structural uterine abnormalities e.g. fibroids
• IVF
• Previous caesarean sections
• Previous placenta praevia

Question 13

Rf for vasa praevia

Answer 13

• IVF
• Multiple pregnancy
• Low lying placenta

Question 14

Rf for vulval cancer

Answer 14

• Age > 75
• Immunosuppression
• HPV
• Lichen sclerosus

Question 15

Rf that would indicate an OGTT at 24-28 wks

Answer 15

• Past gestational diabetes
• Previous big baby
• 1st degree relative with diabetes
• BMI > 30
• Non-white ethnicity