other

Question 1

what can you get post partum related to thyroid and how do you tx

Answer 1

pp thyroiditis- only treat hyperthyroid phase with propranaolol- resolves in less than year

Question 2

Hyperthyroid tx

Answer 2

propylthiouracil and propranalol
Propylthiouracil = only safe hyperthyroid drug in 1st trimester.

Question 3

Hypothyroid tx

Answer 3

levothyroxine.

Question 4

Parvovirus B19

Answer 4

→ can cause aplastic crisis in baby (esp. sickle cell). if pre existing haemanemia

Question 5

GBS tx

Answer 5

intrapartum IV benzylpenicillin prophylaxis.

Question 6

Syphilis

Answer 6

treat with benzylpenicillin

Question 7

endometritis sx

Answer 7

pyrexile- fever >38 within 72 hours post partum with lower abdominal pain and offensive discharge and Bleeding that gets heavier or does not improve with time

Question 8

tx for emdometritis

Answer 8

hosp referral for iv clindamycin and gentamicin or sepsis 6

Question 9

dx for emdometritis

Answer 9

blood cultures, vag swab, iv abx, tvuss

Question 10

amniotic fluid embolus

Answer 10

Presents as sudden collapse, hypoxia, DIC, shock, SOB sx PP
it is the anaphylaxis from amniotic fluid entering maternal circulation

Question 11

what is the tx for amniotic fluid embolus

Answer 11

ABCDE, fluid, ITU monitoring, blood transfusion ( group and save) ffp ( fresh frozen plasma0

Question 12

when is maternal anemia tested

Answer 12

at booking and at 28 w

Question 13

what are tx cut offs for maternal anemia

Answer 13

1/3- <110
2/3<105
3/3 <100

Question 14

what is the tx for maternal anaemia

Answer 14

ferrous sulfate for 3m pp

Question 15

what do you do if theres reduced fetal movement

Answer 15

• handheld doppler
• uss ( better than CTG)- will show HR and fetal growth

Question 16

what are general contraceptions for post patrum?

Answer 16

if lactating- ammenorrhoeic for 6m- very effective
if not lactaitng- LOCHIA period- 21 days later- this should stop by 6w do an uss if persists

Question 17

what is lochia

Answer 17

the normal vaginal discharge of blood, mucus, and uterine tissue that occurs after childbirth as the uterus sheds its lining to return to its pre-pregnancy state
rubra- red
serosa - pink
alba -white

Question 18

postpartum mhx - blues

Answer 18

very common
<1w birth,vague low mood and tearful - up to 50%, reassure as self resolves

Question 19

postpartum mhx- depression

Answer 19

around 3m pp- >2w of low mood, low energy, anhedonia, edinburgh scale> 10!!!!!!
tx- CBT, CMHT, consider SSRIS- sertraline

Question 20

postpartum mhx- psychosis

Answer 20

around 2-3 weeks pp
severe mood swings
auditory hallucinations
intent/thoughtd to harm baby
tx- admit to mum adn baby ward
25-50% reoccurence

Question 21

where is group b step found in women

Answer 21

common bacteria living in vagina

Question 22

when can group b strep be trasnferred to baby

Answer 22

during labour and cause neonatal sepsis.

Question 23

what is used to reduce the risk of transferring GBS from mother to baby during labou r

Answer 23

Prophylactic antibiotics during labour are used to reduce the risk of transfer if the mother is found to have GBS in their vagina during pregnancy.

The NICE guidelines (2024) recommend intravenous benzylpenicillin with gentamicin first line