Which is the cause of increased incidence of multiple pregnancies in the last 25 years?
Change in the use of ovulation induction agents and assisted reproductive technologies
Minimum criteria for preeclampsia
Blood pressure is over 140/90 after 20 gw and proteinuria over 300 mg/24 hrs
When screening for gestational diabetes, average risk pregnant women should undergo OGTT?
At 24-28 gw. Blood glucose should be lower than 7,8 mmol/l 2 hours after ingesting a 75 g glucose
Which US examination is used to screen intrauterine growth retardation
3rd screening
Which hormone is responsible for milk ejection (letting down)?
Oxytocin
Production: prolactin
Causes of immediate postpartum hemorrhage
- Retained placental tissue
- Trauma to the genital tract
- Coagulation defects
- Uterine atony
All are correct (4 T´s: tone, trauma, tissue, thrombin)
When there is uterine bleeding in the third trimester, to diagnose placental abruption, the first step is
To check with outer examinations whether there is a persistent uterine hypertonus
The most common type of anaesthesia in c-section is
Spinal anesthesia (Emergency: intratracheal, Vaginal: epidural)
Preterm delivery is when?
Before week 37 gw
Select the only one right anwer
In case of anti-TPO positivity the risk of having postpartum thyroiditis is about 40-50%
Pituitary hyperplasia of lactotroph cells is due to:
Estrogen
Progesterone functions and production
- Inhibit lactation and uterine contraction
- Produced by ovaries and placenta
Indications of induced abortion
A) Social: up to week 12
B) Medical: up to week 20, or 24 if lab delay. Indications:
- Fetal
- Maternal
- Feto-maternal
Methods of prenatal diagnosis
A) Invasive
- Genetic amniocentesis (GAC)
- Chorionic villus sampling (CVS)
- Chordocentesis (percutan umbilical blood sampling - PUBS)
B) Non-invasive
- US
- Cell-free fetal DNA in maternal blood (NIPT)
Differential diagnosis vaginal bleeding in gw 30
- Placental abruption: hard
- Placenta previa: soft
Presumptive signs of pregnancy
Nausea, vomit (can also be in men)
Probable pregnancy
- Vulvar changes
- Pregnancy test etc
Definite pregnancy
- US
- CTG
Stages of partution
Phase 0: uterine quiescence
Phase 1: Preparation of labour
Phase 2: the process of labor (1st, 2nd, 3rd)
Phase 3: recovery
Criteria for normal labour
Spontaneous expulsion Of a single (twins/triplets «not normal» labour) Mature fetus (gw 37 - 42) Presented by vertex Through the birth canal Within reasonable time (more than 3, less than 18 hours) Without complications to the mother Without complications to the fetus
3 P´s in progress of labour
Power: uterus (myometrium)
Passenger: fetus (head mostly)
Passage: pelvis of the mother
Stages of delivery
First stage:
- Starts with onset of true labor contractions
- Ends when cervix is fully dilated (10 cm)
- Longest stage of labor
Second stage: birth
- Begin with complete dilation of cervix
- Ends with borth of baby
- Duration between 60-90 minutes
Third stage: placental stage
- Separation and expulsion of placenta and membranes
- Duration between 5-30 minutes
- Shortest stage of labour
Fourth stage: postplacental stage
- First 2 hours of monitoring after expulsion of placenta
- Increased risk for bleeding
Phases of cervical dilation - 2 phases
- Latent phase: slow, first 3 cm (8 hrs at nulliparous, 3 hrs at multiparous), onset: regular contractions
- Active phase: faster (stronger and more frequent contractions), from 3-10 cm, onset - protraction - arrest
Second stage: birth
- Propulsive phase (full dilation - presenting part in pelvic floor)
- Expulsive phase (delivery of fetus)
