Principles 4

Question 1

Tocolysis: is the ???

Answer 1

inhibition of uterine contraction

Question 2

Indication for tocolysis
To allow a __________ for ________
Uterine ____________ (from excess oxytocin)
To perform _________________
Management of ____________
Aspart of post-operative management for _____________

Answer 2

course of steroid ; fetal lung maturation

hyperstimulaion; External cephalic version

dysmenorrhea; cervical cerclage

Question 3

Classification of tocolytics

List 6 classes

Answer 3

Beta-mimetics
Calcium channel blockers
Oxytocin antagonist
Magnesium sulphate (MgSO4)
Prostaglandin synthase inhibitors
Nitrates

Question 4

Classification of tocolytics
Beta-mimetics: ritodrine, _________,____________
Calcium channel blockers: _________
Oxytocin antagonist:__________
Magnesium sulphate (MgSO4)
Prostaglandin synthase inhibitors: __________
Nitrates: __________________

Answer 4

terbutaline, salbutamol

nifedipine; atosiban

indomethacin

glyceryl trinitrate

Question 5

AZT: __________
NVP: __________
3TC: __________
EFV: __________

Answer 5

Zidovudine

Nevirapine ; Lamivudine

Efavirenz

Question 6

Kleihauer-Betke test
- A test of maternal blood to determine the proportion of ________ present; based on the fact that ?????????????

Answer 6

fetal cells

fetal cells resist denaturation by alcohol or acid

Question 7

Kleihauer-Betke test

gives an estimate of volume of ____________________ and amount of __________________________ required

Answer 7

feto-maternal transfusion

extra anti-D immunoglobulin (e.g. RhoGAM)

Question 8

Anti-D level : Outcome

                      HDFN unlikely 
                    Moderate risk of HDFN
             High risk of hydrops fetalis

Answer 8

< 4 IU/mL
4-15 IU/mL
> 15 IU/mL

Question 9

Cervical insufficiency formerly known as cervical incompetence: is the inability of the uterine cervix to _______________ due to a _________ or ___________ detect

Answer 9

sustain pregnancy to term

functional ; structural

Question 10

Cervical insufficiency

It accounts for 20-25% of __________ trimester miscarriage as well as 10% of preterm deliveries

Answer 10

second

Question 11

gestational ages at which miscarriage occurs in cervical insufficiency _____ease progressively as opposed to that due to uterine structure anomaly where gestational ages ______ease
progressively

Answer 11

decr

incr

Question 12

Clinical presentation of Cervical Insufficiency
• Recurrent spontaneous _____-trimester abortion that is
preceded by:
- Pelvic _________ (due to descent of uterine content)
-________ or __________ vaginal discharge
-________ vaginal bleeding or spotting
- Pain_____ cervical dilatation, rupture of membrane, and expulsion of uterine content

Answer 12

mid; heaviness

Watery or mucoid

Painless; painless

Question 13

In cervical insufficiency

Hysterosalpingography: shows a _______ or ______ shaped defect, indicating the __________ ______________ and widened isthmus

Answer 13

funnel ; beak

dilated internal os

Question 14

Contraindications to HSG

P
R
I
M
E

Answer 14

Pregnancy
Reaction to Dye
Infections
Menses
Endometriosis

Question 15

Complications of HSG

List 7

Answer 15

Allergy to die
Haemorrhage
Pain
Intravasation of Dye
Perforation of Uterus
Pulmonary embolism
Miscellaneous (VOTERS)

Question 16

Complications of HSG

VOTERS

Answer 16

Vasovagal attacks
Ovarian abscess
Thyroid function change
Endometriosis
Rupture of pyosalpinx
Sepsis

Question 17

Treatment modalities of cervical insufficiency : surgery (_________ ), medical, use of ____________ , and ___________

Answer 17

cerclage

pessaries

bed rest

Question 18

Cervical cerclage is a minor surgical procedure in which the ___________________ is ______________

Answer 18

cervical opening is stitched close

Question 19

Cerclage is placed between __________ weeks (when early abortion due to other factors would have occurred) and removed at _______ weeks (if indication for early removal does not arise.

Answer 19

14-16

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