Podcast
Questions and Answers
What is the recommended initial dose of Nifedipine for the suppression of preterm labor at greater than 34 weeks of gestation?
Which maternal condition is a contraindication for using Indomethacin as a tocolytic?
Which fetal heart rate range is considered as bradycardia and indicates a potential acute hypoxic event?
What is the main advantage of using Nifedipine over betamimetics for the suppression of preterm labor?
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At what gestational age should a 200mg pessary be recommended for women with a cervix less than 20mm?
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What is the loading dose of Ampicillin for suspected chorioamnionitis?
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Which fetal heart rate pattern is characterized by a transient rise in heart rate above baseline?
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'Chorioamnionitis' is suspected during prenatal care. Which antibiotic regimen is typically recommended for treatment?
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Which medication combines the rapid action of syntocinon with the sustained tonic effect of ergometrine?
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What is the main side effect of Syntometrine?
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Which condition is a contraindication for the use of Syntometrine?
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What is the main purpose of Uterine massage in postpartum hemorrhage management?
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In case of postpartum hemorrhage related to trauma, what is the recommended action?
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What may follow a massive hemorrhage and is characterized by clotting factors being consumed faster than they can be produced?
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Which condition is NOT a risk factor for developing Disseminated Intravascular Coagulation (DIC)?
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Which type of placental insertion has a higher chance of cord avulsion at birth due to its position?
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What are the signs of low blood pressure in pregnant women?
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Which hormone is involved in water retention and vasoconstriction in pregnant women with hypertensive disorders?
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What is the primary function of adrenaline (Epinephrine) and noradrenaline (Norepinephrine) in pregnant women with hypertensive disorders?
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Which condition is characterized by sudden onset of tonic-clonic seizures in pregnant women?
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What is the main cause of HELLP syndrome in pregnancy?
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Which hormone impair insulin function during pregnancy, leading to insulin resistance?
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What is the diagnostic criteria for Gestational Diabetes Mellitus (GDM) based on the Oral Glucose Tolerance Test (OGTT)?
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What is the recommended action for pregnant women with hyperthyroidism who require insulin treatment?
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Study Notes
CTG Tracing
- Baseline: 140, variability normal, accelerations present: no concerns
- Baseline: 140, variability reduced, early decelerations persist for 30 seconds: escalate findings
- On oxytocin, no accelerations, and reduced variability with persistent variable decelerations: change maternal position, escalate and continue tracing until CTG returns to normal
Hypertension
- Causes of hypertension:
- Reduced variability
- Pethidine
- Betablockers
- Preterm hypoxia
- Prior neurological damage
- Infection
- Anaemia
- CNS malformations
- Cardiac malformations/arrhythmia
- Chromosomal abnormalities
Blood Pressure Regulation
- Cardiac output (CO) = stroke volume (SV) x heart rate (HR)
- Blood pressure (BP) = CO x peripheral resistance
- Factors affecting blood pressure:
- Blood volume
- Dietary salt intake
- Vessel radius
- Blood viscosity
- Autoregulation
- Baroreceptor reflex and renin-angiotensin system (RAS) regulate blood pressure
Pre-Eclampsia
- Definition: hypertension after 20 weeks with one or more of the following:
- Renal involvement
- Liver disease
- Neurological problems
- Haematological disturbances
- Pulmonary oedema
- Fetal growth restriction
- Placental abruption
- Signs and symptoms:
- Headaches
- Visual disturbances
- Oliguria
- +1 on dipstick on two or more occasions, 6 hours apart
- Complications:
- Maternal: eclampsia, HELLP syndrome, placental abruption, fetal growth restriction
- Fetal: hypoxia, acidosis, birth asphyxia, stillbirth
Diabetes
- Insulin:
- Secreted by beta cells in pancreas
- Lowers blood glucose levels
- Facilitates uptake of glucose by cells
- Glucagon:
- Secreted by alpha cells in pancreas
- Raises blood glucose levels
- Carbohydrate metabolism during pregnancy:
- Diabetogenic state
- Increased need for nutrients
- Fat deposition
Gestational Diabetes Mellitus (GDM)
- Screening: OGTT at 24-28 weeks
- Diagnosis: one or more of the following:
- Fasting venous glucose ≥ 5.1 mmol/L
- 1-hour venous glucose ≥ 10.0 mmol/L
- 2-hour venous glucose ≥ 8.5 mmol/L
- Risk factors:
- Obesity
- Family history
- Previous GDM
- Ethnicity
- Complications:
- Pre-eclampsia
- Polyhydramnios
- Macrosomia
- Neonatal complications
PPH Management
- Identify cause of PPH
- Rub: fundal massage to encourage uterine contraction
- Repair: repair trauma to perineum, vagina, cervix, etc.
- Remove: remove retained products, clots, membranes
- Replace: replace blood lost by fluid resuscitation
- Anticoagulation: may be necessary in some cases
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Description
Learn to interpret abnormal cardiotocography (CTG) findings in pregnancy, including reduced variability, early decelerations, and the significance of oxytocin use. Understand the potential implications for the baby's well-being.
