NAUSEA AND VOMITING

Morning sickness 50%Hyperemesis gravidarum 1%

Treatment Diclectin (10 mg doxylamine with vit B12)

RestAvoid triggersAdmit if severeLFTs, iv feeding

DIABETES

Incidence 1 %Abnormal GTT 3 - 5 % in PREGNANCY

PREVIOUS STILL BIRTH PREVIOUS LGAFAMILY HISTORYPERSISTENT GLYCOSURIA

poor predictorsSCREENING

Random B.S.50 g load > 7.8 at 1 hr, do OGTT

> 10.3 = GDM

ORAL GLUCOSE TOLERANCE TEST OGTT

fasting >5.31 hour >10.62 hour 8.92 of the 3 values met or exceeded = GDM

risk of anomalies infection pre - eclampsia macrosomia polyhydramnios late fetal death shoulder dystocia

A pregnant woman with a sickle cell trait is at risk for increased incidence of:

a) perinatal mortality

b) a low birth weight infant

c) pregnancy induced hypertension

d) anemia

e) spontaneous abortion

ANTE - PARTUM HEMORRHAGE> 20 / 40

ABRUPTION CONCEALEDREVEALED

PET DICCOCAINESMOKING PAINSLE BLEEDINGTRAUMA + FETAL DISTRESSPREVIOUS ABRUPTION

PLACENTA PREVIA diagnosed by TVSTOTAL (COMPLETE)PARTIALMARGINALLOW LYING PAINLESS BLEEDING

TRANSVERSE LIEVASA PREVIA

RHESUS ISOIMMUNIZATION

7 % BLACK RACES13 % WHITE RACES

IgG anti - D in rhesus negative sensitized women

Causes fetal anemia , heart failurehydrops fetalis. Born with jaundice

In- Utero Dx. Amniocentesis, Cordo, Doppler

PROPHYLAXIS RHOGAM AT 28 WEEKSKLEIHAUER AT

DELIVERY

B ILL ED

PREMATURE LABOURIncidence 7 % < 37 weeksMAJOR CAUSE OF P.N.M.R.OVERALL RECURRENCE RISK 30 %RISK FACTORS

Previous Prem. LabourLow incomesmokingcervical surgeryuterine anomalymultiple gestation

TREATMENT: BED RESTTOCOLYTICSSTEROIDS

PROM ERYTHROMYCIN

PREDICTING PTL TVS / FIBRONECTIN

CONGENITAL INFECTION

Toxoplasmosis

Other - Parvovirus , syphilis, listeria,

Rubella

Cytomegalovirus

Herpes simplex

Chickenpox

Hepatitis B, Grp B Strep

HIV - fetal transmission risk

The most common cause of vaginal bleedingcomplicating premature labour is :

a) a vaginal laceration

b) an endocervical polyp

c) cervical dilation

d) placenta previa

e) placental abruption

PPH

Causes 1° Uterine atony - twins - long labour - oxytocin

Tears Coug. Disorders - APH 2° Retained products Infection

PPHRx Deliver placenta

Repair tears

Bimanual compression

Get help → Blood Bank

X match

platelets

FFP

comp ppt.

Ergotamine

Hemabate

Oxytocin

Explore uterus

Ligate internal ilicecis

Hysterectomy