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NAUSEA AND VOMITING Morning sickness 50% Hyperemesis gravidarum 1%

NAUSEA AND VOMITING Morning sickness 50% Hyperemesis gravidarum 1% Treatment Diclectin (10 mg doxylamine with vit B12) Rest Avoid triggers Admit if severe LFTs, iv feeding. DIABETES Incidence 1 % Abnormal GTT 3 - 5 % in PREGNANCY PREVIOUS STILL BIRTH PREVIOUS LGA

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NAUSEA AND VOMITING Morning sickness 50% Hyperemesis gravidarum 1%

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  1. NAUSEA AND VOMITING Morning sickness 50% Hyperemesis gravidarum 1% Treatment Diclectin (10 mg doxylamine with vit B12) Rest Avoid triggers Admit if severe LFTs, iv feeding

  2. DIABETES Incidence 1 % Abnormal GTT 3 - 5 % in PREGNANCY PREVIOUS STILL BIRTH PREVIOUS LGA FAMILY HISTORY PERSISTENT GLYCOSURIA poor predictors SCREENING Random B.S. 50 g load > 7.8 at 1 hr, do OGTT > 10.3 = GDM

  3. ORAL GLUCOSE TOLERANCE TEST OGTT fasting >5.3 1 hour >10.6 2 hour 8.9 2 of the 3 values met or exceeded = GDM risk of anomalies infection pre - eclampsia macrosomia polyhydramnios late fetal death shoulder dystocia

  4. 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

  5. ANTE - PARTUM HEMORRHAGE > 20 / 40 ABRUPTION CONCEALED REVEALED PETDIC COCAINE SMOKINGPAIN SLEBLEEDING TRAUMA+ FETAL DISTRESS PREVIOUS ABRUPTION PLACENTA PREVIA diagnosed by TVS TOTAL (COMPLETE) PARTIAL MARGINAL LOW LYINGPAINLESS BLEEDING TRANSVERSE LIE VASA PREVIA

  6. RHESUS ISOIMMUNIZATION 7 % BLACK RACES 13 % WHITE RACES IgG anti - D in rhesus negative sensitized women Causes fetal anemia , heart failure hydrops fetalis. Born with jaundice In- Utero Dx. Amniocentesis, Cordo, Doppler PROPHYLAXIS RHOGAM AT 28 WEEKS KLEIHAUER AT DELIVERY

  7. B ILL ED

  8. PREMATURE LABOUR Incidence 7 % < 37 weeks MAJOR CAUSE OF P.N.M.R. OVERALL RECURRENCE RISK 30 % RISK FACTORS Previous Prem. Labour Low income smoking cervical surgery uterine anomaly multiple gestation TREATMENT: BED REST TOCOLYTICS STEROIDS PROM ERYTHROMYCIN PREDICTING PTL TVS / FIBRONECTIN

  9. CONGENITAL INFECTION Toxoplasmosis Other - Parvovirus , syphilis, listeria, Rubella Cytomegalovirus Herpes simplex Chickenpox Hepatitis B, Grp B Strep HIV -fetal transmission risk

  10. The most common cause of vaginal bleeding complicating premature labour is : a) a vaginal laceration b) an endocervical polyp c) cervical dilation d) placenta previa e) placental abruption

  11. PPH Causes 1° Uterine atony - twins - long labour - oxytocin Tears Coug. Disorders - APH 2° Retained products Infection

  12. PPH • Rx 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

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