Obstetrics Questions

What G and P notation would be given to a non-pregnant patient with a previous stillbirth (after 24wks gestation)?

The second trimester is from ...wks until ... wks gestation

What G and P notation would be given to a non-pregnant patient with a previous miscarriage?

which placental hormone is responsible for a positive pregnancy test

Mrs Valentine has a detailed anomaly scan in the FMU. The scan shows that the fetus is affected by hypoplastic left heart syndrome. The fetal medicine team explain that the left side of the heart are severely underdeveloped and unable to support the systemic circulation. The team explain that without intervention, it is a fatal condition. The options of continuation of the pregnancy or termination of pregnancy are discussed.Q5. What members of the MDT would you want to be involved in this patient's care?

Mrs Valentine's first trimester screening result shows that there is a high risk of chromosomal disorder. She opts for CVS for further information and the result shows 45XO karyotype. She attends the fetal medicine unit following the result, to discuss the implications of a diagnosis of Turner's syndrome, and what her options may be.Q3. What are the risks of invasive testing?

Q7. What psychological effects might Mrs Vincent and her partner experience during investigation and diagnosis of fetal anomalies? How would you support their decision-making and psychological wellbeing?

Mrs Valentine opts for induction of labour and delivers a stillborn female infant. She and her family spend the next 24 hours in hospital with their baby. She opts not to have any further testing and is discharged home directly from the delivery suite.Q10. What follow-up and support should she receive?

At 32 weeks gestation, Mrs Valentine presents to the maternity triage department with a history of no fetal movements for the past two days. The midwife is unable to locate the fetal heart with Doppler auscultation and requests that the registrar attends to scan Mrs Valentine. The scan unfortunately shows that the heartbeat is absent and that there has been an in utero fetal death (IUD).Q8. What is the initial management of IUD?

Ms Shelley attends for her routine anomaly scan at 20 weeks' gestation. There are no fetal concerns at the scan, however the placenta is noted to be anterior and completely covering the cervical os.Q5. What are the implications of the scan findings on the pregnancy anddelivery? What are the risks of a low lying placenta?

She has a maternal tachycardia of 120 bpm, respiratory rate of 22 breaths/min, oxygen saturation is 98% and she has a B.P of 95/58 mmHg. She has not passed urine since admission. On abdominal examination, her uterus is hard and "woody" with no resting tone, and she has ongoing fresh red bleeding. The emergency team are called to help stabilise her andprepare for a category 1 emergency caesarean section (baby to bedelivered within 30 minutes of the decision) for presumed fetal abruption. Verbal consent is obtained. A baby boy is born by caesarean section, with Apgars of 5/9/9. A retroplacental clot of 200 ml is noted at the time of the otherwise uneventful procedure.Q12. What are the potential problems and pitfalls of consent in an emergency situation in obstetrics? Is consent valid if it is not written consent?

Ms Shelley presents to delivery suite triage at 36/40 with abdominal pain and significant fresh red vaginal bleeding. She is uncertain about whether her membranes have ruptured.Q10. What are the potential causes of bleeding and what investigations would you consider?

Ms Shelley attends for a further growth scan at 34 weeks, in line with hospital policy. The scan shows that the fetal growth plots below the 3rd centile with normal liquor and Doppler.Q8. What are the potential causes / risk factors for a small for gestational age fetus?

Ms Shelley progresses well in her pregnancy, has normal anomaly and serial growth scan. Her epilepsy remains stable, and she has not experienced any seizure activity in the pregnancy. Her nausea and vomiting have settled, and she has managed to stop smoking cannabis with the support of her local community-based substance misuse team. She is now 30 weeks. She has her first growth scan which shows thatbaby's growth is on the 17th centile with normal liquor and Doppler. It also shows that the placenta is no longer low lying. Despite this, she requests a caesarean section as she is anxious about having a seizure during labour.Q6. What considerations need to be made for management of labour anddelivery in women with epilepsy? How should you counsel Ms Shelley?

Is planned c-section required with low-lying placenta?

What is given to patients between 34 and 35+6 weeks gestation to mature fetal lungs?

Crown rump length ≥ 7mm with no embryonic heartbeat Mean gestational sac diameter ≥ 25mm with no embryoNo increase in mean gestational sac diameter size on ≥ 2 transvaginal ultrasound scans 7-10 days apart

Which scan is used to assess the position of the placenta and diagnose placenta praevia?

If placenta praevia is diagnosed at the 20-week scan, when should the patient be scanned again?

sudden abdominal pain in third trimester cold to touch extreme painabsence of visible bleeding does not rule out diagnosis RF: maternal hypertension, cocaine, trauma, uterine overdistension, tobacco