Notes in OG5.6 Obstetric emergencies

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Published	10/04/2024	Diagnostic Criteria for Preeclampsia Blood pressure {{c1::·Systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or m…
Published	10/04/2024	Diagnostic Criteria for Preeclampsia Proteinuria{{c1::≥ 300 mg for 24 hour urine collection}}{{c1::Protein/creatinine ratio (PCR) of ≥ 30 mg/mmol}}{{…
Published	10/04/2024	Diagnostic Criteria for Preeclampsia in the absence of proteinuria, new-onset hyper- tension with the new onset of any of the following:{{c1::·Thromb…
Published	10/04/2024	The biggest risk factor for pre-eclamptic toxaemia is {{c1::chronic renal disease (RR 20)}}
Published	10/04/2024	Risk factors for pre-eclamptic toxaemia can be separated into:- {{c1::Socio-demographic factors }}- {{c1::Genetic factors }}-…
Published	10/04/2024	Socio-demographic risk factors for pre-eclamptic toxaemia:- {{c1::Extremes of reproductive age }}- {{c1::Socioeconomic status…
Published	10/04/2024	Genetic risk factors for pre-eclamptic toxaemia:- {{c1::1st degree relative}}
Published	10/04/2024	Pregnancy risk factors for pre-eclamptic toxaemia:- {{c1::Multiple pregnancies}}- {{c1::Primigravidae }}- {{c1::Assisted repr…
Published	10/04/2024	Personal risk factors for pre-eclamptic toxaemia:- {{c1::Obesity }}- {{c1::chronic renal disease }}- {{c1::chronic …
Published	10/04/2024	Every seizure in pregnancy is {{c1::eclampsia}} until proven otherwise
Published	10/04/2024	Patient with acute pre-eclamptic toxaemia should have blood pressure monitoring every {{c1::15 minutes}} until stable
Published	10/04/2024	Antihypertensives that can be given for acute pre-eclamptic toxaemia:- Oral {{c1::labetolol}} or {{c1::nifedipine }}- IV {{c1…
Published	10/04/2024	Patients with pre-eclamptic toxaemia should be given {{c1::MgSO4}} to ↓ incidence of seizures
Published	10/04/2024	Management of placental abruption if CTG is reassuring and bleeding is light  → {{c1::acceleration of labour and vaginal delivery}}
Published	10/04/2024	Management of placental abruption if bleeding is heavy and fetus is compromised → {{c1::emergency C-section}}
Published	10/04/2024	Most common out of placenta accreta, increta and percreta is {{c1::accreta}}
Published	10/04/2024	Placenta accreta: {{c1::Invades the myometrium < 50%::definition}}
Published	10/04/2024	Placenta increta: {{c1::Invades the myometrium > 50%::definition}}
Published	10/04/2024	Placenta Percreta: {{c1::Penetrates through the myometrium past the serosa and invades adjacent structures::definition}}
Published	10/04/2024	Cord prolapse palpated → {{c1::shove baby's head back in::next best step}}
Published	10/04/2024	Cord prolapse palpated and baby's head back in → {{c1::fill maternal bladder to elevate the head::next best step}}
Published	10/04/2024	Definition of shoulder dystocia → {{c1::failure to deliver the anterior fetal shoulder at the 1st attempt at downward traction}}
Published	10/04/2024	HELPERR mnemonic for treating shoulder dystocia:{{c1::Call for}} H{{c1::elp }}E{{c1::valuate for}} E{{c1::pisiotomy}}L{{c1::egs (mcroberts)}}{{c1…
Published	10/04/2024	Definition of PPH in vaginal delivery → {{c1::> 500 mL}}
Published	10/04/2024	Definition of PPH in c-section → {{c1::> 1000 mL}}
Published	10/04/2024	Primary PPH occurs {{c1::within 24 hours of delivery::timing}}
Published	10/04/2024	Secondary PPH occurs {{c1::between 24h and 6 weeks post partum::when}} and is usually due to {{c1::retained tissue/endometritis}}
Published	10/04/2024	Causes of secondary postpartum hemorrhage include {{c1::infection}} or {{c1::retained placental tissue }}
Published	10/04/2024	Massive obstetric hemorrhage: {{c1::> 2500 mL loss or needing transfusion of ≥ 5 units of red cell concentrate or coagulopathy secondary …
Published	10/04/2024	Uterotonic drugs to give in management of PPH:- {{c1::Oxytocin}}- {{c1::Ergometrine}}- {{c1::Misoprostol }}- {{c1::Carboprost…
Published	10/04/2024	Patients with postpartum hemorrhage and cardiac disease, pre-eclampsia or asthma may be harmed by {{c1::carboprost::drug}}
Published	10/04/2024	Risk factors for cord prolapse{{c1::polyhydramnios}}{{c1::transverse}} lie{{c1::breech}} presentation{{c1::fetal growth restriction}}{{c1::artifical}}…
Published	10/04/2024	uterine rupture is associated with previous {{c1::uterine surgery}} and the use of {{c1::oxytocin::RX}}
Published	10/04/2024	presentation of uterine rupture{{c1::abdominal pain: "ripping" sensation, increasingly painful contractions, tenderness, guarding}}{{c1::PV bleeding}}…
Published	10/04/2024	{{c1::turtle sign}} = retraction of fetal head back towards maternal perineum, indicative of shoulder dystocia
Published	10/04/2024	risk factors for shoulder dystociaprevious shoulder dystocia ({{c1::10}}% recurrence){{c1::GDM}}{{c1::obesity}}{{c1::macrosomia (>4.5 kg)}}{{c1::po…
Published	10/04/2024	maternal complications of shoulder dystocia = {{c1::PPH, trauma, 3rd/4th degree tears, psychological trauma::4}}fetal complications of shoulder dystoc…
Published	10/04/2024	McRoberts maneuver resolves {{c1::90}}% of shoulder dystocia cases
Published	10/04/2024	{{c1::Suprapubic pressure}} = application of pressure on posterior aspect of fetal shoulder in downward direction
Published	10/04/2024	{{c1::Woods corkscrew}} maneuver = apply pressure to anterior aspect of posterior fetal shoulder, turns fetus counterclockwise
Published	10/04/2024	{{c1::Gaskin}} manuever = patient on all fours, repeat all other manuevers
Published	10/04/2024	acute uterine inversion = {{c1::fundus collapses into endometrial cavity}}{{c1::0.05}}% of vaginal deliveries
Published	10/04/2024	risk factors for acute uterine inversion{{c1::fundal placenta}}{{c1::placenta accreta}}{{c1::excessive cord traction with poorly contracted uterus}}
Published	10/04/2024	management of acute uterine inversioncall for helpmaternal resuscitation: ABCs, IV access, bloods, fluidsstop {{c1::uterotonics}}, no further attempts…
Published	10/04/2024	Four T's{{c1::tone}}: commonest cause of PPH ({{c1::60}}%){{c1::trauma (uterine, cervical, vaginal, perineal)}}{{c1::tissue (retained placenta)}}{{c1:…
Published	10/04/2024	risk factors for uterine atony{{c1::fetal macrosomia}}{{c1::multiple gestation}}{{c1::poly}}hydramnios{{c1::prolonged labor}}{{c1::multiparity}}
Published	10/04/2024	Acute management of PPHcall for helplie mother {{c1::flat}}ABCs: O2, 2 large IV cannulae, urgent bloods (FBC, cross-match, coag screen)resuscitate wit…
Published	10/04/2024	Treatment of PPH if cause is uterine atony {{c1::bimanual compression}}{{c1::uterotonics (oxytocin 5 IU IM then infusion, ergometrine 250 mcg IM …
Published	10/04/2024	amniotic fluid embolism{{c1::50}}% mortality rateresults in immediate and severe {{c1::DIC}} (maternal collapse) and {{c1::PPH}}caused by {{c1::expuls…
Published	10/04/2024	IV MgSO4 dosing for eclampsia prophylaxis loading dose = {{c1::4 gram IV bolus}}maintenance dose = {{c1::1 gram/hour IV infusion}} for {{c1::24}}…
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