G/P- Gravidity – number of times a woman has been pregnant, regardless of outcome
- Parity - X = (any live or still birth after 24 weeks) | Y = (number lost before 24 weeks)
Post-op management - Fluid out should be at least 1/3 of fluid in
- Hear bowel sounds => Oral input
- Stitches out
- 7 days Pfannenstiel
- 10 days midline
- 6 weeks of:
- No lifting
- No driving
- No sex
Fitz-Hugh–Curtis syndrome
- Rare complication of PID
- Liver capsule inflammation => Adhesions of parietal peritoneum to liver
- Acute onset, right upper quadrant abdominal pain aggravated by breathing, coughing or movement
Down's screening - Try to do before 13.5 weeks
- Leave open the possibility of a first trimester termination
- Harder to do US after that, as baby is mobile
- US is inaccurate after that
- S+S
- Before 15 weeks: 90% sensitivity, 97% specificity
- Quad test (after 15 weeks): 70% sensitivity, 95% specificity
- Before 15 weeks (ideally at 11 - 13.5 weeks)
- Demographics
- Age, weight, ethnicity, smoking, previous history, previous pregnancies (IVF/natural)
- Serum biochemistry
- Beta-HCG, PAPP-A (Pregnancy-associated plasma protein A)
- Ultrasound
- CRL, neuchal translucency (use mean of two for monochorionic, measure both for dichorionic)
- Quad test (after 15 weeks)
- Alpha-fetoprotein (AFP)
- Beta-HCG
- Unconjugated estriol (UE3)
- Inhibin A
- CVS
- Amniocentesis
- Can do after 16 weeks
- Take 1 ml of fluid for each week of gestation
- Riskier than CVS (risk of infection)
- Can't use serum markers for multiple pregnancies
12 week scan - Viability
- Multiple pregnancy
- EDD (from CRL)
- Neuchal translucency
- Heart rate
- Early anomalies (anencephaly, gastroschesis, omphalocoele)
Ovarian cancer - Systemic systems
- Change in bowel habit
- Change in appetite
- Abdo pain
- Check CA-125
Management of DUB - Tranexamic acid
- GnRH analogues
- Endometrial ablation
- Progestogens (norethisterone)
- Mirena
- Can increase bleeding for 3 months, then decrease
- Can cover with norethisterone
- Adhesions and/or fibrosis of the endometrium
- From trauma to basal layer of endometrium
- Most often associated with dilation and curettage of the intrauterine cavity
Notes - EDD: + 1 year, - 3 months, + 7 days
- Booking bloods
- Group, Rh
- FBC, Iron studies
- HIV, HepB, Rubella, Syphilis
- Rifampicin/enzyme inducers => COCP interference
- Food/Drink irritating to bladder:
- Tea (inc. green), coffee, hot chocolate, blackcurrant juice, cola, alcohol
- Citrus fruit, tomatoes
- Indications for RRT
- A cidosis
- E lectrolyte imbalance
- I ngestion
- O verload
- U raemia
- "Foetal reduction"
- 20% of pregnancies => Early pregnancy failure (silent miscarriage/empty sack)
- Hydrosalpinx
- Caesarian => Twice the blood loss of vaginal delivery
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