28/01/2025 21:23:00
LECTURE Intro to Obstetrics &
Gynaecology
General obstetrics
- Pre-eclampsia
- bleeding: placenta praevia, placental abruption, cervical, unexplained
- fetal growth restriction (FGR) or (SGA) small for gestational age
- birth planning incl previous CS choice
- pain
- thrombotic events
- pregnancy loss (incl stillbirth)
- screening for & prevention of pre-term labour
Maternal medicine
Any disease a (F) can have & still get pregnant
- HT/renal/cardiac/neuro/psychiatric
obstetrics and gynecology
Obstetrics: covers pregnancy, childbirth & postpartum period
- general obstetrics ('high risk care'), maternal medicine, fetal medicine
Pre-pregnancy planning
Fetal medicine
- diseases of unborn babies
- abnormalities/anomalies: congenital (developmental/programmed [DNA faults]) /
acquired
- infection (CMV/parvovirus)
Screening in pregnancy
Offered to all pregnant women to assess if woman/baby have health issue/disability
- simple tests: bloods/USS/questionnaire
- not diagnostic (follows on tests for diagnosis)
Blood tests
- FBCs
- blood group & rhesus state
- haemoglobinopathies: thalassemia & sickle cell
- infectious diseases
- chromosomal disorders: trisomies (21 most common, 13 & 18)
1st trimester screening test
Choice of: no screening, Down's only, Edward's & Patau's only, all 3
Combined test: 11+2 - 14+1 wks gestation = crown rump length (CRL = 45mm-
84mm)
- US scan for nuchal translucency (NT): in twins, NT measure for each
- blood test: free β-human chorionic gonadotrophin (free β-hCG & pregnancy
associated plasma protein A (PAPP-A)
Results w value 1:2-1:150+ considered at higher chance of baby having condition
Detection rate ~86% for singleton pregnancies (1in10 w down's undetected)
2nd trimester quadruple screen
LECTURE Intro to Obstetrics &
Gynaecology
General obstetrics
- Pre-eclampsia
- bleeding: placenta praevia, placental abruption, cervical, unexplained
- fetal growth restriction (FGR) or (SGA) small for gestational age
- birth planning incl previous CS choice
- pain
- thrombotic events
- pregnancy loss (incl stillbirth)
- screening for & prevention of pre-term labour
Maternal medicine
Any disease a (F) can have & still get pregnant
- HT/renal/cardiac/neuro/psychiatric
obstetrics and gynecology
Obstetrics: covers pregnancy, childbirth & postpartum period
- general obstetrics ('high risk care'), maternal medicine, fetal medicine
Pre-pregnancy planning
Fetal medicine
- diseases of unborn babies
- abnormalities/anomalies: congenital (developmental/programmed [DNA faults]) /
acquired
- infection (CMV/parvovirus)
Screening in pregnancy
Offered to all pregnant women to assess if woman/baby have health issue/disability
- simple tests: bloods/USS/questionnaire
- not diagnostic (follows on tests for diagnosis)
Blood tests
- FBCs
- blood group & rhesus state
- haemoglobinopathies: thalassemia & sickle cell
- infectious diseases
- chromosomal disorders: trisomies (21 most common, 13 & 18)
1st trimester screening test
Choice of: no screening, Down's only, Edward's & Patau's only, all 3
Combined test: 11+2 - 14+1 wks gestation = crown rump length (CRL = 45mm-
84mm)
- US scan for nuchal translucency (NT): in twins, NT measure for each
- blood test: free β-human chorionic gonadotrophin (free β-hCG & pregnancy
associated plasma protein A (PAPP-A)
Results w value 1:2-1:150+ considered at higher chance of baby having condition
Detection rate ~86% for singleton pregnancies (1in10 w down's undetected)
2nd trimester quadruple screen
