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 % 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

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

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

ANTE - PARTUM HEMORRHAGE > 20 / 40 ABRUPTIONCONCEALED 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

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 PROPHYLAXISRHOGAM AT 28 WEEKS KLEIHAUER AT DELIVERY

B ILL ED

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

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

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

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

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