Archive for the ‘Obstetrics & Gynaecology’ Category

Female sterilisation counselling

October 6, 2013

FILM V

  • Failure rate – results not guaranteed
  • Irriversible – important esp. if <30yo as may want family in future
  • Laparoscopic/laparotomy – common surgical methods
  • Menstruation – periods may initially be heavier following lap sterilisation
  • Vasectomy – more desirable, simpler procedure with fewer complications

Source: www.gpnotebook.co.uk

IUGR effects in adult life

December 31, 2011

CHAD

  • Coronary artery disease
  • Hypertension
  • Autoimmune thyroid disease
  • Diabetes mellitus (type 2)

Pre-eclampsia maternal complications

December 28, 2011

ADHD

  • Acute renal failure
  • Disseminated intravascular coagulation
  • HELLP syndrome
  • Death

HELLP syndrome – Haemolysis, Elevated Liver enzymes, Low Platelets

Epileptic medication considerations in women

December 15, 2011

TAMPon

  • Teratogenicity – avoid sodium valproate, use lamotrigine instead
  • Abnormalities to the fetus – 5% risk so requires pre-conception counselling
  • Milk from breast can contain anti-epileptic medication (except carbamazepine and valproate)
  • Pill (oral contraceptive pill) rendered inactive by liver enzyme-inducing drugs (see post) including carbamazepine, phenytoin and barbituates

Post-partum haemorrhage (PPH) causes

November 11, 2011

The four T‘s

  • Tone – uterine atony (cause in 80-90% of patients)
  • Trauma – cervix, vagina, perineum, anus and rectum
  • Tissue – retained placenta
  • Thrombin – development of DIC
Treatment requires:
ABC approach, IV fluids, oxytocin infusion, bimanual compression and surgery such as uterine artery embolisation or a hysterectomy (if required)

Post-partum pyrexia causes

September 28, 2011

B-5W

  • Breast – engorgement, mastitis
  • Wind – atelectasis, pneumonia
  • Water – UTI
  • Wound – Cesarean section site
  • Walking – DVT, thrombophlebitis
  • Womb – endometritis

Endometriosis triad

September 28, 2011

The three D‘s

  • Dysmenorrhoea
  • Dyspareunia (pain during sexual intercourse)
  • Dyschezia (since deposits may be in uterosacral ligament or rectum)

Cervical cancer risk factors

March 9, 2011

OH SIMPSON

  • Oral contraceptive
  • Human Papillomavirus (HPV)
  • Smoking
  • Immunocompromised (e.g. transplant patients, HIV positive)
  • Multiparity
  • Partners who have had many previous partners
  • Sexually active at early age
  • Other sexually transmitted disease (STDs)
  • Numerous partners