Sunday, August 24, 2008

Obstetric Mnemonic

Oral contraceptive complications: warning signs ACHES:
Abdominal pain
Chest pain
Headache (severe)
Eye (blurred vision)
Sharp leg pain



Abdominal pain: causes during pregnancy LARA CROFT:
Labour
Abruption of placenta
Rupture (eg. ectopic/ uterus)
Abortion
Cholestasis
Rectus sheath haematoma
Ovarian tumour
Fibroids
Torsion of uterus


Post-partum haemorrhage (PPH): causes 4 'T's:
Tissue (retained placenta)
Tone (uterine atony)
Trauma (traumatic delivery, episiotomy)
Thrombin (coagulation disorders, DIC)


Prenatal care questions ABCDE:
Amniotic fluid leakage?
Bleeding vaginally?
Contractions?
Dysuria?
Edema?
Fetal movement?


Asherman syndrome features ASHERMAN:
Acquired Anomaly
Secondary to Surgery
Hysterosalpingography confirms diagnosis
Endometrial damage/ Eugonadotropic
Repeated uterine trauma
Missed Menses
Adhesions
Normal estrogen and progesterone


Gestation period, oocytes, vaginal pH, menstrual cycle: normal numbers 4 is the normal pH of the vagina.
40 weeks is the normal gestation period.
400 oocytes released between menarche and menopause.
400,000 oocytes present at puberty.
28 days in a normal menstrual cycle.
280 days (from last normal menstrual period) in a normal gestation period.


CVS and amniocentesis: when performed "Chorionic" has 9 letters and Chorionic villus sampling performed at 9 weeks gestation.
"AlphaFetoProtein" has 16 letters and it's measured at 16 weeks gestation.


Alpha-fetoprotein: causes for increased maternal serum AFP during pregnancy "Increased Maternal Serum Alpha Feto Protein":
Intestinal obstruction
Multiple gestation/ Miscalculation of gestational age/ Myeloschisis
Spina bifida cystica
Anencephaly/ Abdominal wall defect
Fetal death
Placental abruption


Female pelvis: shapes GAP:
· In order from most to least common:
Gynecoid
Android /Anthropoid
Platypelloid


Pelvic Inflammatory Disease (PID): complications I FACE PID:
Infertility
Fitz-Hugh-Curitis syndrome
Abscesses
Chronic pelvic pain
Ectopic pregnancy
Peritonitis
Intestinal obstruction
Disseminated: sepsis, endocarditis, arthritis, meninigitis


B-agonist tocolytic (C/I or warning) ABCDE:
Angina (Heart disease)
BP high
Chorioamnionitis
Diabetes
Excessive bleeding


Secondary amenorrhea: causes SOAP:
Stress
OCP
Anorexia
Pregnancy


Preeclampsia: classic triad PREeclampsia:
Proteinuria
Rising blood pressure
Edema


Alpha-fetoprotein: some major causes for increased maternal serum AFP during pregnancy TOLD:
Testicular tumours
Obituary (fetal death)
Liver: hepatomas
Defects (neural tube defects)


Dysfunctional uterine bleeding (DUB): 3 major causes DUB:
Don't ovulate (anovulation: 90% of cases)
Unusual corpus leuteum activity (prolonged or insufficient)
Birth control pills (since increases progesterone-estrogen ratio)


IUGR: causes IUGR:
Inherited: chromosomal and genetic disorders
Uterus: placental insufficency
General: maternal malnutrition, smoking
Rubella and other congenital infecton


Early cord clamping: indications RAPID CS:
Rh incompatibility
Asphyxia
Premature delivery
Infections
Diabetic mother
CS (caesarian section) previously, so the funda is RAPID CS


Oral contraceptives: side effects CONTRACEPTIVES:
Cholestatic jaundice
Oedema (corneal)
Nasal congestion
Thyroid dysfunction
Raised BP
Acne/ Alopecia/ Anaemia
Cerebrovascular disease
Elevated blood sugar
Porphyria/ Pigmentation/ Pancreatitis
Thromboembolism
Intracranial hypertension
Vomiting (progesterone only)
Erythema nodosum/ Extrapyramidal effects
Sensitivity to light


Forceps: indications for delivery FORCEPS:
Foetus alive
Os dilated
Ruptured membrane
Cervix taken up
Engagement of head
Presentation suitable
Sagittal suture in AP diameter of inlet


Delivery: instrumental delivery prerequisites AABBCCDDEE:
Analgesia
Antisepsis
Bowel empty
Bladder empty
Cephalic presentation
Consent
Dilated cervix
Disproportion (no CPD)
Engaged
Episiotomy


APGAR score components SHIRT:
Skin color: blue or pink
Heart rate: below 100 or over 100
Irritability (response to stimulation): none, grimace or cry
Respirations: irregular or good
Tone (muscle): some flexion or active


Postpartum collapse: causes HEPARINS:
Hemorrhage
Eclampsia
Pulmonary embolism
Amniotic fluid embolism
Regional anaethetic complications
Infarction (MI)
Neurogenic shock
Septic shock


Multiple pregnancy complications HI, PAPA:
Hydramnios (Poly)
IUGR
Preterm labour
Antepartum haemorrhage
Pre-eclampsia
Abortion


IUD: side effects PAINS:
Period that is late
Abdominal cramps
Increase in body temperature
Noticeable vaginal discharge
Spotting


Labour: preterm labor causes DISEASE:
Dehydration
Infection
Sex
Exercise (strenuous)
Activities
Stress
Environmental factor (job, etc)


Miscarriage: recurrent miscarriage causes RIBCAGE:
Radiation
Immune reaction
Bugs (infection)
Cervical incompetence
Anatomical anomaly (uterine septum etc.)
Genetic (aneuploidy, balanced translocation etc.)
Endocrine


Shoulder dystocia: management HELPER:
Call for Help
Episiotomy
Legs up [McRoberts position]
Pressure subrapubically [not on fundus]
Enter vagina for shoulder rotation
Reach for posterior shoulder and deliver posterior shoulder/ Return head into vagina [Zavanelli maneuver] for C-section/ Rupture clavicle or pubic symphisis


Labour: factors which determine rate and outcome of labour 3 P's:
Power: stength of uterine contractions
Passage: size of the pelvic inlet and outlet
Passenger: the fetus--is it big, small, have anomalies, alive or dead


Post-partum examination simplified checklist BUBBLES:
Breast
Uterus
Bowel
Bladder
Lochia
Episotomy
Surgical site (for Cesarean section)




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3 comments:

thegooddrlaura said...

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