Notesale: Turn your study into money

Document Preview

Extracts from the notes are below, to see the PDF you'll receive please use the links above

---

OBSTETRICS :
This note intend to help with preparation for OSCE stations, both history
taking and counselling station
...
There are also a few tips along the
notes
...
Hopefully it helps with
your exam!
POSSIBLE OSCE STATIONS FOR COUNSELLING AND HISTORY TAKING
1
...
Chorionic villus sampling
3
...
Caesarean section
5
...
Diabetes in pregnancy
7
...
Thrombophilia in pregnancy
9
...
Epilepsy in pregnancy
11
...
Premature rupture of membranes
13
...
Foetal abnormality
15
...
VBAC
17
...
Twins
19
...
Group B streptococcus
21
...
Post-operative assessment
23
...
Anemia in pregnancy including sickle cell anaemia
25
...
IUGR/SGA and foetal wellbeing
27
...
Shortness of breath in pregnancy
29
...

Fluid which contains the babies’ cells are sent to the laboratory for testing
Prenatal diagnosis – management of rhesus disease, estimate maturity, analyse
chromosomes, genetics, biochem etc
It is an invasive test
It is not used for screening, its diagnostic

Most commonly used for:
-

Advanced maternal age (>35yo) (on its own is not a reason for the test)
Previous child with neural tube defect, chromosomal abnormalities, birth defect
High risk antenatal screening tests eg USS, AFP
Family history of genetic disorder
Want to know for sure whether baby has genetic disorder or not
Ultrasound scan show abnormal features eg: congenital heart defect

Procedure :
-

If blood group is rhesus negative, recommend injection of anti-D immunoglobulin
after the procedure to prevent formation of antibodies
Ultrasound guidance to ensure safe distance from baby
Thin needle put into belly through muscle and into sac
10-20ml of fluid taken
Needle taken out and baby observed with ultrasound

Slight discomfort but not usually painful
Results :
-

Full karyotype to check baby’s chromosomes (results back in two weeks)
Also there are rapid tests to check certain genetic disorders (results take about 4 days)
If results abnormal, will be arranged to discuss the options as soon as possible
...

Can continue with pregnancy or end the pregnancy (will offer support with either
decision)

Risks :

-

1-2% risk of miscarriage
Small risk of infection
may notice spotting down below and cramping few hours after the procedure (normal
and safe to take paracetamol)
seek advice immediately if experience any unsual symptoms
cell culture may not work
anxiety

Other diagnostic options
-

Chorionic villus sampling
Do nothing (perfectly reasonable)

Discuss with partner or midwife
Remember :
-

Avoid jargon
Check understanding (are you following me?)
Offer leaflet at the end



---