Basic mnemonics in obstetrics and gynaecology - part one

Basic mnemonics in obstetrics and gynaecology - part one

Studying medicine is not an easy task. Although it is good to understand every concept, some things need that we device a technique to remember them more easily. As part of our duties to make medical profession more interesting, we have decided to write on mnemonics in obstetrics and gynecology for easy learning of the course.

Note: this mnemonics are created by anonymous individuals.

 

Each of the conditions/items will be discussed under the following contents:

  • Condition/Item
  • Brief introduction
  • Mnemonic proper

 

1. Preeclampsia 

It is the combination of pregnancy induced hypertension and proteinuria with or without oedema 

 

Preeclampsia: classic triad: 

PREeclampsia

  • Proteinuria
  • Rising blood pressure
  • Edema

 

2. Right Lower Quadrant Pain in Female

This is the pain that result from the right lower part of the abdomen.

 

Some differentials are:

AEIOU:

  • Appendicitis/ Abscess
  • Ectopic pregnancy/ Endometriosis
  • Inflammatory disease (pelvic)/ IPD
  • Ovarian cyst (rupture, torsion)
  • Uteric colic/ Urinary stones

 

3. Abdominal Pain(causes during pregnancy)

Pain is a complex experience consisting of a physiological and a psychological response to a noxious stimulus.

 

Some differentials are:

LORA CRAFT:

  • Labour
  • Ovarian tumour
  • Rupture (eg. ectopic/ uterus)
  • Abortion
  • Cholestasis
  • Rectus sheath haematoma
  • Abruption of placenta
  • Fibroids
  • Torsion of uterus

 

4. Alpha-fetoprotein

Protein produced by the liver of the human fetus, which accumulates in the amniotic fluid. A high or low concentration of this protein is an indication for certain conditions.

 

Causes of 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

or  

TOLD:

  • Testicular tumours
  • Obituary (fetal death)
  • Liver: hepatomas
  • Defects (neural tube defects)

 

Causes of decreased maternal serum AFP during pregnancy

Chromosomal abnormalities

  • Edward syndrome
  • Down syndrome

 

5. APGAR SCORE

Method of judging the condition of a newborn baby in which the baby is given a maximum of two points on each of five criteria which are

 

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

 

6. Asherman’s Syndrome Features

Asherman's syndrome is an uncommon, acquired, gynecological disorder characterized by changes in the menstrual cycle. 

 

Features are:

ASHERMAN

  • Acquired Anomaly
  • Secondary to Surgery
  • HSG confirms diagnosis
  • Endometrial damage/ Eugonadotropic
  • Repeated uterine trauma
  • Missed Menses
  • Adhesions
  • Normal estrogen and progesterone

 

7. B-agonist tocolytic (C/I or warning)

Beta-adrenergic receptor agonists have been used for tocolysis in the setting of preterm labor for more than three decades.

 

ABCDE:

  • Angina (Heart disease)
  • BP high
  • Chorioamnionitis
  • Diabetes
  • Excessive bleeding

 

8. Chorionic Villus Sampling and amniocentesis: when performed?

Chorionic villus sampling, sometimes called "chorionic villous sampling", is a form of prenatal diagnosis to determine chromosomal or genetic disorders in the fetus. It entails sampling of the chorionic villus and testing it for chromosomal abnormalities, usually with FISH(Fluorescent In situ Hybridization) or PCR(Polymerase Chain Reaction).

 

Amniocentesis is a procedure which involves taking a test sample of the amniotic fluid during pregnancy using a hollow needle and syringe.

 

So when?

"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.

 

9. Delivery: instrumental delivery prerequisites  

AABBCCDDEE:

  • Analgesia
  • Antisepsis
  • Bowel empty
  • Bladder empty
  • Cephalic presentation
  • Consent
  • Dilated cervix
  • Disproportion (no CPD)
  • Engaged
  • Episiotomy

 

10. Dysfunctional uterine bleeding (DUB): 3 major causes

DUB is defined as "abnormal uterine bleeding that is not associated with uterine pathology or medical illness. So it is a diagnosis of exclusion.

 

Causes are:

DUB

  • Don't ovulate (anovulation: 90% of cases)
  • Unusual corpus leuteum activity (prolonged or insufficient)
  • Birth control pills (since increases progesterone-estrogen ratio)

 

Read also: basic mnemonics in paediatrics

 

11. Early cord clamping: indications

The World Health Organisation (WHO) defines early cord clamping as the clamping of the umbilical cord within the first 60 seconds of birth.

 

Indications are:

RAPID CS:

  • Rh incompatibility
  • Asphyxia
  • Premature delivery
  • Infections
  • Diabetic mother
  • CS (caesarian section) previously

 

12. Fetus: cardinal movements of fetus

The mechanisms of labor, also known as the cardinal movements, involve changes in the position of the fetus’s head during its passage in labor. These are described in relation to a vertex presentation. 

 

The movements are:

"Don't Forget I Enjoy Really Expensive Equipment"

  • Descent
  • Flexion
  • Interal rotation
  • Extension
  • Restitution
  • External rotation
  • Expulsion

 

13. Forceps: indications for delivery  

Forceps delivery is a type of assisted delivery in which forceps are used to aid in the delivery of the fetus by applying traction to the fetal head.

 

Indications are:

FORCEPS:

  • Foetus alive
  • Os dilated
  • Ruptured membrane
  • Cervix taken up
  • Engagement of head
  • Presentation suitable
  • Sagittal suture in AP diameter of inlet

 

14. Forceps: indications for use

FORCEPS:

  • Fully dilated cervix
  • Outlet adequate (e.g. no CPD)
  • Ruptured membranes
  • Cephalic or at least deliverable presentation/ Contracting uterus
  • Engaged head
  • Surrounding structure  empty (bladder and bowel)

 

15. Gestation period, oocytes, vaginal pH, menstrual cycle: normal numbers 

Gestation period is the he period usually of days from conception to birth during which the baby develops in the mother’s womb.

 

Oocyte is a cell which forms from an oogonium and becomes an ovum by meiosis.

 

Vaginal PH is the level of acidity of the vaginal

 

Menstrual cycle is a cyclical process that involves changes in the ovaries and the lining of the uterus (endometrium), starting with the preparation of an egg for fertilization.

 

The normal numbers are:

  • 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.

 

16. Intrauterine Device(IUD): side effects

An intrauterine device (IUD), also known as an intrauterine contraceptive device (IUCD), is a small T-shaped plastic device with copper banded around the transverse arms, which is inserted into the uterus to prevent pregnancy.

 

Side effects are:

PAINS:

  • Period that is late
  • Abdominal cramps
  • Increase in body temperature
  • Noticeable vaginal discharge
  • Spotting

 

17. Intrauterine Growth Restriction(IUGR): causes

Intrauterine growth restriction (IUGR) refers to a condition in which a fetus is unable to achieve its genetically determined potential size.

 

Some causes are:

IUGR:

  • Inherited: chromosomal and genetic disorders
  • Uterus: placental insufficiency
  • General: maternal malnutrition, smoking
  • Rubella and other congenital infection

 

18. Labour: preterm labor causes

Preterm labor is defined as the presence of uterine contractions of sufficient frequency and intensity to effect progressive effacement and dilation of the cervix after age of viability and before 37 weeks.

 

Causes are:

DISEASE:

  • Dehydration
  • Infection
  • Sex
  • Exercise (strenuous)
  • Activities
  • Stress
  • Environmental factor (job, etc)

 

19. Complications of multiple pregnancy

Multiple pregnancy is a pregnancy in which more than one fetus develops in the uterus at the same time.

 

Complications are:

HI PAPA:

  • Hydramnios (Poly)
  • IUGR
  • Preterm labour
  • Antepartum haemorrhage
  • Pre-eclampsia
  • Abortion

 

Read also: basic mnemonics in surgery

 

20. Oral contraceptive complications: warning signs:

Contraceptive is a device that can be used to intentionally prevent pregnancy.

 

Warning signs are:

ACHES:

  • Abdominal pain
  • Chest pain
  • Headache (severe)
  • Eye (blurred vision)
  • Sharp leg pain

 

21. 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

 

22. Ovarian cancer: risk factors

This refers to the malignancy of the ovary. It often go undetected and therefore patient usually report at the advanced stage of the disease.

 

Risk factors are:

Blue FILM:

  • Breast cancer
  • Family history
  • Infertility
  • Low parity
  • Mumps

 

23. Pelvic Inflammatory Disease (PID): complications

Pelvic  inflammatory  disease  is  characterized  by inflammation  and  infection  arising  from  the endocervix  leading  to  endometritis,  salpingitis, oophoritis,  pelvic  peritonitis  and  subsequently formation  of  tubo-ovarian  and  pelvic  abscesses. The most causes are chlamydial  and  gonococcal  infections however,  other  organisms,  such  as bacterial vaginosis, may be identified. It may be acute or chronic.

 

Complications are:

I FACE PID:

  • Infertility
  • Fitz-Hugh-Curitis syndrome
  • Abscesses
  • Chronic pelvic pain
  • Ectopic pregnancy
  • Peritonitis
  • Intestinal obstruction
  • Disseminated: sepsis, endocarditis, arthritis, meninigitis

 

24. Postpartum collapse: causes

Maternal collapse is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent conscious level (and potentially death).

 

Causes are:

HEPARINES:

  • Hemorrhage
  • Eclampsia
  • Pulmonary embolism
  • Amniotic fluid embolism
  • Regional anaethetic complications
  • Infarction (MI)
  • Neurogenic shock
  • Septic shock

 

25. Causes of Post-partum haemorrhage

Post-partum haemorrhage is the blood loss after delivery, this may be primary which is within 24 hours of delivery or secondary which is between 24hours of delivery to 6week.

 

Primary PPH

Blood loss of 500mls following vaginal delivery or 1000mls following caesarean section or any blood loss that results in cardiovascular compromise, irrespective of volume

 

Secondary PPH:

Loss of fresh or frank blood after the lochia rubra has ended

 

Causes are:

4 T’s:

  • Tissue (retained placenta)
  • Tone (uterine atony)
  • Trauma (traumatic delivery, episiotomy)
  • Thrombin (coagulation disorders, DIC)

 

 

Read also: Basic mnemonics in obstetrics and gynaecology - part two


Kindly leave a comment in the comment section below if you have any. You can also follow us on twitter @MedsJoin or like us on Facebook @medsjoin



leave a comment

Comment

There are no comments yet.