Question Easy:
A 27-year-old pregnant woman, at 24 weeks gestation, presents with a low anterior placenta identified on her routine anomaly scan. She is worried about the implications for her pregnancy. What is the most appropriate advice to give her regarding the placenta? 🌸
A) Immediate admission and bed rest
B) No heavy lifting until delivery
C) Most low-lying placentas resolve by the third trimester
D) Scheduled caesarean section at 38 weeks
E) Avoid sexual intercourse
Explanations & Answers:
Question Easy Answer: C) Most low-lying placentas resolve by the third trimester
Question Easy Explanation: The majority of low-lying placentas diagnosed at the mid-pregnancy scan will resolve naturally as the uterus grows. According to NICE guidelines, placental position should be reassessed in the third trimester, and most cases resolve by 32 weeks. There is no need for immediate intervention in most cases.
Question Medium:
A 32-year-old woman presents with irregular heavy menstrual bleeding. She has no significant medical history. After examination and blood tests, she is diagnosed with uterine fibroids. What is the first-line treatment option for controlling her bleeding? 🌿
A) Hysterectomy
B) Progestogen-only pill
C) Tranexamic acid
D) Gonadotropin-releasing hormone agonists
E) Non-steroidal anti-inflammatory drugs (NSAIDs)
Explanations & Answers:
Question Medium Answer: C) Tranexamic acid
Question Medium Explanation: Tranexamic acid is recommended as a first-line treatment for heavy menstrual bleeding in the presence of fibroids, according to NICE guidelines. It helps in reducing blood loss and can be used when hormonal contraception is not desired or appropriate.
Question Hard:
A 37-year-old G2P1 woman has a history of intrauterine fetal demise in her previous pregnancy at 36 weeks. She is now 12 weeks pregnant and seeking advice on how to prevent recurrence. Which of the following is the most appropriate intervention to reduce the risk of recurrent stillbirth? 🍀
A) Planned induction at 40 weeks
B) Low-dose aspirin starting in the second trimester
C) Cervical cerclage
D) Daily low-molecular-weight heparin injections
E) Increased antenatal surveillance from 32 weeks
Explanations & Answers:
Question Hard Answer: B) Low-dose aspirin starting in the second trimester
Question Hard Explanation: Low-dose aspirin is recommended by NICE to reduce the risk of pre-eclampsia and associated complications, which can contribute to stillbirth. It is particularly indicated for women with a history of complications, including intrauterine fetal demise. Starting aspirin early in the second trimester has been shown to improve placental function and pregnancy outcomes.
Medical fact of the day: Did you know that the UK sees approximately 6,000 new cases of ovarian cancer annually? This makes it the sixth most common cancer among women in the UK, and research is continuously ongoing to improve early detection and treatment methods.
Quote of the day: “In the hands of those who care, small gestures weave miracles of healing.” 🌟