Anemia in Pregnancy MCQs

Iron deficiency microcytic anemia is the anemia that is most commonly associated with In this condition, oral iron supplementation is indicated. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 834-37

Fetal complications during pregnancy—There is diminished placental function, oligohydramnios and meconium stained liquor. These lead to fetal hypoxia and fetal distress. Reference: D C Dutta’s textbook of obstetrics 8 th edition, chapter 22

Hydrostatic(O’Sullivan’s) method: The inverted uterus is replaced into the vagina. Warm sterile fluid (up to 5 liters) is gradually instilled into the vagina through a douche nozzle. The vaginal orifice is blocked by the operator's palms supplemented by labial apposition around the palm by an assistant. Alternatively, a silicon cup (vacuum extraction cup) is placed into the vagina. The douche can be placed at a height of about 3 feet above the uterus. The water distends the vagina and the consequent increased intravaginal pressure leads to replacement of the uterus. Reference: D C Dutta’s textbook of obstetrics 8 th edition, chapter 28

Neonatal complications Chemical pneumonitis, atelectasis and pulmonary hypertension are due to meconium aspiration; Hypoxia (low Apgar scores) and respiratory failure; Hypoglycemia and polycythemia and Increased NICU admissions. Reference: D C Dutta’s textbook of obstetrics 8 th edition, chapter 22

Endometrial polyp -- Hysteroscopy and resection (best) Removal by ovum forcep Incase of recurrence and, if family completed— uterine curettage hysterectomy Cervical polyp -- Twisting of the pedicle Big fibroid in vagina -- Removal of polyp by morcellation If associated with inversion enucleate Ref. Dutta Gynae 6th/ed p 287, 288

In countries like India, anemia due to iron and folic acid deficiency commonly occur during pregnancy. Only Vitamin B 12 deficiency as a cause of anemia is rare. 'Megaloblastic anemia caused by lack of vitamin B 12 , that is cyanocobalamin, during pregnancy is exceedingly rare' - Williams Obs. 22/e, p 1147, 23/e, p 1082 Reference: Dutta Obs. 7/e, p 268; Williams Obs. 22/e, p 1147, 23/e, p 1082; Fernando Arias 3/e, p 469

DOSE OF FOLIC ACID IN PREGNANCY: PER DAY: To prevent neural tube defect: 400 micro grams In pregnant females with previous h/o ntd: 4mg To treat megaloblastic anaemia: 1mg In patients with sickle cell disease: 4mg Reference: High Risk Pregnancy, Arias 4/e, p 237

Other indications of Ring pessary: In puerperium – to facilitate involution. Patient unfit or unwilling for surgery. Women who have undergone at least one previous attempt at surgical intervention without relief. Diagnostic – It may be placed diagnostically to identify which women are at risk for urinary incontinence after prolapse correction surgery. Note: Pessaries are of two varieties : Supportive pessary eg–Ring pessary Space occupying pessary eg–Gellhorn pessary Reference: Dutta Obs 6th/ed p 312-3; Shaw 15th/ed p 337-8; Williams Gynae 1st/ed p 545-7