EFOG-EBCOG Part 1 cheat sheet

Gestational age by Naegele's rule: first day of last menstrual period + 280 days; dating ultrasound (crown-rump length 7-13+6 weeks) supersedes LMP when discrepancy exceeds 5-7 days.

Estimated fetal weight formulas: Hadlock uses BPD, HC, AC and FL; AC alone is the single best predictor of fetal weight and the first parameter to fall in growth restriction.

Amniotic fluid: oligohydramnios = deepest vertical pocket <2 cm or AFI <5 cm; polyhydramnios = DVP >8 cm or AFI >24 cm.

Fetal heart rate interpretation: baseline 110-160 bpm; late decelerations reflect uteroplacental insufficiency; variable decelerations reflect cord compression; prolonged deceleration >2 minutes requires delivery assessment.

Preeclampsia: hypertension after 20 weeks plus proteinuria (>=300 mg/24 h) or end-organ dysfunction; severe features include BP >=160/110, platelets <100, LFT elevation, creatinine >1.1 mg/dL, pulmonary oedema, visual or cerebral symptoms.

Postpartum haemorrhage: >500 mL after vaginal or >1000 mL after caesarean birth; causes are tone, trauma, tissue, thrombin; first-line uterotonics are oxytocin, then ergometrine, carboprost, misoprostol.

Rhesus prophylaxis: anti-D immunoglobulin at 28 weeks and within 72 hours of delivery of an Rh-positive infant, plus after miscarriage, ectopic pregnancy, amniocentesis or abdominal trauma.

Magnesium sulphate for eclampsia: 4 g loading dose IV over 20 minutes then 1 g/hour; monitor deep tendon reflexes, respiratory rate and urine output; antidote is calcium gluconate.

Shoulder dystocia manoeuvres in sequence: McRoberts position, suprapubic pressure, internal rotation (Rubin II, Woods screw), delivery of posterior arm, then all-fours or Zavanelli as last resort.

Cervical screening: liquid-based cytology from age 25; high-risk HPV types 16 and 18 account for most cervical cancers; HPV testing has higher sensitivity but lower specificity than cytology.

Endometrial cancer: most common gynaecological malignancy; risk factors include obesity, unopposed oestrogen, nulliparity, diabetes, tamoxifen; postmenopausal bleeding warrants endometrial sampling.

Ovarian cancer: CA-125 lacks sensitivity for stage I disease; risk of malignancy index combines CA-125, menopausal status and ultrasound score; BRCA1/2 carriers have markedly elevated lifetime risk.

Combined oral contraceptive mechanism: suppresses ovulation via negative feedback on gonadotropins and thickens cervical mucus; oestrogen component stabilises endometrium and reduces breakthrough bleeding.

Menopause: defined retrospectively after 12 months of amenorrhoea; average age 51 years; premature ovarian insufficiency before age 40; FSH elevated and oestradiol low.

Ectopic pregnancy: transvaginal ultrasound diagnostic; discriminatory human chorionic gonadotropin zone around 1500-3500 IU/L; methotrexate is contraindicated with ruptured tube, significant haemoperitoneum or fetal cardiac activity with high hCG.

Polycystic ovary syndrome Rotterdam criteria: two of three of oligo/anovulation, clinical or biochemical hyperandrogenism, polycystic ovarian morphology on ultrasound; exclude other causes.

Fibroids: classified by FIGO position (submucosal, intramural, subserosal); submucosal fibroids most affect fertility and bleeding; GnRH agonists shrink fibroids preoperatively.

Gynaecological tumour markers: hCG for gestational trophoblastic disease, alpha-fetoprotein for yolk sac tumours, inhibin for granulosa cell tumours, CA-125 for epithelial ovarian cancer.