Iraqi Board OB/GYN flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Active first stage labour

Regular painful contractions with progressive cervical dilatation from 5 cm to 10 cm; the latent phase extends to 5 cm and may not progress linearly.

Primary postpartum haemorrhage

Blood loss of at least 500 mL after vaginal birth or 1000 mL after caesarean within 24 hours; uterine atony is the most common cause.

Group B streptococcus prophylaxis

Intrapartum penicillin G 5 million IU IV loading dose then 2.5–3 million IU every 4 hours; cefazolin is used for non-severe penicillin allergy.

Gestational diabetes OGTT thresholds

At 24–28 weeks, a 75-g OGTT is abnormal if fasting glucose is at least 5.1, 1-hour at least 10.0, or 2-hour at least 8.5 mmol/L; one value diagnoses gestational diabetes.

Preeclampsia severe features

Blood pressure at least 160/110 mmHg, platelets below 100,000/µL, transaminases above 2× normal, creatinine above 1.1 mg/dL, pulmonary oedema, or new cerebral/visual symptoms; delivery at 34 weeks or later.

Antiphospholipid syndrome obstetric criteria

One or more unexplained fetal deaths at 10 weeks or later, three or more consecutive miscarriages before 10 weeks, or one preterm birth before 34 weeks due to preeclampsia, eclampsia or placental insufficiency.

Preterm corticosteroids regimen

Betamethasone 12 mg intramuscularly every 24 hours for two doses, or dexamethasone 6 mg every 12 hours for four doses, given between 24 and 33+6 weeks for anticipated preterm birth.

Twin delivery timing

Uncomplicated dichorionic twins are delivered at 37 0/7–37 6/7 weeks; monochorionic diamniotic twins at 36 0/7–36 6/7 weeks; monoamniotic twins at 32–34 weeks.

FIGO cervical cancer stage IB

Stage IB1 is 2 cm or less, IB2 is more than 2 to 4 cm, and IB3 is more than 4 cm; all are confined to the cervix and measured clinically.

Endometrial cancer risk factors

Type I endometrioid carcinoma is associated with obesity, diabetes, nulliparity, early menarche, late menopause, unopposed oestrogen and tamoxifen; postmenopausal bleeding is the usual presentation.

Ovarian cancer first-line chemotherapy

Carboplatin AUC 5–6 plus paclitaxel 175 mg/m² every 3 weeks for six cycles; PARP inhibitor maintenance is used for BRCA-mutated or homologous recombination-deficient advanced disease.

Gestational trophoblastic neoplasia treatment

Low-risk disease (WHO score 6 or less) is treated with single-agent methotrexate or actinomycin-D; high-risk disease (score 7 or more) receives EMA-CO multi-agent chemotherapy.

Rotterdam PCOS criteria

Two of three: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound (at least 12 follicles 2–9 mm or volume at least 10 mL).

WHO 2021 semen reference limits

Volume at least 1.4 mL, total sperm at least 39 million, concentration at least 16 million/mL, progressive motility at least 30%, total motility at least 42%, and normal morphology at least 4%.

Premature ovarian insufficiency definition

Ovarian failure before age 40 with FSH above 25 IU/L on two occasions at least 4 weeks apart and oestrogen deficiency; hormone replacement continues until at least age 50.

Letrozole in PCOS

An aromatase inhibitor used as first-line ovulation induction in PCOS; it has higher live-birth rates than clomiphene citrate and is taken for 5 days early in the cycle.

POP-Q stage 2

The leading edge of prolapse lies between 1 cm above and 1 cm below the hymenal ring; stage 2 is measured relative to the hymen.

Urodynamic stress incontinence

Involuntary urine leakage during filling cystometry when abdominal pressure rises, without a detrusor contraction; it is the urodynamic diagnosis underlying genuine stress incontinence.

Overactive bladder treatment

Bladder training plus an antimuscarinic or beta-3 agonist such as mirabegron; infection and malignancy are excluded first, and refractory cases may need botulinum toxin or neuromodulation.

Apical prolapse sacrocolpopexy

A surgical suspension of the vaginal apex to the sacral promontory using mesh; it has lower recurrence than native tissue repair but requires specialist training and informed consent about mesh risks.

Amsel criteria for bacterial vaginosis

Three of four: thin grey discharge, vaginal pH above 4.5, positive whiff test, and clue cells on microscopy; metronidazole 500 mg twice daily for seven days is first-line.

PID outpatient regimen

Ceftriaxone 500 mg intramuscularly once, plus doxycycline 100 mg twice daily and metronidazole 500 mg twice daily for 14 days; treat partners and retest for chlamydia and gonorrhoea.

Early syphilis treatment

Benzathine penicillin G 2.4 million IU intramuscularly as a single dose for primary, secondary or early latent syphilis; late latent requires three weekly doses.

Emergency contraception options

Levonorgestrel 1.5 mg within 72 hours, ulipristal acetate 30 mg within 120 hours, or a copper IUD within 5 days; the copper IUD is the most effective.

LARC duration etonogestrel implant

A subdermal etonogestrel implant provides contraception for 3 years; insertion is quick, fertility returns promptly after removal, and irregular bleeding is the commonest side effect.

Medical abortion regimen

Mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 µg vaginally, buccally or sublingually; this regimen is approved up to 10 weeks of gestation.

Nuchal translucency timing

Measured at 11 0/7–13 6/7 weeks with crown-rump length 45–84 mm; NT of 3.5 mm or more increases risk of aneuploidy and structural anomalies and warrants specialist review.

Amniocentesis timing and risk

Performed from 15 weeks of gestation; procedure-related miscarriage risk is about 0.1–0.5% in experienced centres, lower than the 1% often quoted in older counselling.

Middle cerebral artery PSV

Peak systolic velocity above 1.5 multiples of the median suggests fetal anaemia; it is used to guide intrauterine transfusion in red-cell alloimmunisation and can reduce unnecessary invasive procedures.

Number needed to treat

The reciprocal of the absolute risk reduction: NNT = 1/(control event rate − intervention event rate); it expresses how many patients need treatment for one additional benefit.

Sensitivity and specificity formulas

Sensitivity = true positives/(true positives + false negatives); specificity = true negatives/(true negatives + false positives); both are properties of the test and do not depend on prevalence.

GRADE certainty domains

Risk of bias, inconsistency, indirectness, imprecision and publication bias; certainty is rated high, moderate, low or very low, and recommendations are strong or conditional.