ob complications of pregnancy

Question 1

What is the rate of doubling for beta hCG in normal pregnancy?

Answer 1

-double every 48 hrs (approx.)

Question 2

When can a pregnancy be visualized by transabdominal ultrasound? by transvaginal ultrasound? give answer in form of hCG level

Answer 2

• 6500 mIU/mL for transabdominal

- 15000 mIU/mL for transvaginal

Question 3

What are the most common causes of spontaneous abortions?

Answer 3

1st trimester: chromosomal abnormalities
2nd trimester: infection, cervical insufficiency, uterine abnormalities, hypercoagulability, or poor maternal health (drugs, meds, other problems)

Question 4

What are the risk factors for SAB?

Answer 4

incr maternal age, multiple prior births, prior SAB, uterine abnormalities, smoking, alcohol, NSAIDs,

Question 5

How is an inevitable abortion diagnosed and treated?

Answer 5

pain or bleeding with open cervix

give misoprostol or D&C to remove uterine contents

Question 6

What is the definition of spontaneous abortion?

Answer 6

miscarriage of pregnancy at less than 20 wks

Question 7

What are the ultrasound findings for IUGR?

Answer 7

abd circumference

Question 8

What is intrauterine fetal demise?

Answer 8

fetal death that occurs after 20 wks gestation and before the onset of labor

Question 9

What are the causes of intrauterine fetal demise?

Answer 9

placental or cord abnormalities due to maternal CV or hematologic conditions; maternal HTN, infection (another major cause), fetal anomalies, poor maternal health

Question 10

What is the treatment for intrauterine fetal demise?

Answer 10

• 20-24 wks: consider D&E

- after 24 wks, must do oxytocin and misoprostol to induce labor and delivery

Question 11

What are the causes of symmetric IUGR?

Answer 11

early pregnancy problems, usually due to chromosomal abnormalities, congenital infection, or maternal drug use

Question 12

What are the causes of asymmetric IUGR?

Answer 12

80% of IUGR. Due to decr abd size with preservation of head and extremities
caused by POOR MATERNAL HEALTH, multiple gestation, placental insufficiency

Question 13

What does physical exam show in IUGR?

Answer 13

fundal height at least 3 cm smaller than expected

Question 14

What are the ultrasound findings for IUGR?

Answer 14

abd circumference

Question 15

What ultrasound finding indicates oligohydramnios?

Answer 15

amniotic fluid index

Question 16

What is the signficance of timing for oligohydramnios?

Answer 16

first trimester: causes SAB most of the time
second trimester: fetal renal abnormalities or placental thrombosis, or due to maternal problems like preeclampsia, renal disease, HTN,
third trimester: PROM, preeclampsia, placental abruption

Question 17

What is the definition of polyhydramnios?

Answer 17

amniotic fluid index >25 cm or one pocket >8cm can be caused by swallowing defects or maternal diabetes, multiple gestation, fetal anemia

Question 18

What is the tx for polyhydramnios?

Answer 18

only given if a threat of preterm labor exists

32 wks get amnioreduction alone