7 Obstetric Complications Flashcards
(49 cards)
Criteria for CERCLAGE
Cervical length > 25mm by vaginal sonography
Prior to 24wks
Prior preterm birth (<34w)
Mcdonald vs Shirodkar
Removable suture vs submucosal placement
MDC allows vaginal delivery
Multiple ovulation with 2 zygotes
Always dichorionic, diamnionic
Dizygotic twins
Arise from 1 zygote cleaved during the morula stage
Lowest risk of all MZ twins
Mono-Di-Di
MZ separated during the embryonic stage (9-12th day)
Highest risk of all MZ twins
Mono-Mono-Mono
MZ twins cleaved during the blastocyst stage (4-8th days)
Mono-Mono-Di
MZ twins cleaved 12th day onwards
Conjoined Twins
Fetal risk is present (alloimmunization)
1) AAb are detcted in the mother’s circulation
2) Ab are assoc w HDN
3) AAb titer >1:8
4) FOB is RBC antigen (+)
Amniotic fluid bilirubin Liley zone III or PUBS fetal Hct =25% or MCA flow is ⬆️⬆️
Severe Fetal Anemia
<34w IU IV transfusion
>/=34w delivery
RhoGAM
routine: Rh D negative at 28w and w/in 72hrs CVs, amniocentesis or D&C
Within 72h of delivery to an RhD positive infant
Qualitative vs Quantitative test in alloimmunization
Rosette Test
Kleihauer-Betke Test
Pregnancy 20-36w
>/= 3 UC in 30mins
Dilated <2cm and no change
Preterm Contractions
Preterm Delivery Prophylaxis (singleton pregnancy)
Cervial length >/= 25mm, w prior PTB - IM 17-OH-P
Cervical length <25mm, w prior PTB - IM + cervical cerclage
<20mm, no prior PTB - daily vaginal progesterone before 24wks
Its positive result raises the likelihood of PTB to 50%
Fetal fibronectin
Reduce the severity and risk of cerebral palsy among surviving very preterm neonates (<32w)
It takes 4h to achieve steady sate in the fetus
Maternal IV MgSO4
Preterm labor tocolysis, hypokalemia, hyperglycemia
B-adrenergics (Terbutaline)
PT labor tocolysis
Hypotension
Myocardial depression
Calcium Channel Blockers
PT labor tocolysis
Oligohydramnios
PDA closure in utero
Pg synthase inhibitors
INDOMETHACIN
Antidote to MgSO4
Calcium Gluconate
Ruptured Membranes
Pooling positive (posterior vaginal fornix)
Nitrazine (+) = Blue
Fern (+)
Maternal fever, uterine tenderness in the presence of confirmed PROM in the absence of URI or UTI
Chorioamnionitis
Favorable cervix is
Cervix is dilated, effaced, soft and anterior to mid position
Bishop score is >/= 8
Mngt for dates sure, favorable cervix
Labor induction
Mngt for dates sure, unfavorable cervix
Cervical ripening
Oxytocin induction
Or NST, AFIs twice weekly
