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8 OB Flashcards

1
Q
A
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2
Q

at what rate does the b-HCG rise during the first 4 weeks of normal pregnancy?

A

doubles evry 48 hrs

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3
Q

What do the “triple” and “quad” screens include?

When should they be performed?

A
  1. maternal serum alpha fetoprotein (MSAFP)
  2. beta-HCG
  3. estriol

quad 4. inhibin A

15-18 weeks gestation

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4
Q

Combines with an increased MSAFP what does this indicate?

A

neural tube defect

(compression of the cerebellum in posterior fossa)

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5
Q

What does the first screening include?

When is it performed

A

Combined Test:

  1. HCG
  2. PAPP-A
  3. nucal translucency

9-13 wks

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6
Q

When can the cell -free DNA testing be performed?

A

7 wks

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7
Q

What does the Quad test for a trysomy 21 look like?

A

MSAFP ↓

bHCG ​↑

estriol ↑

inhibin A ↓

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8
Q

What does the Quad test for a trysomy 18 look like?

A

MSAFP ↓

bHCG ↓

estriol ↓

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9
Q

Normal Biophysical Profile (BPP)

A

*in 30 minutes

  1. NST ≥ 2 accelarations (15bmp)
  2. Fetal Breathing ≥ 1 lasting 30 seconds
  3. Fetal Movements > 3
  4. Fetal Muscle Tone ≥ 1 episode of flex/ext

5 Amniotic Fluid Index ≥ 2 cm max vertical pocket

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10
Q

birth steps

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. external rotation
  7. expulsion
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11
Q

most common implantation site for ectopic pregnancies?

A

ampulla

(90% in fallopian tube, 70-80% ampulla)

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12
Q

Qualifiers for treatment of ectopic pregnancy with metotrexate?

A
  1. sable
  2. available for follow up
  3. bHCG <5000
  4. no fetal heart rate
  5. lab tests normal
  • CBC
  • blood type/screen
  • liver function
  • kidney function
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13
Q

Contraindications for treatment for ectopic pregnancy with metotrexate?

A
  • does not neet criteria
  • inmunodeficiency
  • concurrent viable pregnancy
  • ruptured ectopic pregnancy
  • breats feeding
  • hypersensitivity to metrotraxate

relative:

  • >3.5 mass
  • fetal heart rate
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14
Q

When should preterm labor occur?

A

MATERNAL

  1. severe HTN
  2. cardiac disease
  3. hemorrage

PREGNANCY

  1. cervical dilation >4 cm
  2. premature membrane rupture >34 wks
  3. chorioamnionitis

FETAL

  1. death
  2. distress
  3. IUGR with reverse diasistolic flow
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15
Q

What should I give a patient with:

  • >37 wks gestation
  • unknown GBS
  • PROM >18 hrs
A

prophylactic penicilin!

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16
Q

up to what weeks can I administer corticosteroids to a patient with preterm labor?

A

up to 34 wks

GA: 24-36.6

weight 600-<2500

17
Q

up to what weeks can I administer corticosteroids to a patient with PPROM?

18
Q

what is the first thing I should think about when I have a patient with third semester bleeding?

A

placenta previa

19
Q

what exam is contraindicated in a patient with suspected placenta previa?

A

digital exam!!!

do not introduce anything in the vagina -> no transvaginal US

20
Q

what are some of the risk factors of placental abruption?

A

HTN

cocaine use

smoking

trauma

previous abruption

21
Q

what is the treatment for uterine rupture?

A

immediate laparotomy with delivery of the fetus

22
Q

In what scenarios is the RhoGAM given (to unsensitized patients)?

A
  1. abortion
  2. delivery
  3. vaginal bleeding
  4. placental abruption
  5. amniocentesis
23
Q

what is the antidote of magnesium sulfate?

A

calcium gluconate

24
Q

symmetric IUGR

A

brain in proportion to body

before 20 wks

intrinsic factor

25
asymmetric IUGR
brain weight is NOT decreased abdomen smaller than the head after 20 wks extrinsic factors
26
empiric treatment for asymptomatic bacteriuria
1. nitrofurantoin 2. amoxicillin 3. cephalexin
27
when should women be tested for asymptomatic bacteriuria?
12-16 wks
28
what is the treatment sequence for hyperemesis gravidarum
1. dietary modification + avoidance of triggers + non-pharmachological (acupuncture, giner, vitamin B6) 2. diphenydramine 3. metoclopramide 4. ondansetron
29
antibiotics that should be avoided during pregnancy
* TMP-SMX (1st trim) * aminoglucosydes * tetracyclines * fluoroquinolones
30
drugs that can be used to treat hypertension (chronic and gestational) during pregnancy?
metildopa labetalol nifedipine
31
what is the only definitive treatment of preeclampsia?
delivery!
32
thyroid disease in pregnancy: what crosses the placenta?
TRH inmunoglobulins against TSH receptor
33
thyroid disease in pregnancy: what does not cross the palcenta?
TSH T4
34
type of deceleration? what does it indicate?
early decelerations head compression
35
type of deceleration? what does it indicate?
variable decelerations umbilical cord compression
36
type of deceleration? what does it indicate?
late decelerations fetal hypoxia **DELIVER!**
37
Duration of the stages of labor: Stage 1
primigravid: 6-18 multipara: 2-10
38
Duration of the stages of labor: latent phase / active phase
latent phase: - primigravid: 6-7 - multipara: 4-5 active phase: - primigravid: \>1.2 cm/hr - mulitpara: \>1.5 cm/hr
39
what is the treatment for septic abortion
D&C + IV ATB Clindamycin + gentamycin Cefoxitin + doxicycline

IFOM (11 decks)

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