OB prologue Flashcards
(21 cards)
Sonographic feature with strongest association for placenta accreta
placenta previa
PAS definitions
Accreta-attaching to myometrium
Increta-trophoblastic invasion into the myometrium, percreta-invasion through serosa and potentially surrounding organs
Mechanism of PAS
failure of normal decidualization usually due to uterine scarring
MC RF of PAS?
c/s
risk of PAS w/ placenta previa and 2nd C/S? 3rd C/S? 4th C/S? 5th C/S?
2nd c/s=11%
3rd c/s=40%
4th c/s=61%
5th c/s=67%
gold standard for dx of PAS?
ultrasound not MRI
US findings of PAS?
persistent previa, lacunae in placenta, loss of normal hypoechoic zone between placenta and myometrium, thinned retroplacental myometrium (<1mm), abnml uterovesical interface, placental bulging, exophytic extension, abnormalities of doppler flow
management of PAS?
bmz tertiary care team, delivery at 34 to 35+6wks
pregnancy RF of obesity?
c/s, endometritis, wound complications, VTE
RF for VTE
class 3 obesity=BMI >40, immobilization, preE, FGR, infxn, emergency birth
percentage of breech fetuses at term?
2-3%
recommended daily intake of vit d in pregnancy?
600 units
<34wk operative?
forceps only
% of breech babies at term
2-3%
annual rate of preterm birth in US
10.2%
incidence of twins in US?
32/1,000
for adequate CST you need
at least 3 ctx in 10min and ctx need to last 40s or more
what anomaly is associated w/ lithium exposure
ebstein anomaly=abnml tricuspid valve
SE of isotretinoin in utero
congenital pinna anomalies, micrognathia, heart defects, brain malformation
risk of uterine rupture after 1 c/s?
0.5%
the safest route of deliver for pt with hx of c/s x1 when compared w/ a planned elective repeat C/S is a TOLAC but the route of deliver w/ the highest morbidity is a repeat c/s after a failed TOLAC
