Flashcards in OB Shelf Deck (361)
What are the screening recommendations for chlamydia?
1. All sexually active non-pregnant women aged 24 and younger, or >25 if high risk
2. All pregnant women aged 24 and younger, and >25 if high risk
What are the risk factors for chlamydial infection?
- Hx of chlamydial or other STIs
- New or multiple sex partners
- Inconsistent condom use
- Exchanging sex for money or drugs
What is Goodells sign?
Softening of the cervix during pregnancy
What is Hegars sign?
Softening of the uterus during pregnancy
What is Chadwicks sign?
bluish purple hue in the cervix and vaginal walls during pregnancy
- caused by hyperemia
How do you date pregnancies?
minus 3 months, plus 7 days!
so if LMP was Sept 25th, 9-3 = 6, June 25th, Add 7 days = July 2nd
Triad of interstitial cystitis??
1. Urinary urgency
2. Urinary frequency
3. Chronic pelvic pain
In interstitial cystitis, what exacerbates the pelvic pain?
1. Sexual intercourse
2. Filling of the bladder
4. Spicy foods
5. Certain beverages
Relieved via voiding of bladder
What does cystoscopy classically demonstrate in interstitial cystitis?
submucosal petechiae or ulcerations
What is the triad of pelvic inflammatory disease?
1. Pelvic pain
2. Cervical motion tenderness
What is the single most useful parameter for predicting fetal weight by ultrasonogram in suspected FGR?
What is fetal growth restriction? Describe the 2 types
2 types: symmetrical and asymmetrical
1. Symmetrical: insult to fetus <28wks gestation and growth of head and body is deficient
- usually the result of genetic anomalies or TORCH infections
2. Asymmetric: insult to fetus after 28wks, normal head size and reduced abdominal circumference
When is FGR suspected?
when fundal height is at least 3cm less than the actual gestation age in weeks
What measurement can be used to differentiate between symmetric and asymmetric FGR?
head to abdomen circumference
When are serum progesterone measurement taken to detect ovulation?
What are the symptoms of severe preeclampsia?
1. HTN (160/110)
2. Proteinuria (>5g on 24hr urine)
4. Pulmonary edema
6. Elevated liver enzymes
What is HELLP syndrome?
Elevated liver enzymes
What causes RUQ pain in preeclampsia?
hematoma formation and formation of thrombi in the portal capillary system can cause swelling of the liver with distention of he hepatic (Glissons) capsule
Pt with eclampsia is given what to prevent further seizures?
what screening test is performed in all pregnant women, regardless of risk factors?
What is the difference between mild and severe eclampsia?
Mild: HTN >140/90, proteinuria >0.3g/24hr after the 20th week gestation
Severe: HTN >160/110, proteinuria >5g/24hrs, oliguria, elevated liver enzymes, thrombocytopenia, and possibly Pulmonary edema
when is transient HTN seen in pregnancy?
second half of pregnancy or during labor and delivery
What is the tx for the HTN seen in preeclampsia and eclampsia?
Methyldopa: centrally acting alpha agonist
What is the ideal range of maternal fasting glucose?
What is the tx for gestational diabetes?
subcutaneous insulin (doesnt cross the palcenta)
What are the risks to the fetus associated with gestational diabetes?
2. Hypocalcemia (from PTH suppression)
4. Hyperviscosity due to polycythemia
5. Respiratory difficulties
What is the mechanism behind the polycythemia in infants of a diabetic mother?
- fetal hypoxia due to increased BMR incuded by hyperglycemia
- this causes increased EPO production by the fetus -> increased red blood cell mass and O2 capacity of the blood
What causes early decelerations?
Fetal head compression leading to a vagal response
What causes variable decelerations?
Umbilical cord compression