OB Test 2: Infection, Contraception & Infertility Flashcards Preview

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Flashcards in OB Test 2: Infection, Contraception & Infertility Deck (53)
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What are TORCH infections?

Toxoplasmosis
Other (hepititis)
Rubella
Cytomegalovirus
Herpes

1

What are toxoplasmosis, where can you get it and what does it cause?

Protazoa, not an STI but can cross the placenta
Found in cat feces and raw meat
Cn cause fetal damage, heart defects, stillborns and abortions

2

What can rubella cause and why don't we give it to post partum mothers

Still born, heart ducts, congenital cataracts
It is a viral vaccine so it can cross the placenta so teach mothers to not get pregnant within 6 months of the vaccine

3

What does cytomegalovirus cause and how can you prevent it?

CMV crosses the placenta and causes disability, hearing loss, hepatosplendmegaly, jaundice

Prevention through really good hand washing

4

How is herpes spread, what does it mean for birth and how can a newborn get it?

Virus from active lesions
Must have a C section
Can get it from amniotic fluid or vaginal birth

5

What is the transmission of HIV/AIDS?

Across the placenta, breastmilk and during labor or birth.

Avoid vaginal births, scalp electrodes and forceps

6

What are the transmission rates of HIV/AIDS.

20% of infants with c-section
1-2% with meds

7

HIV/AIDS maternal antibodies?

Antiviral drugs during pregnancy, don't breastfeed

8

What is contraception? What is the difference between birth control and family planning?

The intentional prevention of pregnancy during sexual intercourse
Birth control are methods and devices that prevent conception
Family planning is deciding when to conceive

9

Why are pharmacological contraception methods?

Hope
Coitus interruptus: abstinence only good if practiced

10

Wha are the types of fertility awareness?

Rhythm method: relying on avoiding intercourse during fertility cycle. Not too reliable

Symptoms-based methods
- basal body temperature: ovation temperature
- cervical mucous: changes at ovulation to thin slippery and clear
- sympto-thermal: combining signs of temp and mucous

11

What are barriers to conception?

Spermicide
-foams, cream, film
-nonoxynol-9 interefere with sperm movement
- increased HIV transmission
- timing: important, has to be placed up by cervix before sex
- failure rate: 29%

Condoms
- failure rate: 5%
- barrier against STI

Diaphragm
- barrier of rubber, cap filled with spermicide anchored by cervix, fitted by physican
- failure rate 16%
- kept in 6 hours after

Cervical caps
- sized and filled with spermicide
- left in 6 hours after.
- failure rate 32%

12

What is the correct condom use?

- pinch top to get air out so semen won't break condom
- petrollium jelly breaks down the latex

13

What is toxic shock syndrome?

Comes when keep barriers in
Dont use during me station
Only keep things in for 6 hours

14

What is the action of combined estrogen-progestin contraceptives?

GNRH not released so interrupts menstration cycle and interferes with endometrium development

15

What are the side effects of combined estrogen-progestin contraceptives?

Thromboembolism, heart attack, hypertension, if smoker less then 35, stroke

16

What are the products and failure rates of combined estrogen-progestin contraceptives and what does it interfere with

Oral
Transdermal: every day for 3 weeks then out for 1 week
Vagina, ring: removed on fourth week

Failure rate of 8%

Interferes with lactation

17

What is the action of progesterone only contraception?

Inhibits ovulation and thickens cervical mucous

18

Why is the side effect of progestin-only contraception?

Irregular vaginal bleeding
No menses
Weight gain
Decreased libido
Headaches
Decreased bone density

19

What are the products and failure rate of progstin-only contraception? Does it interfere with lactation?

Oral mini pill: 10% fail rate
Injectable Devo-Provera: one every 3 months, failure rate 3%
Implantable-implanon: thin rod under skin and releases every 3 years

Don't interfere with lactation

20

What is emergency contraception action and products?


Used within 120 hours of unprotected sex
Action: alters sperm motility and endometrium. Inhibits egg release if prior to ovulation
Products:
-"plan B" is high dose progestin only
- high doses of combined oral contraceptives

21

Intrauterine device products, years of protection. And insertion?

Flare rate <1%
Products:
-paragard: copper T acts as spermicide for 10 year protection
-mirena: progestin, 5 year protection

22

What are the types of sterilization?

Tubal ligation
Vasectomy
Reversal: reanastomosis

23

What is tubal ligation?

Clamp, cotorize, cut out a piece or apply bands
Goal is to occlude tubes, done easily in c-section or laporodomy
Fill abdomen with gas and after may have shoulder pain so give analgesic

24

What is a vasectomy?

Out patient procedure with local anesthetic
Have to do sperm count twice
Sperm absorbed in the body
Failure rate is 0.15%

25

How do you reverse sterilization?

Stitch tubes back together
Increase risk of ectopic pregnancy

26

What is infertility? Primary and secondary?

The inability to conceive after 1 year of unprotected sexual intercourse

Primary: never been pregnant
Secondary: pregnant once and not again, can't carry fetus to term

27

What are the psychosocial effects of infertility?

Major life stressor
Attitude of health care provider
Religious considerations
Cultural considerations

28

What are requirements for pregnancy?

Ovulation
Sexual intercourse
Sperm placed near cervix
Viable oocyte and sperm
Prepared endometrium

Average sex from 2-3 times a week

29

What are associated factors to pregnancy?

Abnormal reproductive system development
Abnormal hormonal control
Blockage: scarring

30

How do you assess ovulation and a hormone analysis?

Assessment of ovulation: basal body temperature, cervical mucous change
Hormone analysis: endometrial biopsy

31

How do you do tubal patency assessment?

Hysterosalpingograohy
Laparoscopy

32

What is hysterosalpingography?

Inject opaque dye to see if tubes are open
Is there a problem with sperm getting to the egg
May cause referred shoulder pain

33

What is laparoscopy?

Abdomen inflated with CO2
Post-procedural pain
Can see endometriosis

34

What are female factors to fertility?

Congenital abnormalities
-DES exposure
- bicornuate uterus

Ovarian
- hormonal balance: amennorreic, dysmenorrhea indicated ovulation

35

Medication for infertility?

Ovulation stimulants
-Clomid: increase FSH and LH
-repronex: pro lactation secretion
- parlodel: interferes with prolactin.

Hormone replacement therapy
- GnRH and Progrsterone

Antibiotics

36

What are tubal factors?

Inflammation and infection: biggest cause blockage in Fallopian tubes
Endometriosis
Treatment: Prevention, electrocotory
Prevention

37

What are uterine factors?

Congenital defects
Adhesions and scarring
Tumors, fibrosis, polyps
Assessment
Treatment

Scar prevents implantation

38

Vaginal & cervical factors?

Ph < 4 in vagina
Ph > 7 at cervix
Cervical competence fall open
Isoimmunization: immunized to self

Trichinosis increases acidity
Stress, antibiotics and diabete changes bodies pH

39

What is treatment?

Prevention
Good hygiene: maintain vaginal and cervical pH
Treat chronic cervicitis: freeze abnormal tissue, burn it away
Artificial insemination
Desensitization

40

What is male infertility?

Sperm must be normal, motile, adequate in number and placed near cervix

41

What is male infertility congenital defects?

Hypospadius: surgical correction

42

What is male infertility and substance use?

Alter morphology and amount of sperm

43

What is male infertility related to blockage?

Infections

44

What are male infertility hormones?

Hypothalamus
Pituitary
Testicular
Adrenal

45

With male infertility how do you do semun analysis?

2-3 times
2-5 mL of ejaculate, 50% active

46

Wha is the post coital test

After intercourse women vaginal contents are examined to see if tbe are penetrated

47

What is the treatment of male infertility?

Prevvention and treatment of STI
surgical repair and lifestyle changes

48

What are the reproductive alternatives?

IVF
GIFT
Micro manipulation
Therapeutic insemination
Surrogates
Adoption

49

What is IVF?

In vitriol fertilization
- ovulation is stimulated
- graafian follicle are aspirated and placed in tissue culture and mised with sperm
- progesterone injections to prepare endometrium
- blastocyst transferred to uterus to implant

50

What is GIFT?

Gamete intrafallopian tube transfer

Ovum and sperm placed in Fallopian tube to combine. Not outside body

51

What is micromanipulation?

Intra cytoplasmic soerm injection
ICSI

52

What is therapeutic insemination?

Husband or donor inseminated woman