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Flashcards in OB Uworld Deck (67):
1

causes of asymmetric fetal growth restrictions

vascular disease like HTN and preeclampsia and DM
antiphospholipids Ab
autoimmune
cyanotic cardiac disease
substance abuse

2

causes of symmetric fetal growth restrictions

genetic
congenital heart disease
intrauterine infections: malaria CMV, rubella, toxo, varicella)

3

causes of variable heart decelerations

cord compression
oligohydramnios
cord prolapse

4

Tx variable decelerations

maternal repositioning to left lateral then if fail to improve do amnioinfusion

5

PPROM and fetus has bilateral renal agenesis
next step

allow spontaneous vaginal delivery because baby wont survive anyway

6

when to do C section no matter what

prior classic cesarean (vertical)
myomectomies

7

postpartum endometritis

fever greater than 100.4 outside first 24 hours postpartum

8

risk factors postpartum endometritis

prolonged rupture of membranes
prolonged labor >12 hours
C section
use of intrauterine pressure catheters or fetal scalp electrodes

9

signs Sx of endometritis postpratum

fever, uterine tenderness foul smelling lochia and leukocytosis

10

pathogens in postpartum enodmetritis

polymicrobial

11

Antibiotics for postpartum endometritis

clinda and genta IV

12

low grade fever and leukocytosis in first 24 hours postpartum

normal

13

management of missed spontaneous abortion

D and C

14

indication for induction labor for fetal demise

when coagulation studies are low normal range
impending DIC

15

chorioamninitis

prolonged rupture of membranes
>18 hours

16

Dx chorioamnionitis

maternal fever and 1+:
-uterine tenderness
-maternal or fetal tachy
-malodorous amniotic fluid
-purulent vaginal discharge

17

risk factor for chorioamnionitis

prolonged rupture of membranes

18

management chorioamnionitis

broad spec antibiotics and delivery

19

Dx intrauterine fetal demise

US

20

patient has confirmed intrauterine fetal demise and passes baby. next step to address?

autopsy to determine cause and if can prevent for future pregnancies

21

when is serial bhCG monitoring required post delivery

for molar pregnancies

22

what can you give patient if want to pass their spontaneous abortion at home

misoprostol

23

when to give anti D Ig or rhogam

28-32 weeks in Rh negative patient
within 72 hours of delivery
ectopic
molar
CSV or amniocentesis
abdominal trauma
2nd and 3rd trimester bleeding
external cephalic version

24

management for preterm labor

tocolytics, NSAIDs
corticosteroids and MgSO4 for neuroprotection

25

risk for fetus if mom has Hx of anorexia nervosa

higher risk for baby small for gestational age

26

common findings in anorexic patients

osteoporosis
elevated cholesterol and carotene
cardiac arrythmias like long QT
euthyroid sick syndrome
HPA dysfunction
hyponatremia from drinking excess water

27

very high AFP is associated with what

open NT defects
ventral wall defects
multiple gestation

28

placenta previa with bleeding at 37 weeks
hemodynamically stable

C section

29

greatest risk placental abruption

DIC

30

risk factors for placental abruption

tobacco use and preeclampsia

31

tonic clonic seziure in pregnancy and now has arm adducted and internally rotated
normal DTR and strength

posterior shoulder dislocation

32

contraindications to external cephalic version

indications for c sextion
placental abnormalities
oligohydramnios
ruptured membranes
hyperextended fetal head
fetal or uterine anomaly
multiple gestation

33

what vaccines can be given during pregnancy

Tdap and inactivated influenza

34

avoid conception for how long after live attentuated vaccines

4 weeks

35

severe features preeclampsia

proteinuria or end organ damage
BP >160 ?110 on 2 occasions more than 4 hours apart
thrombocytopenia
Cr >1.1
inc LFTs
Pulmonary edema
new onset visual or cerebral Sx

36

Tx preeclampsia

delivery if term
MgSO4 and hydralazine or labetolol or nifedipine PO

37

most comon cause postpartum hemorrhage

uterine atony

38

Tx uterine atony

bimanual uterine massage
IV fluids, oxygen
Uterotonic medications (oxytocin, methylergonovine, carboprost, misoprostol)

39

risk factors uterine rupture

prior uterine surgery
induction labor or prolonged
congenital uterine anomalies
fetal macrosomia

40

presentation uterine rupture

vaginal bleeding
intra abdominal bleeding (hypotension)
fetal deceleartions
loss of fetal station
loss of intrauterine pressure

41

suspect ectopic, and transabominal US shows no implant in uterus
next step

transvaginal US

42

when do majority breech presentation self correct by

37 weeks

43

risk factors placental abruption

cocaine and HTN

44

is there pain with problems with vasa previa

no

45

management threatened abortion

reassurance and US one week later
bed rest and no sex

46

lumpke palsy presentation

extended wrist
hyperextened MCP join with flexed ICP joints
absent grasp reflex

can also get ptosis and miosis
injury to C8 and T1

47

erb duchenne

decreased moro and biceps reflexes
waiters tip
intact grasp

48

risk for chorioamnionitis

protracted labor and prolonged membrane rupture

49

pain RUQ with HELPP

distention liver capsule

50

hard to breath with preeclampsia is from what

pulmonary edema from increased pulmonary capillary pressure from increased afterlod from generalized arterial vasoaspasms

51

screen all women at first visit for what

syphilis Hep B and HIV

52

when to screen for Hep C in pregnant women

HIV patients and those at high risk

53

risk for uterine inversion

nulliparity, fetal macrosomia
placenta acreta and rapid labor and delivery

54

management uterine inversion

aggressive fluid replacement
manual replacement uterus
placental removala nd uterotonic durgs after replacement

55

greates risk for pregnancy in someone with primary HTN

preterm labor

56

US of placental abruption can show what

retroperitoneal hemorrhage

57

first step placental abruption

aggressive fluid resuscitation with crystalloids and put in L lateral decubitus

58

old patient with vulvar atrophy and urinary Sx
cause of urinary problems

estrogen deficiency

59

if patient quad screen shows low AFP and estriol with high bhCG and inhibin A
at 18 weeks
next step

US to look for endocardial cushion defects, duodenal atresia, cystic hygroma

60

PPROM with unknown GBS status

give penicillin

61

Tx septic abortion

suction curretage

62

preterm labor and many late declerations
next step

C section

63

problem with dribbling urinary Sx post partum

urinary retention because of epidural

64

risk uterine rupture

previous C section
scar!!

65

loss of fetal station, fetus retracts

uterine rupture

66

contraindication to breastfeeding

active substance abuse
unTx active TB
maternal HIB
herpetic lesions
varicella infection

67

lab findings in hyperemesis gravidarum

severe persistent vomiting
fluid and electrolyte abnormalities
ketones!!! in urine
>5% body weight loss