ObGyn Flashcards
(36 cards)
what are the ONLY 2 reasons to perform emergency Csection?
- Fetal tachycardia
2. unstable hemodynamics in mom
normal wt loss rule in new borns (what percent is lost & when is it gained back)
within first 7 days <7% of weight is lost
over next 2 weeks weight is gained back
how does monochorionic diamnionic monozygotic pregnancy lead to twin-to-twin transfusion syndrome?
2 diff amniotic sacs, but SAME placenta (chorion)
donor twin develops anemia, oliguria, and complications of oligohydramnios (e.g., craniofacial abnormalities and clubfoot due to intrauterine growth restriction). The recipient twin develops polycythemia.
at what week can you see intrauterine pregnancy?
5 weeks
at what bHCG can you see intrauterine pregnancy?
> 1500 mIU/mL. So do NOT attempt transvaginal US until bHCG is elevated to 1500
What is the appropriate rate in rise of bHCG in early pregnancy?
doubling of β-hCG approx. every 2.5 days within the first 4 weeks
how does obstructed labor/prolonged labor lead to a vesicovaginal fistula?
when labor is obstructed, the fetus head compresses the vaginal canal> pressure necrosis of the vaginal wall and bladder> vesicovaginal fistula
Cervical insufficiency criteria:
- PMHx
- cervix response to intraabdominal pressure
- cervical length
pt has cervical insufficiency IF:
1) previous preterm birth!!!
2) cervix dilates to 1cm w/ pressure
3) cervix is < 25cm
at what weeks can pt receive cerclage for cervical insufficiency?
only when <24 weeks
what are the contraindications to cerclage placement?
what is the other tx option in these cases?
contraindications:
- no Hx of preterm birth
- active preterm labor, chorio, premature rupture of membranes, high risk of miscarriage
vaginal progesterone supplementation can be considered if there are contraindications to cerclage
at what week do you face the fact that the breeched baby is not going to spontaneously flip into a normal position?
what do you offer mom to prevent birth complications ( fetal asphyxia and delivery-related injury)?
week 37 = baby can no longer flippity flip in belly
external cephalic version at 37 weeks
what benign, bilateral ovarian tumor forms during Pregnancy and causes hyper-andgrogenism (hirsutism, deep voice, facial acne, clitoromegaly)
Leutomas
what are 2 emergency complications of Luteomas?
1) ureter obstruction
2) ovarian torsion!
pregnancy causes what nerve complication
carpal tunnel syndrome
- physiological fluid retention, which leads to edema of soft tissue in and around the carpal tunnel.
preterm
term
post term
late term
preterm = <37 weeks (<28 weeks is extremely preterm & may not be viable) TERM = 39 weeks late = 40-41 weeks post = 42 weeks
post term babies are at high risk for what complication?
meconium aspiration syndrome (an OLD placenta cant clear meconium as well as a term placenta can)
what causes caudal regression syndrome? (aka lower/caudal deformities)
maternal diabetes
at what gestational week can you no longer perform an abortion?
13 weeks!
is parental consent required when treating a minor (<18yo) sexually transmitted infections or substance abuse, access to birth control, or prenatal care?
NO.
when is the only time you need parental consent to treat a minor?
when someone <18yo is requesting an abortion for a pregnancy that was NOT brought on by incest/rape
what type of PPH does magnesium sulfate cause?
Atony.
magnesium sulfate stops cerebral palsy BUT it is also a TOCOLYTIC> stops uterus from contraction> atony
what are the complications of PID?
infertility
peritonitis (Fitz-Hugh-Curtis syndrome/perihepatitis or peri-appendicitis)
tubo-ovarian abscess !!
management of chorioamnionitis depends on the form of delivery;
what is the management for vaginal vs cesarean delivery?
Vaginal delivery: IV ampicillin plus gentamicin
Cesarean delivery: IV ampicillin and gentamicin, PLUS clindamycin (anaerobe coverage to minimize postcesarean complications, e.g., endometritis)
what is the range of a normal amniotic fluid index?
between 5-25 is normal
<5 = oligo
>25 = poly
