Obstetric Complications of pregnancy Flashcards
(20 cards)
How do you treat ectopic pregnancy?
- Unruptured, early:
- Unruptured, advanced:
- Ruptured:
- Methotrexate (MTX)
- Salpingostomy
- Salpingectomy
What is the recommended management for a hemodynamically unstable patient with a suspected ectopic pregnancy?
Surgical exploration (laparoscopy)
Is anti-D immunoglobulin given to O- patients following management of an ectopic pregnancy?
Yes
What is the first-line treatment for intrahepatic cholestasis of pregnancy?
Ursodeoxycholic acid
What is the likely diagnosis in a pregnant patient that presents with intense generalized pruritus, especially at night, elevated liver enzymes, and elevated serum bile acids?
Intrahepatic cholestasis of pregnancy
What is the most sensitive and specific measure of intrahepatic cholestasis of pregnancy?
Elevated bile acid
Woman with lower abdominal pain, amenorrhea, vaginal bleeding and history of STI is suggestive of:
ectopic pregnancy
What is the likely diagnosis in a hemodynamically stable patient with vaginal spotting, tenderness in the LLQ, and a remote history of pelvic inflammatory disease?
Ectopic pregnancy
How is ectopic pregnancy diagnosed?
- Quantitative β-hCG
- Transvaginal ultrasound (TVUS)
RUQ pain, elevated LFTs, and hypoglycemia/thrombocytopenia in the third trimester is suggestive of :
Acute fatty liver of pregnancy (AFLP)
Acute fatty liver of pregnancy (AFLP) is managed with:
Immediate delivery
How to differentiate HELLP from Acute fatty liver of pregnancy (AFLP) ?
- AFLP: hypoglycemia, leukocytosis, severe hyperbilirubinemia are more common
- HELLP: hypertension and proteinuria are more common
Contraindications of methotrexate therapy in ectopic pregnancy:
β-hCG concentration > 5000 mIU/mL and mass size > 3.5 cm,
Post-term pregnancy (≥ 42 weeks) and oligohydramnios is managed with:
Induction/delivery
Indications of Immediate in late-term pregnancies:
- Pregnancies ≥ 41 weeks’ gestation with evidence of complications (e.g., oligohydramnios, placental insufficiency)
-All pregnancies by 42+6 weeks of gestation.
Next step in late-term pregnancies with oligohydramnios and evidence of fetal distress:
Emergency cesarean delivery
- An amniotic fluid index __ is consistent with oligohydramnios
- An amniotic fluid index __ is consistent with polyhydramnios
-≤ 5
- ≥24
When is fetal growth restriction symmetric vs. asymmetric?
- Infections / chromosomal abnormalities in the 1st trimester:
- Uteroplacental insufficiency / malnutrition in the 2nd / 3rd trimester:
- Symmetric
- Asymmetric
Asymmetric fetal growth restriction is fetal weight below 10th percentile and is most commonly caused by:
placental insufficiency
