Flashcards in Obstetrics Deck (109)
Why do pregnant women get anemia?
Dilutional effect, RBC rises 30% but volume rises 50%
What are the degrees of vaginal lacerations?
1st degree: Skin
2nd degree: Muscle
3rd degree: anus
4th degree: Rectum
What is Vernix?
Cheesy baby skin
What is Meconium?
Green baby poop
What is Lochia?
What is normal blood loss during a vaginal delivery?
What is normal blood loss during a C- section?
How do you treat A1 Gestational DM?
How do you treat A2 Gestational DM?
What are identical twins?
Egg split into perfect halves "monochorionic"
What are fraternal twins?
Multiple eggs fertilized by different sperm
What is ovarian hyperstimulation syndrome?
Weight gain and enlarged ovaries after clomiphene use
Who makes the trophoblast?
Who makes the cytrophoblast?
Mom=> GnRH, CRH, TRH, Inhibin
Who makes the Syncitotrophoblast?
Mom and baby => HCG, HPL
When does implantation occur?
1 week after fertilization
When is B-HCG found in urine?
2 weeks after fertilization
What is the function of Estrogen?
Muscle relaxant, constipation , ^protein production, irritability, varicose veins
What is the function of Progesterone?
^ appetite, ^acne, dilutional anemia, quiescent uterus, pica, hypo TN, melasma
What makes progesterone <10wk old?
What makes progesterone > 10 wk old?
What is the function of B-HCG?
Maintains corpus luteum, sensitizes TSHr => act hyperthyroid (to ^BMR)
What makes B -HCG?
How fast should B-HCG rise?
Doubles every 2 days until 10 wks (when placenta is fully formed)
What is the function of AFP?
Regulates fetal intravascular volume
What is the function of HPL?
Blocks insulin receptors => sugar stays high (baby's stocking up on stuff needed for the journey)
What is the function of inhibin?
Inhibits FSH=> no menstruation
What is the function of. Oxytocin?
Milk ejection, baby ejection
What is the function of Cortisol in pregnancy?
Decreases immune rejection of baby, lung maturation
What are the thyroid hormone levels during pregnancy?
^TBG => ^bound t4, normal free t4 levels
When can you first detect fetal heartones?
When can you tell the sex of a fetus by US?
What does an AFI <5 indicate?
Oligohydramnios (cord compression)
What does an AFI >20 indicate?
How fast should fundal height change?
Uterus grows 1cm/wk
What is the pool test?
Fluid in vagina
What is Ferning?
Estrogen crystallizes on slide
What is nitrazine?
Shows presence of amniotic fluid
What is the risk of chorionic villus sampling?
Fetal limb defects
What is the risk of amniocentesis?
Abortion (2% risk)
What is a normal biophysical profile?
What is a biophysical profile?
"Test the Baby, MAN"
Tones of the heart
Movement: BPD, HC, AC, FL
Non-stress test (normal = "reactive")
What pelvis types are better for vaginal delivery?
Wht pelvis type will need C/S?
How do you predict a due date with Nägele's Rule?
9 months from last menses -> add 1 wk
Why is Nägele's rule inaccurate?
B/c it does not start from ovulation date
How do you correct Nägele's Rule for cycles >28 days?
Add x days if cycle is x longer
How much weight should a pregnant woman again?
When should intercourse be avoided during pregnancy?
3rd trimester b/c PG-F in semen may cause uterine contractions
What are the Leopold maneuvers?
1) Feel fundus
2) Feel baby's back
3) Feel pelvic inlet
4) Feel baby's head
What is Stage I of labor?
Up to full dilation
1) Latent Phase ( 4cm cervical dilation
2) Active Phase (<12h): 4-10 cm cervical dilation (1cm/hr)
What is Stage II of labor?
Full dilation -> delivery
Station 0: baby above pelvic rim (most uteri are anteverted)
3. Flex head
4. Internal rotation
5. Extend head
6. Externally rotte
7. Expulsion: LDA most common presentation
What is Stage III of labor?
Delivery of placenta (due to PG-F)
Blood gush-> cord lengthens -> fundus firms
How do you monitor baby's HR?
Doppler, scalp electrode
How do you monitor uterus?
Tocodynamics, uterine pressure catheter.
What Bishop's score predicts delivery will be soon?
What are braxton-hicks contractions?
Irregular contractions w/closed cervix
What is a Vertex presentation?
Posterior fontanel (triangle shape) presents firts, normal
What is a sinciput presentation?
Anterior fontanel (diamond shape) presents first
What is a face presentation?
Mentum anterior -> forceps delivery
What is compound presentation?
Arm or hand on head -> vaginal delivery
What is a complete breech?
Butt down, thighs and legs flexed
What is a Frank breech?
Butt down, thigh flexed, legs extended (~pancake)
What is a footling breech?
Butt down, thigh flexed, one toe is sticking out of cervical os
What is a Double Footling breech?
Two feet sticking out of cervical os
What is a Double footling breech?
Two feet sticking out of cervical os
What is a transverse lie?
Head is on one side, butt on the other
What is a Shoulder dystocia?
Head out, shoulder stuck
Can you try vaginal delivery on a woman who has had a Classic horizontal C/Spreviously?
No, must have C/S for all future pregnancies
Can you try vaginal delivery on a woman who has had a low transverse C/S previously?
What is early deceleration?
Normal, due to head compression
What is late deceleration?
Uteroplacental insufficiency b/c placenta can't provide O2 /nutrients
What is a variable deceleration?
What is increased beat-to-beat variability?
What is decreased beat-to-beat variability?
What is Pre-eclampsia?
What is HELLP syndrome?
Hepatic injury causing:
Elevated Liver enzymes
What is Eclampsia?
HTN + seizures
What are the symptoms of eclampsia?
H/A, changes in vision , epigastric pain
What is the treatment for eclampsia?
4mg Mg sulfate as seizure prophylaxis
What is a chorioamnionitis?
Fever, uterine tenderness, lower fetal HR
What are the symptoms of amniotic fluid emboli?
Mom just delivered baby and has SOB -> PE, death (amniotic fluid-> lungs)
What is endometritis?
Post partum uterine tenderness
What is an incomplete molar pregnancy?
2 sperm + 1 egg (69, XXY) has embryo parts
What is a complete molar pregnancy?
2 sperm + no egg (46, XX-both paternal) , no embryo
What is Pseudocyesis?
Fake pregnancy w/ al the signs and symptoms
What is the most common cause of 1st trimester maternal death?
Whatis the most common cause of 1st trimester espontaneous abortions?
Whatis the most common cause of 3rd trimester espontaneous abortions?
Anti-cardiolipin Ab, placenta problems, infection, incompetent cervix
What is threatened abortion?
Cervix closed, baby intact (Tx bed rest)
What is an inevitable abortion?
Cervix open, baby intact (Tx cerclage = sew cervix shut until term)
What is an incomplete abortion?
Cervix open, fetal remnants (Tx: D&C to prevent placenta infection)
What is a missed abortion?
Cervix closed, no fetal remnants (Tx: D&C)
What is a complete abortion?
Cervix open, no fetal remnants (test B-HCG)
What is a septic abortion?
Fever >100 degress F, malodorous discharge
What is Placenta Previa?
Post-coital bleeding, placenta covers cervical os; ruptures placenta arteries
What is vasa previa?
Placenta aa. Hang out of cervix
What is Placenta Accreta?
Placenta attached to superficial lining
What is placenta increta?
Placenta invades into myometrium
What is Placenta percreta?
Placenta perforates through myometrium
What is Placenta abruptio?
Severe pain, premature separation of placenta
What is velamentous cord insertion?
Fetal vessels insert between chorion and amnion
What is a uterus rupture?
Tearing sensation, halt of delivery
What is an Apt test?
Detects HbF in vagina
What is Wrights stain?
Detects nucleated fetal RBC in Mom's vagina
What is Kleihauer-Betke test?
Detects pecentage of fetal blood in maternal circulation (dilution test)
What is maternity blues?
Post-partum crying, irritability
What is post partum depression?
Depression > 2 weeks