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Flashcards in Obstetrics Deck (166)
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1

primary cause third trimester bleeding

Placental abruption and placenta previa

2

Classic US and gross appearance of complete hydatidiform mole

Snowstorm on US
Cluster of grapes on gross exam

3

Chromosomal pattern of complete mole

46 XX

4

Molar pregnancy containing fetal tissue

Partial mole

5

Sx of placental abruption

Continuous painful bleeding

6

Sx of placenta previa

Self limited, painless vaginal bleeding

7

When should a vaginal exam be performed with suspected placenta pre via?

Never

8

Abx with teratogenic effect

Tetracycline
Fluoroquinolones
Aminglycosides
Sulfonamides

9

Most common cause of postpartum hemorrhage

Uterine atony

10

Tx postpartum hemorrhage

Uterine massage
If that fails - oxytocin

11

Abx prophy for GBS

IV penicillin or ampicillin

12

Meds to accelerate fetal lung maturity

Bethamethasone or dexamethasone x 48 hrs

13

Pt fails to lactate after an emergency C section with marked blood loss

Sheehan syndrome (postpartum pituitary necrosis)

14

Uterine bleeding at 18 weeks gestation, no products expelled, cervix open

Inevitable abortion

15

Uterine bleeding at 18 wks gestation, no products expelled, cervical os closed

Threatened abortion

16

Teratogens effect during which weeks

2-12 wks

17

Which is older, gestational age or embryonic/developmental age? by how much

Gestational age 2 weeks older than embryonic age because is based on LMP which is 14 d prior to fertilization which occurs at ovulation

18

Naegele rule

EDP = LMP + 7 days - 3 months + 1 year

19

CV changes in pregnancy

CO increased 40% with SV and HR increase
Systolic murmur b/c inc CO
Myocardial O2 demand increases
SP and DP decrease
Uterus push heart superiorly
Venous distension increases
PVR decreases

20

Respiratory changes in pregnancy

Uterus pushes diaphragm up and decreases RV, FRC, ERV
Total O2 consumption increases
TV increases 40% with increase in minute ventilation 2/2 progesterone stimulation
PCO2 decreases = dyspnea
VC does not change

21

Renal changes in pregnancy

Renal plasma flow and GFR increase
BUN and Cr decrease
Inc renal loss bicarb due to compensation for resp alkalosis
Blood and interstitial fluid v increases

22

Endocrine change in pregnancy

Nondiabetic hyperinsulinemia with mild glc intolerance
Production human placental lactogen inc glc intolerance by interfering with insulin activity
Fasting TG inc
Cortisol Inc
TBG and T4 inc, free T4 unchange
TSH decrease but WNL

23

Hematologic changes in pregnancy

Hypercoaguable state
Increased RBC
HCT dec bc inc blood V

24

GI changes in pregnancy

Inc salivation
Dec gastric motility
Increased gastric emptying time
Sphincter tone decreases

25

Weight gain mom

Calorie intake

BMI 26: 15-25 lbs

Calories: 2500

26

Labs at initial visit

9-14 wks
CBC
Blood ab and Rh
Pap
GC/Chlam
UA-every visit
RPR or VDRL
Rubella titer
Hep B surface antien
HIV
TSH?

27

Labs 16-18 wks

Quadruple screen - trisomies 21, 18, NTD

28

Labs 18-20 wks

US dating and anatomy

29

Labs 24-28 wks

1 hr OGTT

30

labs 32-37 wks

N\GC and chlam, HIV and RPR screen in high risk
GBS screening