Flashcards in OG Deck (119):
1
embryo
fertilization to 8 weeks
2
fetus
8 weeks to birth
3
developmental age
number of days since fertilization
4
gestational age
number of days/weeks since LMP
5
naegle rule
subtract 3 months, add 7 days
6
first trimester dates
12 weeks DA
14 weeks GA
7
second trimester dates
24 weeks DA
26 weeks GA
8
pre-viable
born before 24 weeks
9
post term
greater than 42 weeks
10
F-PAL
full term
preterm
abortions
living children
11
goodell sign
FIRST sign of pregnancy,
4 weeks
= softening of the cervix
12
ladin sign
softening of the midline of the uterus,
6 weeks
13
chadwick sign
blue discolouration of vagina and cervix
6-8 weeks
14
when does palmar erythema present
first trimester
15
when does chloasma present
16 weeks
16
when does linea nigra present
second trimester
17
US in pregnancy
CONFIRMS INTRAUTERINE
18
PREGNANCY=
beta hCG greater than 1500 OR
5 weeks= gestational sac on ultrasound
19
morning sickness caused by
increase in estrogen, progesterone, hCG
20
other GI complication of pregnancy
constipation
21
renal in pregnancy
INCREASE GFR--> decrease BUN/cr
22
haem in pregnancy
- anaemia
- hypercoagulable
23
most accurate way of establishing gestational age at 11-14 weeks
ULTRASOUND
24
triple screen
MSAFP, estriol, beta hCG
25
quad screen
+ INHIBIN A
26
triple and quad screening done when
15-20 weeks
27
after 36 weeks how often does the mum come to see the doctor
every week
28
braxton hicks that are continued
CHECK THE CERVIX
since real contractions will have a dilated cervix, vs. BH contractions= closed cervix
29
CBC done when
27 weeks,
if Hb less than 11 replace iron orally
30
glucose load
24-28 weeks, fasting or non fasting ingestion of 50g glucose and serum glucose checked 1 hr later
31
glucose tolerance test
FBG, 100g glucose and serum glucose check 1,2,3hrs
32
GDM if....
either glucose load or GTT is positive
33
postive glucose load
glucose greater than 140 send for OGTT
34
if gave them pregnant woman iron--->
give stool softener
35
CVS done during
10-13wks
36
Amniocentesis done during
11-14wks
37
strongest risk factor for ectopic pregnancy
PREVIOUS HISTORY of ectopic
38
contraindications to MTX
1. immmunosuppressed
2. liver disease
3. non compliant
4. greater than or equal to 3.5cm
5. fetal heart
39
MCC spontaneous abortions
chromosomal abnormalities
40
work up for spontaneous miscarriage
- CBC
- blood type-- RH
- US*********
41
what must be done for a miscarriage
ULTRASOUND-- to determine what type of misacarriage
42
missed miscarriage
death of fetus, but all products of conception present in uterus
43
tx of threatened abrtion
bed rest,
pelvic rest
44
septic abortion
infection of uterus and surrounding areas
45
medical tx of misacarriages
PGE1 to dilate cervix for expulsion of products
46
when to stop delivery if....
24-33 EGA
600-2500g
47
when to deliver
34-37 EGA
greater than 2500g
48
list of conditions where you should NOT NOT NOT NOT NOT stop with tocolytics
- PET/ eclampsia
- maternal cardiac disease
- greater than 4 cm cervical dilation
- maternal haemorrhage
- fetal death
- chorioamnionitis
49
most commonly used tocolytic
magnesium sulfate
50
side effects of magnesium sulfate
- RESPIRATORY DEPRESSION
and cardiac arrest--- thus nb to check DTRs often
51
commonly used tocolytics
- magnesium sulfate
- CCBs
- terbutaline
- NOT NOT NOT NOT NOT NOT NOT indomethacin
52
preterm fetuses WITHOUT chorioamnionitis
tx= betamethasone
53
what type of US for placenta previa
TRANSABDOMINAL
54
complete previa
completely covers the internal cervical os
55
partial previa
partially covers the internal cervical os
56
marginal previa
on the MARGIN, adjacent to internal os, touching the edge of os
57
low lying placenta
NOT covering the internal os-- more than 0cm, but less than 2cm away; implanted in the lower uterine segment
58
tx for placenta previa
STRICT PELVIC REST-- NOTHING INTO VAGINA
59
risk factors for abruption
- HTN
- previous hx
- cocaine
- external trauma
- smoking
60
MCC DIC in pregnancy
placenta abruption
61
complications of concealed placental abruption
- DIC
- uterine tetany
- fetal hypoxia
- fetal death
- sheehan syndrome
62
tx of uterine rupture
LAPAROTOMY ASAP-- since baby could be outside of the uterus floating around in the abdomen
63
gestational HTN
bp greater than 140/90mmHg without proteinuria or edema
64
mild preclampsia
greater than 140/90
dipstick 1+-2+
24hr urine greater than 300mg
65
edema in mild PET
hands, feet, face
66
edema in severe PET
GENERALIZED
67
32-36 weeks test needed
NST: fetal well being
US: fetal size
68
greater than 36 weeks test needed
twice weekly testing
1 NST
1 BPP: AF and fetal well being
69
37 weeks test needed
L/S ratio
70
38-39 weeks if patient refuses L/S ratio
NO TEST-- INDUCE LABOUR
71
tx for GDM
diet and exercise
do NOT NOT NOT NOT tell them to lose weight
72
macrosomia, when should US be done
if fundal height is greater than 3cm
73
earl deceleration
decrease in HR that occurs with contractions
HEAD COMPRESSION
74
variable decelerations
decrease in HR and return to baseline with no relationship to contractions
UMBILICAL CORD COMPRESSION
75
late decelerations
decrease in HR after contraction started. no return to baseline until contractions ends
FETAL HYPOXIA
76
lightening
fetal descent into pelvic brim
77
stage 1
labor--> cervical dilation
primi: 6-18hrs
multi: 2-10hrs
78
latent phase
labor--> 4cm
primi: 6-7hrs
multi: 4-5hrs
79
active phase
4cm--> full
primi: 1cm/hr
multi: 1.2cm/hr
80
stage 2
cervical dilation--> delivery neonate
primi: 30-3hrs
multi: 5-30 minutes
81
stage 3
delivery neonate--> delivery placenta
30 minutes
82
what not to give asthmatic pregnant women
PROSTAGLANDINS--> bronchospasm
83
protracted cervical dilation causes
3P's
- power: strength and frequency of uterine contractions
- passenger: size and position of fetus
- passage: passenger larger than pelvis= cpd
84
TX OF cpd
CS
85
arrest disorders
- cervical dilation
- fetal descent
86
cervical dilation arrest
no cervical dilation for past 2 hrs
87
fetal descent arrest
no fetal descent for 1 hour
88
frank breech
hips F
knees E
89
complete breech
hips F
knees F
90
footling breech
feet first
- complete= both feet
- incomplete= 1 foot
91
up until what point is it okay for baby to be breech
36 weeks
92
PPH extra side note
assure there is no rupture of the uterus
93
premenstural dysphoric disorder
PSYCHIATRIC DISORDER
94
vaginal diaphragm...
USELESS without the jelly
6hrs before
6hrs after
95
labial fusion
21 beta hydroxylase deficiency
- excess androgens
- reconstructive surgery
96
chronic irritation of vulva with hyperkeratosis (Raised white lesion)
squamous cell hyperplasia
97
tx squamous cell hyperplasia of vulva
sitz baths or lubricants
98
PC bartholins
- PAIN PAIN PAIN
- dyspareunia
99
tx bartholins
incision and drainage
--> MARSUPIALIZATION= allow the space to remain open
100
bilateral pagets of vulva
radical vulvectomy
101
unilteral pagets of vulva
modified vulvectomy
102
PC SCC of vulva
PRURITUS
103
stage 0 SCC vulva
CIS
104
stage 1 SCC vulva
vaginal wall, less than 2 cm
105
stage 2 SCC vulva
vulva or perineum more than 2 cm
106
stage 3 SCC vulva
tumor spreading to lower urethra or anus, unilateral lymph nodes present
107
stage 4 SCC vulva
tumor invasion into bladder, rectum, or bilateral lymph nodes
108
stage 4a SCC vulva
distant mets
109
unilateral LNs SCC vulva tx
modified radical vulvectomy
110
bilateral LNs SCC vulva tx
radical vulvectomy
111
PC adenomyosis
- dysmenorrhea
- menorrhagia
112
dx of adenomyosis
CLINICAL
- large, globular, boggy uterus
113
most accurate dx of adenomyosis
MRI
114
definitive dx of adenomyosis
hyterectomy
115
tx of adenomyosis
HYSTERECTOMY
116
rf for endometriosis
FDR with endometriosis
117
pain in endometriosis
cyclical-- 1-2 weeks before menses
118
exam for endometriosis
nodular uterus and adnexal mass
119