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Flashcards in Pregnancy Complications - Hill Deck (35):
1

What vaccines do you not give during pregnancy?

1) Live vaccines!
a) rubella
b) varicella
c) flu nasal mist

2

When is it best to give folic acid?

3 months before getting pregnant

3

When is the flu vaccine ok to give?

Flu is ok to give IM during any trimester and if breastfeeding

4

What diseases are all pregnant women screened for?

1) gestational DM
2) gonorrhea
3) chlamydia
4) syphilis
5) HIV
6) Hep B

5

What can happen if the mom (who is Rh-) makes antibodies to the babies Rh+ blood?

1) hemolysis of fetal blood
2) release of bilirubin and fetal anemia
3) fetal cardiac failure
4) fluid accumulation
5) hydrops fetalis

6

Which baby is most affected by Rh antibodies?

THE SECOND!!! - moms first response is IgM and that is too big to cross the placenta

7

What antibody and blood typing do all women get at their first PNV?

1) Rh typing
2) antibody screening

8

What test is done if mom is positive for antibodies?

Indirect Coombs test - detects antibody titer

9

What are the steps in an indirect coombs test?

1) patients serum incubated with reagent RBC
2) IgG will bind to RBC if they are +
3) incuated with antibodies to human IgG
4) you will get agglutination of RBCs if they bound the original IgG

10

What is the definitions of hydrops?

Fluid in 2 of the following:
a) hert
b) lungs
c) abdomen
d) skin

11

What is RhoGAM?

IgG towards Rh antigen - prevents isoimmunization to Rh

12

What is the treatment for hydrops if the titer is < 32?

1) repeat titer every 4 weeks
2) at 24 weeks check every 2 weeks
3) if remains < 32 deliver at term

13

What is the treatment for hydrops if the titer is > 32?

1) test fathers antigen and genotype
a) homozygous - MCA dopler *****
b) heterozygous - perform amniocentesis
for fetal DNA, if Rh+ proceed with A
c) Rh - deliver fetus at term, no further test

14

What is there is an abnormal MCS test?

test fetal HCT - transfuse

15

What is required to have preeclampsia/eclampsia?

new HTN and proteinuria > 20 wga

16

What is gestational HTN?

elevated BP > 20 wga without proteinuria

17

What is mild preeclampsia?

1) systolic BP > 140 or diastolic > 90 (after 20 weeks gestational age)
2) proteinuria > 300mg on 24 hour urine (or +1 on urine drip)

18

What is severe preeclampsia?

1) systolic BP > 160, diastolic BP > 110 (on 2 occasions, 6 hours apart)
2) >5g of protein on 24 hr urine (3+ urine dip)
3) oliguria
4) HA, visual changes, Pulmonary edema, RUQ pain
5) bad liver function tests
6) low platelets

19

When they say zygote, you think?

Egg

20

When they say chorion, you think?

placenta

21

When they say amnionic, you think?

sac

22

A dizygote is always what?

dichorionic/diamnionic

23

Is a dichorinoic/diamnionic pregnancy always Dizygotic?

NO - it can also be monozygotic

24

What is a fraternal twin?

1) Dizygotic
a) dichorionic/diamnionic

25

What are identical twins?

Monozygotic

26

When do MZ di/di twins split and how many chorions are there?

1) split at 1-3 days
2) 2 chorions

27

When do MZ mo/di split and how many chorions?

1) 3-8 days
2) 1 chorion

28

When do MZ mo/mo twins split?

8-11 days

29

When do conjoined, monoamnionic twins split?

> 13 days

30

What are the most common twins?

MZ mo/di
Monozygotic: monochorionic, diamnionic

31

What are risk factors for a big baby?

1) History
2) weight gain/obesity
3) > 40 weeks gestation
4) diabetes

32

What are risk factors for a small baby?

1) HTN/vascular disease (uterine artery)
2) smoking/alcohol
3) genetics
4) infections
5) renal disease

33

How many vessels are in the umbilical cord?

1 artery
2 veins

34

When do most abnormalities occur in the fetus?

1-13 weeks

35

How much is in 1 vial of standard RoGAM?

30cc