4 Flashcards
whats considered post partum hemorrahge
500 cc in vag birth
1000 cc in c sect
protocol for post partum hemorrhage
- uterine massage
- meds: pitocin
- balloon tamponade
- surgery: 1-uterine artery ligation, 2-internal iliac artery ligation, 3-hysterectomy
when do we use methotrexate for ectopic pregnancy?
bHCG<5000
less than 3 cm
no fetal heart tones
what do we normally use for ectopic?
salpingostomy if no rupture
salpingectomy if rupture
uterine perforation signs/symptoms
history: two days after D and C
fever, lower abdominal pain, nausea, scant bleeding (as opposed to retained products of conception where itd be profuse bleeding)
most common abnormal karyotype
autosomal trisomies
systemic diseases associated with early pregnancy loss
diabetes
chronic renal disease
lupus (antiphosphlipid)
thyroid diseases
if anemic and having miscarriage, what should you do?
D and C
patients at moderate risk for glucose intolerance tested when?
24-28 weeks with 50 g gluc challenge test
should you delay BV treatment in pregnancy?
no
risk of pregnant mother with pulm HTN
maternal mortality 25-50%
what med for pregnant woman with mitral valve prolapse with chest pain and palpitations
beta blockers
major complication of obese pregnant woman
hypertension
severe lupus best treated with what in pregnancy
corticosteroids
which antidepressant is contraindicated in pregnancy
paroextine
which med treats intrahepatic cholestasis of pregnancy
ursodeoxycholic acid
how do you diagnose suspected appendicits in pregnant woman?
graded compression US
signs/symptoms of magnesium toxicity
muscle weakness
loss of deep muscle tendon reflexes
respiratory depression
nausea
what should you give in case of mag tox?
calcium gluconate to restore resp function
therapeutic mag level
4-7
what factors makes you deliver a woman with severe preclampsia rather than expectant management pre 32 weeks?
platelets below 100,000 AST/ALT x2 inability to control bp despite 2 meds nonreassuring fetal surveillance persistent CNS symptoms oliguria eclampsia
what is risk of isoimmunization if woman decides not to use rhogam after first pregnancy
less than 20%
which tests detects severe fetal anemia
middle cerebral artery peak systolic velocity using doppler US
fetal signs of Rh disease
fetal hydrops- pericardial effusion, pleural fluid, ascites, scalp edema
polyhydramnios, HSM, placental enlargment
how many ccs of fetal blood is neutralized by 300 micrograms of Rhogam?
30 ccs
when is rhogam given
- 28 weeks
- within 72 hours of delivery
- following abortion
- following antepartum hemorrhage
- following amniocentesis or chorionic villous sampling
treat fetus with Rh disease
if preterm, intrauterine intravascular transfusion
