c section and systemic disorders of pregnancy

Question 1

estimated due date?

Answer 1

since LMP, 40 weeks

Question 2

initial counseling

Answer 2

violence

tobacco/drug use EtOH

weight gain recs

exercise (NO HOT things)

Question 3

dietary restrictions?

Answer 3

raw dairy, deli meat, fish

Question 4

initial test:

Answer 4

Blood and RH

AB screen

Hep A SAg

Rubella, HIV, Chalmydia, Gonorrhea

A1C

optional: trisomy, CF, Fragil X

Question 5

prenatal visits 1-2 trimester?

Answer 5

1/4weeks

Question 6

prenatal visits in 3rd trimester?

Answer 6

1/2weeks

Question 7

prenatal visits

Answer 7

FHR, fundal height, glucose

Question 8

Dx eval

Answer 8

US survey every 20 weeks

flu vaccine

Question 9

AFP measure to screen for

Answer 9

neural tube defects etc

Question 10

preeclampsia?

Answer 10

proteinuria, after New onset 20 weeks htn (>140/90), increased FHR

Question 11

HELLP syndrome?

Answer 11

hemolysis
elevated liver enzymes, low platelets

MAY NOT HAVE HTN and PROTEINURIA BEFOREHAND

Question 12

headache that isn’t going away

edema?

Answer 12

severe preeclampsia

Question 13

abnormal _____invasion of the spiral arteries and consequent secretion of _____ factors

Answer 13

trophoblast invasion

placental secretion of angiogenic factors

Question 14

systemic _______ dysfunction caused by preeclampsia?

Answer 14

endothelial dysfunction

Question 15

mgmt of preeclampsia

Answer 15

magnesium sulfate

Question 16

magnesium sulfate to prevent

Answer 16

seizures

Question 17

Ddx 3rd trimester bleeding

Answer 17

MAIN ONES

Placental abruption
PRevia
Vasa Previa
Uterine rupture

Question 18

Ultrasound or digital exam for bleeding in 3rd trimester?

Answer 18

US always first

Question 19

causes of placental abruption?

Answer 19

htn, cocaine/smoking, abdominal trauma

Question 20

placenta previa risk factors

Answer 20

prior uterine surgery, many pregnancies, mutliple gestations, smoking, older moms

Question 21

Vasa previa presentation and risk factors

Answer 21

painless vaginal bleeding

multiple gestations

VERY EMERGENT

Question 22

what type of plancental abnormality common to see in preeclampsia?

Answer 22

placental abruption

Question 23

c section indications

Answer 23

breech presentation

abnormal placentation

prior myometrial surgery

macrosomia (over 5000 grams)

HIV

Active Herpes outbreak

Question 24

C section tries to avoid what layer of the uterus?

Answer 24

Myometrium which is why it is done int he lower uterine segment

Question 25

vaginal delivery after c section poses what risk?

Answer 25

uterine rupture (.5%)