CF: 16-20 Flashcards
19 yo G1P0 woman who delivered at 29 wk gestation is noted to have severe preeclampsia, epigastric tenderness, and markedly elevated LFTs. Shortly after delivery, she develops sudden, severe abdominal pain, abdominal distention, syncope, hypoTN, and tachycardia.
Most likely Dx?
Next step?
Hepatic rupture
Emergent ex lap and blood product replacement
Healthy 19 yo G1P0 at 29 wk gestation c/o intermittent abd pain, VS nl. FHR shows baseline of 120 bpm and is reactive. Contractions noted q3-5 min. 3 cm dilated, 90% effaced, and -1 station. Most likely Dx? Next step in management? Test of vaginal fluid? Neuroprotective meds?
- Preterm labor
- Tocolysis, attempt to ID cause of PTL, antenatal steroids, Abx for GBS Ppx
- Fetal fibronectin assay
- MgSO4 (if
24 yo G2P1 @ 30 wk gestation was admitted 2 day ago for PROM. Temp 38.2, uterine fundus slightly tender. Persistent fetal tachycardia in 170-175 range.
Most likely dx?
Best management for this patient?
Etiology?
- Intraamniotic infection (chorioamnionitis)
- IV Abx (amp/gent) + induction
- Ascending infection from vaginal organisms
24 yo G2P1 woman at 22 wk gestation c/o episode of myalgias and low-grade fever 1 month ago. Her 2 yo son had a high fever and red cheeks. The fundal height is 28 cm and fetal parts are difficult to palpate.
Most likely Dx?
Most likely mechanism?
- Hydramnios w/ probable fetal hydrops 2/2 parvovirus B19
- Fetal anemia 2/2 neonatal parvo infection, which inhibits bone marrow erythrocyte production
18 yo G1P0 woman @ 22 wk gestation has a positive chlamydia DNA assay of endocervix. Denies lower abdominal pain and is afebrile. Abd is non-tender and gravid. GC Cx is negative. HIV ELISA positive.
Next step in therapy?
Next Dx step for HIV?
Optimal Tx of HIV in pregnancy?
- PO erythromycin, azithro, or amoxicillin
- Either western blot confirmation or PCR
- Assessment of stage of HIV infection, start HAART, offer elective C/S, PO zidovudine to neonate
