CF Flashcards
Nulliparous women dilate at what rate during active phase
1.2cm/hr
What features would suggest retained products of conception (i.e. after abortion)?
Open cervical os, lower abdominal cramping, vaginal bleeding, signs of infection
Why are we concerned about hemorrhage when performing curettage in an infected uterus?
Higher risk of perforation when infected
2 most common complications ass. with spontaneous abortion
Infection and Hemorrhage
Signs/sxs of septic abortion
Uterine bleeding and/or spotting in 1st Trimester + signs of infection. May see abdominal tenderness, cervical motion tenderness, foul-smelling vag discharge
In septic abortion, where does the infection come from/travel to?
Ascends from Vagina or Cervix. Goes to Endometrium –> Myometrium –> Perimetrium –> Peritoneum
Which organism causes septic abortion?
Polymicrobial –> Anaerobic strep, bacteroides, E coli, GBS are common
Bloody Show
A sign of impending labor that is often accompanied by the loss of the mucus plug. May present as bloody mucus in the vaginal vault.
What is the cutoff for ‘anemia in pregnancy’
10.5
Accelerations
> 15bpm above baseline for at least 15 seconds
Adequate Contractions
> 200 Montevideo Units in a 10min. window
Protracted Labor
Some progression but taking longer than normal (i.e. 0.5cm/hr)
Bloody Show
A sign of impending labor that is often accompanied by the loss of the mucus plug. May present as bloody mucus in the vaginal vault.
Combination of which 2 antibiotics works well for septic abortion tx 95% of the time
Gentamicin + Clindamycin (want broad spectrum with good anaerobic cover)
When do you begin uterine curettage for removal of retained products of conception/septic abortion?
4 hours after starting IV antibiotics
Why is urine output carefully observed in the setting of septic abortion?
because Oliguria = early sign of septic shock
Pelvic exam finding for Mullerian agenesis pt
blind vaginal pouch/vaginal dimple
Why does uterine inversion lead to PPH
Prevents adequate myometrial contraction
Absence of breast development points towards what hormonal state and condition?
Hypoestrogenic state –> Gonadal dysgenesis aka Turner syndrome
Next step in management after a shoulder dystocia has occurred
McRobert’s Maneuver - hyperflexion of maternal hips onto maternal abdomen and/or suprapubic pressure
Primary Amenorrhea = no menarche by age ____
16
Primary amenorrhea, normal breast, pubic, and axillary hair. Absent uterus
Mullerian agenesis
First dx test for any woman with primary or secondary amenorrhea?
Pregnancy test
T/F Fundal Pressure should be applied immediately following Dx of shoulder dystocia
False, it should be avoided due to increased risk of neonatal injury. McRoberts uses suprapubic pressure