Clinical Pregnancy- Westra

Question 1

At what weeks do you screen for gestational diabetes in asymptomatic women??

Answer 1

24-28 weeks

Question 2

After the glucose challenge, a blood sugar greater than what is a positive screening test?

Answer 2

Greater than 130

Question 3

Main treatment for gestational diabetes?

Answer 3

Metformin or insulin

Treatment aims for a blood glucose of 130, 1 hour after eating

Question 4

What things can increase your risk for gestational diabetes?

Answer 4

35 years or older
BMI > 25
Family Hx
Macrosomia in first pregnancy
Ethnic groups: Asian, Native, African

Question 5

Define preterm labor

Answer 5

Cervical changes associated with uterine contractions prior to 37 weeks

In nulliparous woman:
Uterine Contractons
2 cm dilation
> 80% effacement

Question 6

Why would you measure cervical length in pre term labor?

Answer 6

Because if

Question 7

What is the fetal fibronectin assay measured in preterm labor?

Answer 7

Fibronectin = large glycoprotein that acts as adhesive of fetal membranes to decidua

**HIGH NEG. PREDICTIVE VALUE

• If negative, probably will not deliver with-in the next 14 days….
• If positive, may or may not deliver

Question 8

What is congenital rubella syndrome?

Answer 8

Triad:
Deafness
Cataracts
PDA/ cardiac abnormalities

*mental retardation

Question 9

How should you first evaluate vaginal bleeding in a pregnant woman?

Answer 9

ULTRASOUND FIRST!

Don’t want to perforate a placenta previa

Question 10

Painless Vaginal bleeding during pregnancy

Answer 10

Placenta Previa

Question 11

Painful vaginal bleeding during pregnancy

Answer 11

Placental Abruption

Question 12

What is vasa previa?

Answer 12

Umbilical cord vessels that insert in the membranes with vessels overlying the internal cervical os

Vulnerable to exsanguination upon rupture of membranes

Question 13

What HTN medication is a teratogen?

Answer 13

KNOW
ACE inhibitors
Associated with oligohydramnios and neonatal renal failure

Question 14

Define preeclampsia

Answer 14

Systolic BP > 140/90 occurring after 20 weeks gestation in a woman whose BP has previously been normal

Question 15

What 2 things can reduce the risk of preeclampsia?

Answer 15

1. Ca+ supplements if low Ca in diet

2. Aspirin from 12-36 weeks if hx of risk factors

Question 16

What is the bishop’s score for?

Answer 16

Induction!

Looks at:
Position
Consistency
Effacement
Dilation
Fetal Station

Question 17

What bishop’s score would indicate that induction would have a high probability of success?

Answer 17

8 or more

Question 18

What is an “unfavorable” bishop’s score?

Answer 18

Less than 5

Question 19

What is a good antidepressant to use during pregnancy?

Answer 19

SSRIs:
Citalopram
Fluoxetine
Sertraline