Day 14 - Ob3 Quiz Flashcards
Definition of PROM
Premature Rupture of membranes = spontaneous rupture before labor
Define PPROM
Premature (GA
When to suspect chorioamnionitis in pt with PROM
Fever & one other thing (maternal tachycardia, fetal tachycardia, maternal leukocytosis > 15K, uterine tenderness, or foul smelling discharge)
What GA age for active labor mgt rather than expectant mgt in pre-term labor
34+ wks or proven fetal lung maturity
Risk factors for placental abruption
HTN (chronic, gestational, preeclampsia), Prior placental abruption, Trauma, Tobacco use, Cocaine, PROM, multiple gestation, multiple parity
Drugs used for tocolytics
Nifedipine, Terbutaline, Ritodrine, MgSO4, Indomethacin
Reversal agent for Mg toxicity
Calcium gluconate
Mgt pre-term labor at 33 wks & 3 days v. 34 & 3
GBS PPx in both cases; 33 - Tocolysis so can use steroids, then after 48 hrs, Active mgt ; 34 - Active mgt
Components biophysical profile for fetal well being
Fetal tone, breathing, movement, AFI, Nonstress test (HR accelerations)
Compare appearance of early, late, and variable decelerations & ddx
EARLY - begin & end w/ uterine contraction (head compression) ; LATE - begin & end after (uteroplacental insufficiency, hypoxia); VARIABLE - begin & end inconsistently, V-shaped (may or may not be a sign of fetal distress, umbilical cord compression)
Define Oligohydramnios
AFI
Define Polyhydramnios
AFI > 25
Classic s/sx Mg toxicity
Hyporeflexia (decreased DTRs), Respiratory depression/arrest (possible pleural effusion also) Cardiac arrest
Tests used to confirm rupture of membranes
Amnionic pooling in vaginal vault on speculum exam can, Fern test, or Nitralizine blue test
W/u Infertility for couple
Semen analysis, Eval anovulatory cycles (menstrual hx, basal body temp monitoring, home urinary ovulation test, postovulation serum progesterone, endomentrial bx on day 26), hysterosalpingogram
