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Reproductive Medicine > Exam #4 > Flashcards

Exam #4 Flashcards

1
Q

What supplementations should a pregnant patient be taking daily?

A
  • Folic acid (4 mg/day)
  • Calcium
  • Iron
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2
Q

At ________ weeks, an U/S can detect fetal age up to +/- 7 days

A

6-11 weeks

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3
Q

At ________ weeks, an U/S can detect fetal age up to +/- 10 days

A

12-20 weeks

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4
Q

At ________ weeks, an U/S can detect fetal age up to +/- 14-20 days

A

20+ weeks

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5
Q

Important maternal history dz to look out for (6):

A
  1. DM
  2. HTN
  3. CVD
  4. Renal dz
  5. Pulmonary dz
  6. Autoimmune
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6
Q

Important family history dz to look out for (6):

A
  1. DM
  2. HTN
  3. CVD
  4. Anemia
  5. CA
  6. Blood clotting d/o
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7
Q

Labs for the Initial PN visit

A 
Blood type
Anemia
Syphilis (Rapid Plasma Reagin / VDRL)
Kidney Dz (UA)
Cervical Dysplasia (Pap Smear)
Chlamydia
DM (glucose)
Hep B/Hep C/HIV
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8
Q

When should a pregnant patient be screened early for gestational DM?

A 
Fam hx of DM
High BMI (Obesity > 30)

Should be screened early, and then again at 28 wks

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9
Q

TORCH Titer

A 
Toxoplasmosis
Rubella
CMV / HSV / HIV / EBV
Syphilis
Hepatitis B
Parvovirus B19
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10
Q

Category X Medications

A

Warfarin
Chemo (antineoplastic agents)
Retinoids
DES (diethylstilbestrol)

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11
Q

Category C Medications

A

SSRIs

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12
Q

Craniofacial findings for Fetal Alcohol Spectrum D/O

A

Small Eye Openings
Smooth philtrum
Thin upper lip

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13
Q

Risky seizure medications during pregnancy

A

Phenytoin
Valproic Acid
Carbamazepine
Phenobarbital

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14
Q

What can happen to the fetus/mother if the mother has a seizure during pregnancy?

A

Trauma from fall
Hypoxia
Decreased heart rate
Premature labor, miscarriage

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15
Q

Live attenuated immunizations, such as Rubella, MMR, and Varicella, must be given during which time frame?

A

> 3 months before/after pregnancy

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16
Q

Which immunizations can be given during pregnancy?

A 
Recombinant Immunizations
Influenza
Gardasil
Hep B
Tetanus
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17
Q

What can cause a blueberry muffin baby?

A 
Rubella
Toxoplasmosis
Syphilis
Hep B
CMV
EBV
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18
Q

Fetal heart can be heard around _____ weeks

Normal rate?

A

12 weeks

120-160

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19
Q

Symptoms of pregnancy

A 
N/V
HA
Acne
Varicose Veins
Hemorrhoids
Leg Cramps
Heartburn
Backache
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20
Q

When does N/V of pregnancy start? How long can it continue to?

A

Starts around 4-6 weeks

Usually resolves by 16 weeks

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21
Q

Tx for N/V of pregnancy

A 
Rest
BRAT diet
Sea bands
Ginger
Several small meals
Carbohydrate snacks before bedtime
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22
Q

Signs/Symptoms of hyperemesis gravidarum

A

Persistent vomiting / inability to tolerate PO
Weight loss > 5% of pre-pregnancy weight
Dehydration (ketones, orthostasis)
Electrolyte abnormalities

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23
Q

Tx of hyperemesis gravidarum

A
  1. IV hydration
  2. Antiemetics (Phenergan, Zofran)
  3. GI motility drugs (Reglan)
  4. Goal is toleration of po liquids
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24
Q

If a patient with hyperemesis gravidarum is admitted, what should be done?

A

U/S to rule out multiple gestations, molar pregnancy

Thyroid panel to r/o Graves

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25
Q

Urinary frequency of pregnancy improves after _____ weeks when the uterus rises in the abdomen, but worsens again in the third trimester. Tx includes:

A

12 weeks
Kegel exercises, frequent urination
Make sure to watch for sx of UTI

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26
Q

Management of heartburn in pregnant patient

A

Avoid lying flat
Sleep with more pillows, lay on right side
Small frequent meals, avoid late night snacks
Antacids

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27
Q

Management of varicosities in pregnant patient

A

Elevate feet, pump leg muscles

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28
Q

Management of constipation in pregnant patient

A

Fruits and vegetables, drink lots of water
Exercise and walking
Stool softeners, laxatives prn

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29
Q

Patients > 35 years old are at increased risk for:

A

Trisomy 18, 13, and 21

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30
Q 
Risk of Trisomy 21:
\_\_\_\_\_\_\_ at age 35
\_\_\_\_\_\_\_ at age 39
\_\_\_\_\_\_\_ at age 45
\_\_\_\_\_\_\_ at age 49
A

1/800
1/300
1/80
1/20

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31
Q

Tests used to detect chromosomal abnormalities in first trimester

A

U/S: nasal bone absence and nuchal translucency

Serum: bHCG and PAPPA

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32
Q

When should fundal height measurement start?

A

20 weeks

Within +/- 3cm of gestational age

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33
Q

Fetal movement is first noted in the patient around ________ weeks in the first pregnancy, but the examiner cannot typically feel until _________ weeks

A

18-22 weeks

20-24 weeks

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34
Q

One in ______ pregnancies have recognizable chromosomal abnormalities. _____% are trisomy 21, 18, 13, or changes in X and Y

A

300

95%

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35
Q

Pregnancy Check Up Timings

A

Every 4 weeks until 28 wks
Every 2 weeks until 36 wks
Every week until 40 wks
2x a week after 40 wks

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36
Q

Worrisome in 3rd trimester:

A 
Vaginal bleeding (including spotting)
Persistent abdominal pain
Severe / persistent vomiting
Absence or decreased fetal movement
Severe HA
Edema of hands, face, legs, and feet
Fever above 100F
Dizziness, blurred vision, double vision, spots
Painful urination
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37
Q

> ____% of structural and chromosomal fetal abnormalities are born to low risk women

A

90%

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38
Q

When can a nuchal translucency test be performed to be valid?

A

First trimester

11 weeks to 13 weeks and 6 days

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39
Q

What is involved in the integrated prenatal screening (IPS)?

A

1st TM: NT and serum PAPPA

2nd TM: serum AFP, uE3 (estriol), hCG

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40
Q

Why is the integrated prenatal screening controversial?

A

Doesn’t calculate risk until 2nd trimester, so technically withholding information from the parents until. Also has high false positive rates due to wrong gestational dates and undiagnosed multifetal pregnancies.

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41
Q

What is involved in the serum integrated prenatal screening (SIPS)? It is the best option if ______ is not available.

A

1st TM: PAPPA
2nd TM: AFP, uE3, HCG, inhibin-A
Best option if NT is not available.

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42
Q

What do you do if one of the prenatal chromosomal screenings is positive?!

A

Offer CVS or amniocentesis

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43
Q

Timing for CVS?

Timing for amniocentesis?

A

10-13 weeks

15-22 weeks

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44
Q

Miscarriage risk for CVS?

Miscarriage risk for amniocentesis?

A

1/100-1/200

1/200-1/500

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45
Q

Where is the moderator band located?

A

Right ventricle

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46
Q

What’s a lemon sign?

A

Arnold Chiari II malformation

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47
Q

Leopold maneuvers are especially important after ______ weeks

A

34 weeks

Help determine the position of the fetus inside the uterus!

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48
Q

Breech presentation is in ____-____% of fetuses at 24-28 weeks, and ____% at 36 weeks

A

30-40% at 24-28 weeks

5% at 36 weeks

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49
Q

What’s the fetal kick count?

A

Patient sits quietly, observes fetal movement after 30 wks

Should report 10+ movements in 2 hours

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50
Q

Absence of fetal movement usually precedes IU fetal death by _______

A

48 hours

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51
Q

Loss of amniotic fluid prior to labor onset

A

PROM

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52
Q

Loss of amniotic fluid prior to 36 weeks

A

PPROM

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53
Q

Backaches during pregnancy may be due to increased __________. What’s the tx?

A

Lordosis

Exercise, sit with knee slightly higher than hips

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54
Q

Complications of fetus from gestational DM:

A
  1. Macrosomia
  2. Shoulder dystocia (increased rate of C/S)
  3. Hypoglycemia
  4. Hyperbilirubinemia
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55
Q

What is the initial GDM test?

A

50g glucose test

After 1 hour, positive if > 140

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56
Q

What’s the next step if the first GDM test if positive?

A

3 hour glucose tolerance test

+ if 2/4 are elevated or if FBS is high

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57
Q

What is associated with Group B strep in an infant delivery?

A

Sepsis
PNA
Death

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58
Q

When is a vaginal swab for Group B strep performed?

A

36 weeks

If present, give ABX in labor!

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59
Q

Braxton-Hicks contractions is “false labor,” where contractions are irregular, and ______ per 10 minutes. They serve to ______ / _______ the cervix in anticipation of delivery

A

< 3 per 10 minutes

Soften / efface the cervix

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60
Q

A score of < ____ is an unfavorable cervix, while a score of > ____ is a favorable cervix

A

< 5

> 7

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61
Q

When is stripping the membranes performed?

A

39 wks

Can speed up onset of labor within next 48hours

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62
Q

____% of transgender people have attempted suicide

A

41%

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63
Q

____% of transgender people have experienced family rejection

A

57%

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64
Q

Transgender populations have higher rates of: (4)

A
  1. HIV (4x)
  2. EtOH use
  3. Smoking
  4. Drug use
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65
Q

It is important patient information to relay that hormone treatment may decrease _________

A

Fertility

Consider sperm bank for MTF patient

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66
Q

How often do you routinely follow up with a transgender patient?

A

Every 4 weeks

Can taper this as the patient progresses/stabilizes

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67
Q

Screening for TransMen patients:

A
  1. Osteoporosis risk (consider VitD / Ca) - bone density screening 5-10 years after starting T
  2. May need to add progesterone if menses continue > 3 months
  3. Check T level every 6 mo
  4. Annual mammogram starting 40-50 y/o
  5. Bimanual pelvic exam every 1-2 years
  6. Pap smear every 2-3 years
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68
Q

Baseline Labs for TransWomen:

A 
Annual fasting lipid profile
K and Cr if on spironolactone
LFTs periodically
Monitor BP q 1-3 mo
Annual FPG
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69
Q

Screening for TransWomen patients:

A
  1. Annual mammogram starting at 40-50 y/o

2. Annual rectal exam w/ PSA at 50 y/o

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70
Q

Baseline Labs for TransMen:

A
  1. Hemoglobin
  2. Testosterone
  3. Lipids
  4. LFTs
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71
Q

Goals to prevent CVD in transmen planning to start masculinizing hormones within 1-3 yrs

A

SBP < 130, DBP < 90

LDL < 135 mg/dL

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72
Q

What should you advise your transmen patients taking testosterone to avoid tendon rupture?

A

Increase weight load gradually
Emphasize repetitions over weight
Emphasize stretching

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73
Q

________ is a good adjunct tx for hair loss in transwomen

A

Finasteride

Also topical minoxidil

74
Q

What can you give a transmale patient with decreased libido?

A

Low-dose SSRI

75
Q

It is recommended that a transmale patient wait ________ before surgery to remove breast tissue

A

6 mo

Wait to see how much effects the hormones themselves will have

76
Q

It can take up to ________ for the transmale body hair pattern to finalize

77
Q

Clinical Prophylaxis for Rh Isoimmunization

A
  1. If Mom is Rh-, check for Rh antibodies
  2. If Mom has Rh antibodies, REFER
  3. If no Rh antibodies, find out father’s blood type
  4. If Dad Rh-, no action needed
  5. If Dad Rh+, patient needs Rhogam
78
Q

When is Rhogam given?

A

24 weeks or when any bleeding during pregnancy is noted

Repeat Rhogam at time of delivery OR 12 weeks after prior dose (if given early)

79
Q

1st TM Complications

A
  1. Hyperemesis gravidarum
  2. Bleeding
  3. Pregnancy Loss
  4. Molar Pregnancy
80
Q

Spectrum of trophoblastic dzs, which are HCG +, which have the ability to convert to malignancies if their tissue is not removed

A

Molar Pregnancy

Gestational Trophoblastic Neoplasia

81
Q

Which molar pregnancies result in malignancies that need chemo?

A

Choriocarcinoma

Placental site trophoblastic tumor

82
Q

Presenting symptoms of a molar pregnancy

A
  1. Hyperemesis
  2. Bilaterally enlarged theca lutein cysts
  3. Vaginal bleeding (bundle of bloody grapes)
  4. Uterine enlargement > expected for GA
  5. Pregnancy induced HTN

Sx are due to large hydropic growths of the placenta and large amounts of HCG production

83
Q

2nd TM Complications

A
  1. Abnormal Prenatal diagnostics
  2. Second trimester loss
  3. Bleeding
  4. Placenta Previa
  5. Cervical Insufficiency (incompetent cervix)
84
Q

You should suspect ____________ whenever painless vaginal bleeding occurs in the second trimester

A

Placenta Previa

85
Q

Risks if placenta previa found in 3rd TM:

A

Vaginal bleeding
Placental abruption
IUGR (intrauterine growth restriction)

86
Q

If placenta previa found in 3rd TM:

A

Avoid labor!
Monitor closely
Schedule C/S

87
Q

Risk of placenta previa goes up with each _______

88
Q

Weakness of the cervix that results in cervical dilation/effacement in the 2nd TM in the absence of contractions. Often enough to cause early pregnancy loss (2nd or 3rd TM)

A

Cervical Insufficiency (Incompetent Cervix)

89
Q

Cervical insufficiency should be suspected in patient’s with prior _________ _________

A

Cervical surgeries

90
Q

Tx for cervical insufficiency

A

Cervical cerclage
Purse-string type suture placed in cervix to add strength to cervical tissue
Suture are removed if labor ensues or pt has reached near-term gestation

91
Q

Tx for cervical insufficiency in the NEXT pregnancy

A

Cervical cerclage in 2nd TM if needed

Progesterone supplementation starting at 18-20 weeks

92
Q

3rd TM Complications:

A
  1. Preeclampsia
  2. Preterm Labor
  3. Gestational Diabetes
93
Q

Triad of preeclampsia

A
  1. Edema
  2. Proteinuria
  3. HTN
94
Q

Preeclampsia does NOT happen before _____ weeks

95
Q

Placenta and preeclampsia seems to correlate with (3):

A

Placental Pressure
Umbilical blood flow
Spasms of spiral arterioles

96
Q

Who is the problem child in preeclampsia?

A

The placenta!

Placental thromboplastins probably cause the materanl vasospasm associated with it

97
Q

Sx of preeclampsia

A

HA, edema (sudden weight gain), N/V
Blurred vision, seeing spots, or scotomata
Decreased urine output

98
Q

When is there evidence of HELLP?

A

HTN
Platelets < 100K and/or
AST/ALT elevated and/or
Pulmonary edema

99
Q

Tx for preeclampsia (when becoming severe)

A 
MgSO4 infusion (should be continued for 24 hrs)
Best tx is delivery
100
Q

What’s post-partum preeclampsia?

A

Typically happens w/n 24 hrs of delivery
Sometimes as late as 3-4 days after delivery
Same tx - MgSO4

101
Q

Contractions with cervical change at 24-36 wks gestation

A

Preterm labor

102
Q

Fetal risk of preterm labor

A 
Brain: intraventricular hemorrhage, hypoxic injury
Lungs: pulmonary insufficiency
GI: necrotizing enterocolitis
Retina: O2 toxicity
Immune: infxn risk
Neuro-Respiratory: apnea
103
Q

At 24 weeks, the average fetus is _________ and morbidity is _____%

A

1 lb 6 oz

90%

104
Q

At 32 weeks, the average fetus is ________ and there’s a _______% the lungs are mature enough to fxn on RA

105
Q

What disposes to preterm labor?

A 
Cervicitis
Proximate infxns like UTIs
Drug use (cocaine, alcohol)
Dehydration
Polyhydramnios
Multiple gestation
106
Q

A cervical length of > ______ on U/S correlates well with NOT delivery the baby in the next 1-2 weeks

107
Q

Tx options for preterm labor

A 
Betamethasone (surfactant) - 12 mg IM, repeat in 24 hrs
Bedrest
Oral nifedipine (allows more time)
Terbutaline
Indomethacin
IV MgSO4
108
Q

ADRs associated with terbutaline

A

Pulmonary edema
Tachycardia
Increased BF

109
Q

ADRs of MgSO4

A

Flushing
Nausea
Hyporeflexia
Toxicity is possible (watch levels)

110
Q

If a patient has a hx of preterm labor, they will receive this during their next pregnancy

A

Progesterone supplementation
Vaginal gel or IM injection
Start around 18 wks then weekly to 34-36 wks

111
Q

Three tissue types that exist in the breasts

A
  1. Fat
  2. Glandular epithelium
  3. Fibrous stroma
112
Q

Arterial supply to the breasts comes from

A

Internal mammary artery (60%)

Lateral thoracic artery (30%)

113
Q

Venous return from the breasts comes from

A 
Axillary vein (primary)
Internal mammary vein, intercostal vein
114
Q

Lymphatic drainage from the breasts comes from

A

75% to the axillary nodes

115
Q

Nontender, slow growing breast mass, no nipple discharge. Proliferative process in a single lobule.

A

Fibroadenoma Tumor

116
Q

15-35 y/o and a painless lump

A

Fibroadenoma Tumor

117
Q

Dx for fibroadenoma tumor

A

PE: rubbery, mobile, painless mass
US: circumscribed solid mass
FNAC/CNB

118
Q

Rapid growth, large, leaf-like projections in a 40-50 y/o

A

Phyllodes tumor

119
Q

Smooth, multinodular, well-defined, mobile and painless firm mass

A

Phyllodes tumor

120
Q

Tx for phyllodes tumor

A

Wide local excision with follow-up
Simple mastectomy

Have to tx aggressively because only 60% are benign

121
Q

30-50 y/o with smooth, firm, discrete, often tender mass

122
Q

Tx for breast cyst

A

Aspiration (multiple if needed)

Excision if multiple recurrences

123
Q

History of trauma (seatbelt, other blunt trauma, surgery). Will present with pain and lump in breast.

A

Traumatic fat necrosis (TFN)

DDX: carcinoma

124
Q

Tx of traumatic fat necrosis

A

Excision vs. follow

No increased risk of malignancy

125
Q

____% of women report > 5 days per month of mastalgia

126
Q

Cyclic mastalgia usually onsets in the late ______ _______, and dissipates with the onset of menses

A

Late luteal phase

127
Q

Tx for cyclic mastalgia

A 
Diet, breast support (good bra 24/7)
NSAIDs/Acetaminophen, evening oil of primrose
Vitamin E
Danazol
Tamoxifen
Bromocriptine
Topical NSAID
128
Q

Most frequent breast lesion, common in women 30-50 y/o

A

Fibrocystic breast changes

129
Q

Bilateral tender breast lumps and bilateral nipple discharge

A

Fibrocystic breast changes

130
Q

Tx for fibrocystic breast changes

A 
Symptomatic relief (same as mastalgia)
If dominant mass --> have to r/o CA (mammogram, US, cytology)
131
Q

Bloody nipple discharge, usually unilateral, may have associated mass
Tx?

A 
Intraductal Papilloma (IDP)
Tx: Remove!
132
Q

Often asymptomatic, can cause green/black discharge. May have mass, inflammation of nipple/surrounding tissue
Tx?

A

Duct Ectasia

Symptomatic, ABX, excision

133
Q

Purulent discharge

A

Subareolar abscess

134
Q

Milk discharge in a non-lactating breast?

A

Prolactin secreting pituitary adenoma
Hypothyroidism
Medications (dopamine antagonists)

135
Q

Lactating female with throbbing pain in unilateral breast plus a fever

136
Q

Localized inflammation of the breast associated with fever, myalgias, breast pain, and redness

137
Q

Onset of mastitis? Etiologies? Tx?

A

First 2-4 weeks postpartum
Staph aureus, staph epidermidis, candida albicans, strep
Fluids, ice, NSAID, handwashing, regular emptying of breast by pumping or nursing
ABX: dicloxacillin or cephalosporin x 10-14 days

138
Q

If no response to ABX for mastitis in 3 days? Etiology? Dx? Tx?

A

Breast abscess
Often MRSA
Confirm with breast US
Tx: Needle aspiration or surgical drainage

139
Q

Breast CA is the ___ most common CA in women

A

2nd

Skin = 1st

140
Q

Breast CA is the ____ leading cause of CA death in women

A

2nd

Lung = 1st

141
Q

5-year survival for stage 0-1 breast CA is _____%

5-year survival for stage 4 breast CA is _____%1

142
Q

Unalterable RF for breast CA

A

Female, age

Fam hx, personal hx, race, diethylstilbestrol, radiation, genetic, menstrual hx

143
Q

Controllable RF for breast CA

A

Obesity, diet, exercise, breastfeeding, EtOH, HRT, OCP,

144
Q

Risk calculation for breast CA

A

Gail-NCI Model

145
Q

Associated risk for breast CA with BRCA-1

Other CA associated?

A

50-85%
Second primary breast CA
Ovarian CA
Prostate, Colon

146
Q

Associated risk for breast CA with BRCA-2?

Other CA associated?

A

50-85%
Ovarian
Prostate, laryngeal, pancreatic, melanoma

147
Q

When is the best time to do a self-breast examination?

A

7-8 days post menses

148
Q

Clinical breast exams should be performed every 1-3 years ages ____ - _____, and annually after age _____

A

20-39 y/o

40 y/o +

149
Q

Mammograms should be started at age ____ and done annually until age ______

A

40 y/o

75 y/o

150
Q

Enhanced screening in BRCA mutations

A

Self-exams beginning at 18 y/o
Semiannual clinical breast exams beginning at 25 y/o
Annual mammography and breast MRI beginning at 25 y/o or earlier

151
Q

Chemoprevention of Breast CA

A

Tamoxifen
Raloxifene
Aromatase Inhibitors

152
Q

ADRs of Tamoxifen

A 
Increased risk of endometrial CA
Increased risk of DVT
Cataracts
Depression
Vasomotor Sx
Vaginal dryness/discharge
153
Q

ADRs of Raloxifene

A

TE events
Cataracts
Better bone density
Decreased Uterine CA

154
Q

ADRs of aromatase inhibitors

A

Osteoporosis
Vasomotor Sx
Joint pain
Depression

155
Q

___% of the presenting complaint is a painless breast lump for breast CA

156
Q

The ____ _____ quadrant is the location of 60% of breast CA

A

Upper outer quadrant

157
Q

85% of breast CA are ______, not lobular

158
Q

After breast CA:

A 
Need for close f/u
Lymphedema of upper extremity
"Chemo-brain"
Menopausal sx
Osteoporosis, CV issues
159
Q

Itch/burn/superficial erosion of nipple. May not have mass. Dx often missed or delayed tx for dermatitis or infxn

A

Paget carcinoma

160
Q

Most malignant form of breast CA

A

Inflammatory carcinoma

161
Q

Red hot breast

A

Inflammatory carcinoma

162
Q

Inflammatory carcinoma is often mistaken for:

A

Mastitis

Refer for bxx if no response to ABX

163
Q

Contractions of labor come in a regular pattern, ____-____ minutes apart, each lasting ____-____ seconds

A

3-5 minutes apart

Last 30-60 seconds

164
Q

Thinning of the cervix and cervical softening is due to: (2)

A

Increased water content

Collagen lysis

165
Q

Mucous plug often comes out as a result of _________ (bloody show)

A

Effacement

166
Q

The fetus will usually start with ______ position, and will follow with the cardinal movements (7)

A

Left Occiput Anterior

Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

167
Q

Stages of Labor

A
  1. Dilation/effacement
  2. Pushing/Delivery
  3. Placental Delivery
168
Q

2 phases of the first stage of labor (dilation/effacement):

A
  1. Latent phase: early effacement and dilation from 0-4 cm
  2. Active phase: rapid effacement, most dilation occurs 6-fully dilated
    As one goes into active phase, transitioning often occurs
169
Q

What’s involved in the second stage? (pushing/delivery)

A

Full dilation to delivery of the fetus
Pressure and desire to bear down
Molding of the fetal head
Cardinal movements

170
Q

What’s involved in the third stage? (placental delivery)

A

Separation of the placenta from the uterine wall begins
Usually takes 2-10 minutes
Gush of blood, lengthening of the umbilical cord, uterus becomes firm, very gentle traction on the cord, almost none

171
Q

Failure of the myometrium to contract, leading to hemorrhage

A

Uterine Atony

172
Q

Tx of uterine atony

A

Bimanual uterine massage
Uterine packing
Pitocin and Prostaglandins
Hysterectomy (last resort)

173
Q

It is an absolute indication for a C/S if the uterine incision from a prior C/S is ____________________

A

Above the lower uterine segment

174
Q

Procedure in which caregivers attempt to externally manipulate a fetus from breech to vertex. The father in gestation, the less likely to flip

A

External Cephalic Version

175
Q

Methods of induction of labor

A

Membrane stripping
Amniotomy
Pitocin
Vaginal prostaglandins

176
Q

Inflammation of the fetal membranes (amnion and chorion) due to a bacterial infxn. Most often associated with prolonged labor.

A

Chorioamnionitis

177
Q

Chorioamnionitis is suspected when at least 2 of the following are present:

A

Fever
Fetal tachycardia
Uterine tenderness
Foul-smelling amniotic fluid

178
Q

Tx of chorioamnionitis

A 
IV ABX (continue for 24 hr after delivery)
Monitor fetus
Prompt delivery
179
Q

Blood loss > 500 mL in the first 24 hours after vaginal delivery or > 1000 mL after a C/S

A

Early Postpartum Hemorrhage

180
Q

Hemorrhage that occurs after the first 24 hours of delivery

A

Late Postpartum Hemorrhage

181
Q

Causes of early postpartum hemorrhage:

A 
Uterine Atony
Retained Placental Fragments
Placenta Accreta
Cervical or Uterine Lacerations
Inversion of the Uterus
Vulvar or Vaginal Hematomas
182
Q

Postpartum hemorrhage due to a laceration from delivery - what’s the action?

A

Get blood typed and crossmatched early in the process
Inspect entire lower birth canal
Suture any bleeders
Vaginal pack: remove and assess bleeding after 24-48 hrs
Blood replacement as needed

Reproductive Medicine (3 decks)

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