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Extra OB stuff from Pam Flashcards

1
Q

from fertilization until pregnancy is 10 wks GA

A

embryo

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2
Q

10 weeks GA to birth

A

fetus

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3
Q

birth - 1 year

A

infant

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4
Q

How long is 1st trimester?

A

conception → 12-14 wks GA

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5
Q

How long is 2nd trimester?

A

12-14 wks GA → 24-28 wks GA

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6
Q

How long is 3rd trimester?

A

24-28 wks GA → delivery

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7
Q

uterine contractions before 37 weeks that cause cervical changes

A

preterm labor

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8
Q

Maternal cardiovascular changes in pregnancy

A

CO increases by 30-50%

systemic vascular restance decreases (decrease in BP)

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9
Q

maternal pulmonary changes in pregnancy

A

increase in tidal volume by 30-40%

TLC decreases by 5%

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10
Q

Maternal GI changes in pregnancy

A

nausea and vomiting
increase in GERD
constipation

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11
Q

Maternal renal changes in pregnancy

A

increased risk of pyelonephritis

increased GFR

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12
Q

Maternal hematological changes in pregnancy

A

plasma volume increases by 50%
RBC increases by 20-30%
hypercoagulable state

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13
Q

Maternal MSK and dermatological changes in pregnancy

A

shift in center of gravity
increased spider angiomas
palmar erythema
hyperpigmented nipples/umbilicus/abdominal midline/perineum/face

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14
Q

Common routine problems with pregnancy

A

back pain, constipation, dehydration, edema, GERD, hemorrhoids, PICA, round ligament pain, urinary frequency, varicose veins

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15
Q

bluish discoloration of vagina and cervix

A

Chadwick sign

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16
Q

softening and cyanosis of the cervix at or after 4 weeks

A

Goodell sign

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17
Q

softening of the uterus after 6 weeks

A

Ladin sign

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18
Q

fetal movement

A

quickening

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19
Q

Presumptive signs and symptoms of pregnancy

A 
"felt by woman, not proof of pregnancy but will make you suspect it"
fatigue (12 wk)
breast tender (3-4 wk)
N/V (4-14 wk)
amenorrhea (4 wk)
urinary frequency (6-12 wk)
hyperpigmentation of skin (16 wk)
quickening (16-20 wk)
uterine enlargement (7-12 wk)
breast enlargement (6 wk)
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20
Q

Probably signs and symptoms of pregnancy

A 
"observed by examiner, more reliable indicators of pregnancy but not definitive"
Braxton Hick contractions (16-28 wk)
(+) pregnancy test (4-12 wk)
abdominal enlargement (14 wk)
ballottement (16-28 wk)
Goodell sign (5 wk)
Chadwick sign (6-8 wk)
Hegar sign (6-12 wk)
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21
Q

Positive signs and symptoms of pregnany

A

“definitve and unmistakable signs of pregnancy”
US verification of embryo/fetus (4-6 wk)
fetal movement felt by clinician (20 wk)
auscultation of fetal heart tones via Doppler (10-12 wk)

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22
Q

routine tests in prenatal care → initial visit and first trimester

A 
hematocrit
blood type and screen
RPR/VDRL - syphilis
rubella antibody screen
Hep B surface antigen 
gonorrhea and chlamydia cultures
PPD
PAP smear
UA and culture 
HIV offered 
screen for aneuploidy (11-13 wk)
chorionic villus smaple (9-12 wk)
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23
Q

increased level of MSAFP/triple or quad screen is correlated with increased risk for ______

A

neural tube defects

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24
Q

Decreased level of MSAFP/triple or quad screen is correlated with increase risk for

A

aneuploidies → Downs Syndrome

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25
what are some routine tests done in the 2nd trimester?
MSAFP/triple or quad screen (15-18 wk) OB ultrasound (18-20 wk) cell free DNA amniocentesis
26
what are some things you want to check on with the OB ultrasound at 18-20 wks?
gender, amniotic fluid volume and genetic anomalies, placental location and gestational age
27
what does cell free DNA screen for?
genetic anomalies
28
what are some routine screens done in the 3rd trimester → 27-29 wks?
hematocrit RPR/VDRL - syphilis glucose loading test rhoGAM
29
what do you culture mom for at 36 weeks? If she is positive what do you treat her with?
Group B strep | IV PCN @ labor
30
If mom is found to have active HSV, what does this indicate?
C-section needed
31
How often are visits in the 1st and 2nd trimester?
5-6 weeks apart
32
How often are visits after 30 weeks? | How often after 37 weeks?
increased frequency | weekly after 37 weeks
33
how many extra calories does a woman need in pregnancy per day?
300 calories/day
34
what supplements does mom need in 2nd and 3rd trimester?
iron, calcium vitamin D
35
why should women avoid unpasteurized milk and dairy, hot dogs and luncheon meat, refrigerated pate, refrigerated smoked seafood, raw and undercooked seafood, eggs and meat
listeriosis
36
If your patient is underweight, what is the recommended range of total weight gain in pregnancy?
28-40 lb
37
If your patient is normal weight, what is the recommended range of total weight gain in pregnancy?
25-35 lb
38
If your patient is overweight, what is the recommended range of total weight gain in pregnancy?
15-25 lb
39
If your patient is obese, what is the recommended range of total weight gain in pregnancy?
11-20 lb
40
what is the recommended amount of exercise in normal pregnancy
150 min moderate intensity aerobic activity/week
41
what are some concerns about exercising in pregnancy?
joints are more relaxed (increase risk of injury) balance may be off (falls) breathing affected
42
What are some precautions a pregnant woman should take when exercising?
drink plenty of water supportive bra avoid overheating avoid lying flat
43
what types of exercises should a pregnant woman avoid?
contact sports, skydiving, activities that may cause falls, hot yoga, activities about 6000ft in altitude
44
can pregnant women work?
yes as long as there are no complications and the environment is safe
45
when should pregnant women avoid sexual activity?
``` unexplained vaginal bleeding leakage of amniotic fluid cervical incompetence placenta previa preterm labor or risk of ```
46
when can pregnant women travel?
safe until 36 wks
47
when is the best time for pregnant women to travel
14-28 wk
48
when traveling what are pregnant women at increased risk for?
DVT
49
What conditions is travel for pregnant woman not recommended?
preeclampsia, PPROM, preterm labor
50
when are flu and TdaP vaccine recommended in pregnancy?
between 27-36 wks
51
what are TORCHH infections?
``` toxoplasmosis other (syphilis,VZV, parvovirus B19) rubella cytomegalovirus herpes virus HIV ```
52
settling of fetal head into the pelvis → occurs 2+ weeks before labor begins in 1st pregnancies
lightening
53
cervix softens, effaces, and dilates to release the mucous plug → days to weeks before labor
Bloody Show
54
painless uterine contractions, tighening or pressure, begin at 28 weeks gestation and increase with GA
Braxton Hicks Contractions
55
How can you make Braxton Hicks Contractions disappear?
walking
56
contractions that are regular and increase in intensity and duration with walking → felt in lower back and radiates to lower abdomen bloody show dilation and effacement fetus is engaged
true labor
57
contractions are irregular → stop when walking and felt in abdomen above umbilicus no cervical change fetus is ballotable
False labor
58
surgical excision used to enlarge the vaginal opening → make decision on whether to do or not in the 3rd stage of labor
episiotomy
59
indications of labor induction
``` prolonged ROM fetal demise severe preeclampsia diabetes HTN post term pregnancy (>42 wk) ```
60
what do you use to ripen the cervix in labor induction?
PGE1 (misoprostol) | PGE2 (dinoprostone)
61
artificial rupture of membranes
amniotomy
62
what is used to induce active labor?
oxytocin

Obstetrics (17 decks)

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