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Obstetrics > Extra OB stuff from Pam > Flashcards

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
Q

what are some routine tests done in the 2nd trimester?

A

MSAFP/triple or quad screen (15-18 wk)
OB ultrasound (18-20 wk)
cell free DNA
amniocentesis

26
Q

what are some things you want to check on with the OB ultrasound at 18-20 wks?

A

gender, amniotic fluid volume and genetic anomalies, placental location and gestational age

27
Q

what does cell free DNA screen for?

A

genetic anomalies

28
Q

what are some routine screens done in the 3rd trimester → 27-29 wks?

A

hematocrit
RPR/VDRL - syphilis
glucose loading test
rhoGAM

29
Q

what do you culture mom for at 36 weeks? If she is positive what do you treat her with?

A

Group B strep

IV PCN @ labor

30
Q

If mom is found to have active HSV, what does this indicate?

A

C-section needed

31
Q

How often are visits in the 1st and 2nd trimester?

A

5-6 weeks apart

32
Q

How often are visits after 30 weeks?

How often after 37 weeks?

A

increased frequency

weekly after 37 weeks

33
Q

how many extra calories does a woman need in pregnancy per day?

A

300 calories/day

34
Q

what supplements does mom need in 2nd and 3rd trimester?

A

iron, calcium vitamin D

35
Q

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

A

listeriosis

36
Q

If your patient is underweight, what is the recommended range of total weight gain in pregnancy?

A

28-40 lb

37
Q

If your patient is normal weight, what is the recommended range of total weight gain in pregnancy?

A

25-35 lb

38
Q

If your patient is overweight, what is the recommended range of total weight gain in pregnancy?

A

15-25 lb

39
Q

If your patient is obese, what is the recommended range of total weight gain in pregnancy?

A

11-20 lb

40
Q

what is the recommended amount of exercise in normal pregnancy

A

150 min moderate intensity aerobic activity/week

41
Q

what are some concerns about exercising in pregnancy?

A

joints are more relaxed (increase risk of injury)
balance may be off (falls)
breathing affected

42
Q

What are some precautions a pregnant woman should take when exercising?

A

drink plenty of water
supportive bra
avoid overheating
avoid lying flat

43
Q

what types of exercises should a pregnant woman avoid?

A

contact sports, skydiving, activities that may cause falls, hot yoga, activities about 6000ft in altitude

44
Q

can pregnant women work?

A

yes as long as there are no complications and the environment is safe

45
Q

when should pregnant women avoid sexual activity?

A 
unexplained vaginal bleeding
leakage of amniotic fluid 
cervical incompetence
placenta previa
preterm labor or risk of
46
Q

when can pregnant women travel?

A

safe until 36 wks

47
Q

when is the best time for pregnant women to travel

A

14-28 wk

48
Q

when traveling what are pregnant women at increased risk for?

A

DVT

49
Q

What conditions is travel for pregnant woman not recommended?

A

preeclampsia, PPROM, preterm labor

50
Q

when are flu and TdaP vaccine recommended in pregnancy?

A

between 27-36 wks

51
Q

what are TORCHH infections?

A 
toxoplasmosis
other (syphilis,VZV, parvovirus B19)
rubella 
cytomegalovirus 
herpes virus 
HIV
52
Q

settling of fetal head into the pelvis → occurs 2+ weeks before labor begins in 1st pregnancies

A

lightening

53
Q

cervix softens, effaces, and dilates to release the mucous plug → days to weeks before labor

A

Bloody Show

54
Q

painless uterine contractions, tighening or pressure, begin at 28 weeks gestation and increase with GA

A

Braxton Hicks Contractions

55
Q

How can you make Braxton Hicks Contractions disappear?

A

walking

56
Q

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

A

true labor

57
Q

contractions are irregular → stop when walking and felt in abdomen above umbilicus
no cervical change
fetus is ballotable

A

False labor

58
Q

surgical excision used to enlarge the vaginal opening → make decision on whether to do or not in the 3rd stage of labor

A

episiotomy

59
Q

indications of labor induction

A 
prolonged ROM
fetal demise
severe preeclampsia
diabetes
HTN 
post term pregnancy (>42 wk)
60
Q

what do you use to ripen the cervix in labor induction?

A

PGE1 (misoprostol)

PGE2 (dinoprostone)

61
Q

artificial rupture of membranes

A

amniotomy

62
Q

what is used to induce active labor?

A

oxytocin

Obstetrics (17 decks)

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