Extras: OB / Gyn Flashcards
meds for mild vs severe chronic HTN in pregnancy
- mild chronic: ASA for last 12 weeks
2. severe: labetolol, nifedipine, etc.
Dx of preeclampsia
HTN + proteinuria + edema
Tx for preeclampsia with severe features
hospitalize, deliver is 34+ wks, give BP meds
HELLP stands for?
hemolysis, elevated liver enzymes, low platelets
Tx for HELLP syndrome
immediate delivery
5, 6, 7 weeks on US and hCG levels
- 5weeks: gestational sac**, hcg 1500-2000
- 6weeks: fetal pole, hcg 5200
- 7 weeks: cardiac activity, hcg 17,500
when pregnant, one should see the OBGYN q4 weeks until ___wks, when one starts going every 2 weeks
28 weeks
normal amount of fetal movements felt by mom
10 movements in 2 hrs
normal NST
2 accels of 15+ bmp for 15+ seconds
valproid acid during pregnancy causes?
open spina bifida
quadruple screen for genetic anomalies in 2nd trimester
hCG, estriol, AFP, Inhibin A
normal range of fetal heart rate
110-160
when are prolonged decels seen?
while pushing
7 cardinal movements of labor
- engagement
- descent
- flexion
- internal rotation
- extension
- external rotation
- expulsion
MVUs sufficient for labor
200+ per 10mis for 2+ hrs
labor with head positioning: OA, OT, OP
- OA: normal
- OT: need to rotate head manually
- OP: longer labor and more back pain
long end of stage 1 of labor for nulliparous and multiparous women (more = prolonged labor)
- nullip: 20 hours
2. multip: 14 hours
how to treat prolonged latent phase of labor
morphine for therapeutic sleep
fetal descent rates for nullip vs multip women in active stage 1
- nullip: 1cm/hr
2. multip: 2cm/hr
when to give pitocin in active stage of labor
- <3 contractions per 10 min
2. contractions <25 mmHg
definition of retained placenta
no delivery within 30 mins of birth
erb-duschenne palsy vs klumpke palsy
- erb: C5 and C6 injury -> upper arm palsy
2. klumpke: C7 and T1 injury -> lower arm palsy
which type of twin has no risk factors and is present in 1 in 250 births worldwide
monozygotic
arterial to arterial anastomosis presentation
acardiac twin
what presentation can only deliver by cesarean
brow
Kleinhauer-Betke test
tests how much fetal blood is in mom’s blood so extra Rhogam can be given if necessary
MCA doppler
checks for fetal anemia
four prevention pathways for PTL
cervical, placenta-vascular, stress, uterine stretch
treatment for PROM
Admit -> 48hrs Ampicillin + erythro, then 5 days of Amoxil + erythro, deliver at 34 weeks
how to dx IUGR
fundal height is 3cm behind age
when does labor need to be induced by to avoid post-term pregnancy complications
42 weeks
mc cause of DIC in pregnancy
placental abruption
blood loss that qualifies as PPH in vaginal vs cesarean
- vaginal: 500cc+
2. cesarean: 1000cc+
primary vs secondary PPH
primary: within first 24hrs after labor
secondary 24hrs - 12 weeks after labor
biggest cause of PPH
uterine atony
two Abx to give for puerperal sepsis
Ampicillin + Gentamycin
ovarian vein thrombophlebitis vs deep septic pelvic thrombophlebitis
- ovarian V: appear clinically ill, can see 20% on radiography
- deep septic pelvic: dont appear ill, just have unlocalized fever unresponsive to Abx, not seen on XR
