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RCPSC > Gen Obs > Flashcards

Gen Obs Flashcards

1
Q

antihypertensives to be replaced for women planning pregnancy

A

ACEI or ARBs

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2
Q

PET screening at 11-14 weeks

A

Combination of
1. clinical risk markers
2. uterine artery PI
3. PlGF

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3
Q

when to start aspirin for PET prevention

A

preferably before 16 weeks;
till 36 weeks

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4
Q

calcium recommendation for PET prevention

A

500mg/d

if low dietary intake of calcium (ie <900mg/day)

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5
Q

when to initiate anti-HTN

A

140/90 or more

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6
Q

target DBP for pregnant women on meds with chronic HTN or PIH

A

85mmHG

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7
Q

when should PLT transfusion be considered for NVD and for CS

A

<20 x10^9 for vaginal delivery
or
<50 x10^9 for c/s,

or at any time if there is:
- excessive active bleeding
- known PLT dysfunction
- rapidly falling PLT count
- coagulopathy

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8
Q

Timing of delivery for chronic HTN

A

Initiation of delivery offered at 38-39+6

Advised from 40+0

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9
Q

timing of delivery for PIH

A

Initiation of delivery offered at 38-39+6

Advised from 40+0

HOWEVER, for women who are already at 37+0 and present with PIH, delivery should be discussed

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10
Q

timing of delivery for PET

A

Discuss initiation of delivery at 34-35+6.

Consider initiation delivery at 36-36+6

Recommend delivery at 37+0 or later

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11
Q

first line antiHTN for breastfeeding women

A
  • labetalol
  • methyldopa
  • nifedipine
  • enalapril or captopril
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12
Q

definition of hypertension (office based)

A

≥140 mm and/or ≥90 mm Hg,
based on the average of at least 2 measurements,
taken after 5 minutes’ rest, at least 15 minutes apart,
using the same arm

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13
Q

definition of HTN on home monitoring

A

> 135/85

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14
Q

thresholds for severe HTN and management

A

> 160/110:
admit to hospital and keep CTG on until BP stable

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15
Q

proteinuria values

A
  1. PCR >40mg/mmol urinary PCR on random spot test
  2. ACR >8mg/mmol
  3. 24h urine collection >0.3g/day
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16
Q

maternal surveillance for PIH

A
  1. test for PET to rule it out on diagnosis
  2. proteinuria testing at each subsequent antenatal visit
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17
Q

fetal surveillance for PIH

A

At diagnosis
1) angiogenic marker
2) USS (growth, LV, UA doppler)

Followup
1) repeat USS monthly

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18
Q

maternal surveillance for PET

A

at diagnosis
1. comprehensive testing for PET
- O2 sat
- PLT
- Serum creat
- AST or ALT

followup
2. maternal testing twice weekly

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19
Q

fetal surveillance for PET, or superimposed on chronic HTN

A

At diagnosis
1. angiogenic markers
2. USS

Followup
1. USS every 2 weeks for growth
2. USS at least once every 2 weeks for LV and UA doppler

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20
Q

definition of PET

A

gestation HTN with new-onset proteinuria, or one/more adverse conditions

(maternal end organ complication or evidence of uteroplacental dysfunction)

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21
Q

Adverse PET conditions/end organ dysfunction CNS

A

severe headache/visual symptoms

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22
Q

Adverse PET conditions/end organ dysfunction Cardio/resp

A
  • chest pain/dyspnea
  • O2 <97%
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23
Q

Adverse PET conditions/end organ dysfunction: Fetal

A
  • Atypical/abnormal NST/CTG
  • IUGR
  • oligohydramnios
  • AREDF on UA doppler
  • angiogenic imbalance

(soluble fms-like tyrosine kinase-1:placental growth factor ratio of >85 by the Roche assay)

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24
Q

deliver regardless of gestational age for PET - CNS

A
  • eclampsia
  • PRES
  • cortical blindness or retinal detachment
  • GCS <13;
  • Stroke, TIA or RIND (reversible ischemic neurological deficit <48h)
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25
Q

deliver regardless of gestational age for PET - Cardio/Resp

A
  • uncontrolled severe HTN over a period of 12h despite use of 3 agents
  • pulmonary edema
  • positive inotropic support
  • MI
  • O2 <90%
  • need for >50% O2 for >1h
  • intubation (other than for CS)
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26
Q

delivery regardless of gestational age for PET - hematological

A
  • PLT <50
  • transfusion of any blood product
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27
Q

Indications to deliver regardless of gestational age for PET - renal

A
  • AKI : Creat >150uM with no prior renal disease
  • new indication for dialysis
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28
Q

Indications to deliver regardless of gestational age for PET - hepatic

A
  • hepatic dysfunction : INR >2 in absence of DIC or warfarin
  • hepatic hematoma or rupture
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29
Q

deliver regardless of gestational for PET - uteroplacental dysfunction

A
  • abruption with evidence of maternal or fetal compromise
  • Absent or reversed ductus venous a-wave
  • IUFD
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30
Q

transient HTN - risk of progression to persistent HTN

A

40%

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31
Q

masked HTN - found in what % of pregnancy cases

A

30%
(vs 10% of cases outside of pregnancy)

An office BP <140/90 mm Hg, but an out-of-office BP ≥135/85 mm Hg

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32
Q

how often should maternal assessment be performed in PET

A

twice weekly

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33
Q

sensitivity of clinical risk factors for PET

A

<40%

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34
Q

high risk factors for PET (any 1)

A
  • prior PET
  • booking BMI >30
  • Chronic HTN
  • T1 or T2DM
  • CKD
  • SLE or APLS
  • ART
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35
Q

Moderate risk factors for PET (2 or more)

A

prior
- abruption
- SB
- IUGR

Maternal:
- age >40
- nulliparity
- multifetal pregnancy

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36
Q

sensitivity of combining clinical, biochemical, and sonographic risk markers for PET

A

75% for pre-term PET
47% for term PET

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37
Q

ASPRE trial: 150mg of aspirin note reduced preterm PET by ___%

A

62% (to 1.6%)
but no effect on term PET.

NB - good adherence, 80%

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38
Q

daily dose of 91mg aspirin may be less effective based on _____, in up to ___% of women

A

platelet insensivity - 40%

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39
Q

adverse effects of ASA

A
  • vaginal spotting
  • APH
  • PPH
  • post partum hematom
  • 0.06% increase in neonatal intracranial haemorrhage
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40
Q

high dose calcium supplementation should begin from ___ weeks, at ___ dose

A

from 20 weeks gestation at a dose of at least 1000mg/day
(for women with low dietary intake of <900mg)

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41
Q

calcium for prevention of PET in women with prior PET

A

500mg/day before pregnancy, and up to 20 weeks
then 1.5g/day after

need at least 80% adherence

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42
Q

physical activity for reduction of PET

A

to achieve a reduction of 25%, need at least 140 minutes per week of moderate-intensity exercise

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43
Q

stabilisation of maternal condition (PET) for transport

A
  1. BP <160/110
  2. meds given as needed
  3. pt is responsive or intubated/ventilated
  4. IV access established
  5. Foley catheter inserted
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44
Q

MGSO4 for eclampsia prophylaxis for transport

A

5g IM MgSO4 into each buttock (+/- xylocain 1% without epinephrine 2ml)

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45
Q

risk of status asthmatics in poorly controlled asthma with labetalol

A

0.5%

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46
Q

combined IV/IM admin of MgSO4: loading dose

A

4g MgSO4 IV in 100ml NS / 20 minute
+
5g IM into each buttock, every 4h

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47
Q

combined IV/IM admin of MgSO4: maintenance doses

A

5g IM into ONE buttock every 4h

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48
Q

signs of magnesium toxicity

A
  • decreased or absent reflexes
  • resp rate <12/min x 15 min
  • O2 <94% x 15min
  • low BP, low HR or arrhythmia
  • urine <30ml x 4h
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49
Q

FH monitoring with MgSO4

A

<26/40 :
IA q30min

> 26/40 :
cCTG

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50
Q

MgSO4 - when do patellar reflexes disappear

A

10meQ

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51
Q

MgSO4 - when does respiratory depression occur

A

12meq

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52
Q

antidote for MgSO4

A

calcium gluconate 10%, 1 ampule (10ml) IV over 3 minutes

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53
Q

postpartum HTN accounts for up to ___% of all HDPs

A

25%

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54
Q

Placenta previa - risk factors for an increased risk of urgent/preterm C/S

A

Patient features
- APH <29/40 or >3 episodes
- previous CS
- short cx (<3cm PP, <2cm LLP)

Placental features
- thick placenta edge (>1cm)
- presence of a marginal sinus
- evidence of invasive placentation

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55
Q

dx of placenta prevue should be confirmed after ____wks

A

32/40

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56
Q

in women with LLP, USS should be used to confirm location prior to delivery - within last ____

A

7-14 days

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57
Q

C/S timing for PP

A
  • in presence of RF’s 36-36+6
  • in absence of RF’s 37-37+6
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58
Q

C/S timing for LLP (<=10mm)

A
  • in presence of RFs 37 to 37+6
  • in absence of RFs 38-38+6
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59
Q

LLP trial of labour recommended if

A

11-20mm from cervical os;

can be carefully selected women where placenta edge <10mm

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60
Q

incidence of PP

A

4-6/1000 pregnancies

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61
Q

RFs for PP

A
  • AMA, multiparity
  • previous c/s, PP
  • chronic HTN, DM
  • smoking, cocaine
  • multiple gestation, ART
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62
Q

TV USS for PP dx, sensitivity and specificity

A

sen 88%
spec 99%

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63
Q

likelihood of resolution of LLP if dx made in 2nd trimester

A

> 98%

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64
Q

conditions under which PP is more likely to persist

A

if overlap >20-25mm at 18-23 weeks gestation;

40% of cases persisted

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65
Q

for PP/LLP, repeat USS at 36/40 if ?

A

if USS at 32/40 shows:

  • placental edge <20mm,
  • or with overlap <20mm
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66
Q

in PP, cx length associated with increased APH and PTB

A

<3cm (79 vs 38% APH)
and C/S 69% (vs 21%)

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67
Q

in LLP, cx length associated with increased APH and PTB

A

<2cm

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68
Q

APH in presence of PP is associated with contraction in ___% of women

A

33%

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69
Q

risk of APH in LLP <10mm

A

29%

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70
Q

risk of APH in LLP 11-20mm

A

3%

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71
Q

likelihood of a vaginal delivery in LLP <10mm

A

9-38%

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72
Q

likelihood of a vaginal delivery in LLP 11-20mm

A

57-93%

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73
Q

C/S Mat request for LLP 11-20mm timing

A

39-40+6

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74
Q

high risk of vasa previa

A
  • low or velamentous cord insertion
  • bilobate or succenturiate placenta
  • PVB
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75
Q

vasa previa - timing of steroid admin

A

28-32 weeks

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76
Q

vasa previa - timing of hospitalization

A

30-32 weeks

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77
Q

reported incidence of vasa previa

A

1/1275 - 1/5000

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78
Q

incidence of vasa previa with velamentous cord insertion

A

1/50

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79
Q

incidence of vasa previa with ART/IVF

A

1/202 (LR 7.75)

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80
Q

risk factors for vasa previa

A
  • IVF
  • placenta previa (2nd trimester)
  • fetal anomalies
  • prematurity
  • APH
  • IUGR
81
Q

fetal anomalies associated with increased of vasa previa

A
  • renal tract anomalies
  • spina bifidia
  • single umbilical artery
  • exomphalos
82
Q

most frequent presentation of vasa previa

A

PVB at time of membrane rupture

83
Q

methods of diagnosis of vasa previa

A
  • USS or MRI
  • Amnioscopy or palpation (VE)
  • identification of fetal blood in vagina
84
Q

what % of placental cord insertion can be identified on USS at 18-20 weeks

A

99%

85
Q

diagnostic criteria for vasa previa on USS

A
  • linear sonolucent area over internal os
  • absent Wharton’s jelly
  • doppler waveforms
  • vessel is not displaced with maternal movement (aka not umbilical cord)
86
Q

risk factors for vasa previa present in what % of cases

A

89%

87
Q

if vasa previa Dx antenatally, timing of C/S?

A

35-36/40

88
Q

neonatal survival rates with vasa previa

A

97% AN dx,
44% intrapartum dx

89
Q

Ddx for vasa previa

A
  • chorioamniotic separation
  • normal cord loop
  • marginal placental sinus
  • varicosities of uterine veins
  • amniotic band
90
Q

associated fetal M&M with vasa previa/ruptures membranes + bleeding

A

70-100%

91
Q

associated fetal M&M (%) with vasa previa/intact membranes and bleeding

A

50-60%

92
Q

tests for detection of fetal hemoglobin

A
  • alkali denaturation tests (Apt, Ogita, Loendersloot)
  • Hb electrophoresis
  • kleihauer
93
Q

aberrant vessels might regress from the cervix in ___

A

~15% of women

therefore serial TV USS with colour doppler flow recommended

94
Q

vasa previa -what proportion of women may rupture membranes before onset of labour

A

10%

95
Q

treatment of any bacteriuria at what CFU in pregnancy

A

> = 100 000 CFU/ml

96
Q

management of women with asymptomatic GBS bacteriuria

A

Do not treat if <100 000 CFU/ml.

Do not re-screen in third trimester.

Give intrapartum IV prophylaxis.

97
Q

prevalence of asymptomatic bacteriuria in pregnancy

A

2-10% of all pregnancies

98
Q

diagnosis of asymptomatic bateriuria in NONpregnant women

A
  • 2 consecutive quantitative cultures,
  • same bacterial strain,
  • > =100 000 CFU/ml

[or] A single catheterised urine specimen with one bacterial species isolated with high CFU

99
Q

diagnosis of asymptomatic bacteriuria in pregnancy

A

1 single quantitative cultures in any trimester

100
Q

most common pathogen for bacteriuria

A

E. coli (80% of isolates)

101
Q

what proportion of pregnant women show PV/PR GBS colonization

A

6-36%

102
Q

reported incidence of GBS in high CFU quantities

A

0.4-5%

… only 60% of these will be confirmed bacteriuria by bladder tap, (vs 100% e. coli)

103
Q

maternal/perinatal risks associated with any asymptomatic bacteriuria

A

Pyelonephritis
Low birth weight
Preterm birth
Early onset GBS newborn

?chorioamnionitis

104
Q

Abx Rx for asymptomatic bacteriuria risk reduction

A

RR 0.23 for pyelonephritis,
RR 0.66 for LBW.

No significant reduction for PTB

105
Q

definition of recurrent bacteriuria

A

same strain with significant CFU cultured within 2 weeks of completing initial treatment

106
Q

definition of reinfection (UTI/bacteriuria)

A

same or different strain with significant CFU cultured more than 2 weeks after completing initial treatment

107
Q

most common bacterial infection in pregnancy

A

UTI

108
Q

GBS causes what proportion of acute pyelonephritis in pregnancy

A

10%, mainly in second trimester

109
Q

definition of chorioamnionitis

A
  1. intrapartum fever
  2. fetal tachycardia
  3. histologic inflammation of membranes
110
Q

GBS: microbiology characteristics

A

Gram + aerobic diplococci (hemolytic)

10 Types

111
Q

screening for GBS at what gestation and how

A

35-37 weeks
for all women,

swab first to vagina then to rectum (through anal sphincter)

112
Q

indications for GBS IAP

A
  1. positive swab at 35-37w
  2. infant w/ previous GBS
  3. documented GBS bacteriuria regardless of CFU in current pregnancy
  4. all PTL unless recent negative swab
  5. intrapartum fever (>38c)/chorioamnionitis
  6. PROM >18h over 37 weeks, if status unknown
113
Q

GBS: management for <37/40 PTB or PROM

A

IV GBS abx prophylaxis for minimum of 48h,
unless negative swab or NAAT within previous 5 weeks

114
Q

GBS: antenatal management if thought to have significant risk of anaphylaxis

A

request abx susceptibility on urine or swab cultures

115
Q

GBS management for >=37/40 and unknown GBS status

A

give IV GBS IAP if membranes have been ruptured for >18h

116
Q

GBS management for PROM at <37/40 with unknown or positive GBS culture

A

give IV abx prophylaxis for 48h, as well as other abx if indicated, while awaiting spontaneous or obstetrically indicated labour

117
Q

predominant cause of early onset neonatal meningitis

A

Type 3 GBS

118
Q

Most common types of GBS in infants in USA

A

Ia & b
II
III
V

(account for ~95% of cases)

119
Q

timing and mortality of early onset neonatal GBS

A

within 7 days of birth,
5-20% mortality

120
Q

complication rates for early onset neonatal GBS

A

71% bacteremia
19% pneumonia
11% meningitis

121
Q

incidence of neonatal GBS disease USA/Canada

A

0.35-0.5/1000 since adoption of universal screening

122
Q

Overall incidence of neonatal GBS infections in Canada

A

0.64/1000 live births

57% were early onset disease

123
Q

overall case fatality fatality rate from EOGBS

A

5-9%

124
Q

what proportion of infants born to colonised women develop EOGBS

A

1-2%

125
Q

GBS colonisation associated with -

A
  • young maternal age
  • sexual activity
  • tampon use
  • infrequent handwashing
  • high temperatures/humidity
126
Q

risk factors for GBS neonatal infection

A
  • birth at <37/40
  • prolonged PROM >18h;
  • intra-amniotic infection/intrapartum fever;
  • low SES;
  • low maternal levels of anti capsular antigen
127
Q

known antepartum or intrapartum predisposing RFs for GBS disease are lacking in ?

A

30-50% of women with with infants with GBS disease

128
Q

colonisation with GBS associated with which pregnancy outcomes?

A
  1. PTL & PPROM
  2. endometritis
  3. wound infection
129
Q

is GBS chemoprophylaxis before onset of labour or ROM effective?

A

No - results in 67% recurrence of GBS later in pregnancy

130
Q

epidemiological changes due to GPS IAP

A
  • 70% decline in EOGBS
  • 21% decline maternal infection
131
Q

Cochrane review of IAP: no statistically significant reduction in risk for

A
  • neonatal all cause mortality
  • mortality from GBS and non-GBS
  • late onset GBS
132
Q

Cochrane review of IAP: statistically significant reduction in risk for

A
  • incidence of both confirmed and probable EOGBS (80%)

NNT= 20-25

133
Q

GBS transport and medium

A
  • room temperature
  • non-nutritive medium (Amies or Stuart’s)

lab should culture in selective broth media

134
Q

first line recommended abx for GBS

A
  • Pen G 5 mil units IV stat,
  • then 2.5-3.0 mil q4h until delivery
135
Q

GBS abx if mild penicillin allergy

A

cefazolin 2g IV stat, then 1g IV q8h until delivery

<0.5% cross reactivity for first generation cephalosporins

136
Q

GBS abx if severe pen allergy

A
  1. clindamycin 900mg IV q8h (if isolate susceptible and no inducible resistance)
  2. vancomycin 1g IV q12h (preferred if no susceptibility available)
137
Q

criteria for pen allergy/low risk anaphylaxis

A

no
- anaphylaxis,
- angioedema,
- resp distress, or
- significant urticaria

138
Q

PPV and NPV for GBS colonisation at delivery for screening 35-37 weeks

A

PPV 69%
NPV 94%

139
Q

Sens and Spc for GBS screening swabs

A

sens 84%
spec 93%

140
Q

rapid PCR testing for GBS ideal conditions

A
  • turn around <30 mins
  • spens/spec >=90%
141
Q

rapid PCR testing for GBS pros/cons

A

PROS:
- rapid, real-time results

CONS:
- lack of susceptibility data;
- FN due to ROM;
- lack of time for culture w/broth

142
Q

sens/spec of rapid PCR for GBS

A

sens 90.7%
spec 97.6%

143
Q

risk of allergic or anaphylactic reaction to penicillins

A

4/10 000 - 100 000

144
Q

prevalence of resistance among GBS isolates for erythromycin

A

20-25%

145
Q

prevalence of resistance among GBS isolates for clindamycin

A

13-20%

146
Q

implementation of a GBS screening protocol results in what proportion of women receiving abx

A

10-25%

147
Q

GBS at term with PROM

A

immediate IOL with oxytocin rather than PGE2

148
Q

if there is a difference of greater than ____ days between GA and LMP…

A

5 days - EDD should be adjusted as per the second trimester USS

149
Q

offer membrane sweeping commencing at

A

38-41 weeks

150
Q

offer IOL for postdates at

A

41+0 to 42+0

151
Q

antenatal testing for monitoring of 41-42 week pregnancy

A

non-stress test + assessment of LV

152
Q

definition of post-term pregnancy

A

42 weeks

153
Q

proportion of births occurring at 41 weeks

A

16.3%

154
Q

SB rate among delivered at 41+

A

0.9/1000

155
Q

risks of post-term pregnancy

A
  • fetal distress
  • non-progression
  • operative delivery
  • macrosomia
  • shoulder dystocia
  • low Apgar scores
  • meconium aspiration
  • linear decline of umbilical artery PH
156
Q

what % of women originally dated at greater than 42+0 were actually less

A

68%

157
Q

ultrasound biometry in the second trimester ultrasound is accurate for dating +/- ___

A

10 days

158
Q

difference in post-dates deliveries for 1st vs. 2nd trimester dating USS

A

6.7% vs 16.3%

159
Q

ultrasound error for dating by first trimester CRL

A

+/- 5 days

160
Q

plasma concentrations of prostaglandins following S+S

A

10% of those achieved in labour

161
Q

membrane sweep most effective for

A

nulliparous women with unfavourable bishop scores

162
Q

NNT for S+S

A

8

163
Q

twin birth rate in canada

A

31.4/1000

(3% of all live births)

164
Q

accurate dating and chronicity for twins at

A

11 to 14 weeks

165
Q

frequency of growth scans for uncomplicated DCDA twins

A

q3-4 weeks, from 24-25/40

166
Q

delivery considered at what gestation for DCDA twins

A

37-38 weeks

167
Q

if second twin not cephalic at DCDA birth; what recommended

A

internal podalic version and breech extraction

168
Q

adverse maternal and perinatal outcomes for twin pregnancies

A

Antenatal
- miscarriage
- congenital anomalies
- FGR
- GDM, HTN

Peripartum
- PTL
- operative delivery
- PPH

169
Q

signs to look for in determining chorionicity

A
  1. number of placentas
  2. fetal sex discordance
  3. lambda sign
  4. t-sign
  5. thickness of inter-twin membrane
170
Q

if chorionicity cannot be determined?

A

manage as MCDA

171
Q

recommendations for dating twins

A
  • use IVF dates
  • use larger twin
172
Q

recommendations for labelling twins

A

left/right = right A, if laterally orientated

top/bottom = inferior = A, if vertically orientated

173
Q

risk of vanishing twin (spontaneous reduction)

A

20% - more common in ART pregnancies

174
Q

risk of single twin death

A

6%

175
Q

main causes for increasing twin pregnancies

A

delayed child bearing and ART

176
Q

majority of twins (80%) are orientated in which direction

A

laterally (right/left)

177
Q

vanishing twin pregnancies may be at increased risk of:

A
  • structural anomalies
  • FGR
  • Preterm birth
178
Q

single twin death associated with increased risk of

A
  • PTB

Can be delivered at term unlike MC pregnancies

179
Q

growth discordance in twins threshold

A

> =20-25%

180
Q

FGR definition for twins

A
  • EFW <3 centile in one twin
    or
  • >=2/3 of:
  1. EFW <10 centile in smaller twin
  2. EFW discordance >=25%
  3. UA PI smaller twin >95 centile
181
Q

if FGR on twins diagnosed; management:

A

1) BPP or modified BPP +/- NST
2) USS growth q 2wkly
3) BPP/NST in intervening weeks

182
Q

screening for PTL in twins

A
  1. cx length at 20/40
  2. cx length once more before 24/40
  3. subsequent assessment if additional RFs
183
Q

what proportion of twin pregnancies will reach 37/40

A

<50%

184
Q

reported vaginal delivery rate when first twin presents ceph

A

83%

185
Q

first twin presents ceph in labour in what % of pregnancies

A

80%

186
Q

risk of combined twin delivery

A

~5% of DCDA twins

187
Q

twin II EFW for consideration of NVD/IPV/breech extraction

A

> 1500g

188
Q

MOD for twin discordance

A

if smaller twin presenting, C/S should be considered, due to high likelihood of breech delivery of second twin

189
Q

risk of CS delivery for twins with IOL

A

23%
(vs 19% singletons)

190
Q

prevalence of BV in pregnancy

A

6-32%

191
Q

adverse pregnancy outcomes associated with BV

A
  1. PTB and PPROM
  2. Spont abortion
  3. Chorio and endometritis
  4. C/S wound infections

(5. Subclinical PID)

192
Q

Common microbes identified in BV

A
  • gardnerella
  • bacteroids
  • mycoplasma
  • prevotella
  • mobilicuncus
193
Q

RFs for BV

A
  • race (black)
  • smoking
  • sexual activity (frequency and partners)
  • vaginal douching
194
Q

Amsel criteria

A

3 of 4 of:

  • adherent & homogenous discharge
  • pH >4.5
  • clue cells on saline wet mount
  • amine odor/ pos whiff test
195
Q

Nugent score for BV

A

>=7/10 is dx for BV

  • intermediate = 4-6
  • normal = 0-3
196
Q

for BV, there is some evidence of support screening HIGH risk women at what GA?

A

12-16 weeks gestation

197
Q

Rx for BV in pregnancy

A

Metronidazole 500mg BD PO x 7/7

alternative, clindamycine 300mg BD x 7/7

198
Q

for BV in pregnancy, ToC required?

A

yes, at 1/12

RCPSC (17 decks)

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