High Risk OB + Monitoring Flashcards
Placenta Previa
TOD
AFS
36-37.6
no recommendation
Accretta
TOD
AFS
34-35.6
individualized
Vasa Previa
TOD
AFS
34-term
individualized
Prior Classical or
Prior uterine rupture
TOD
36-term
Prior Myomectomy requiring CD
TOD
term
Polyhydramnios
TOD
AFS
39-40.6
once or twice weekly, 32-34 range
Oligohydramnios
TOD
AFS
TOD same as previa
36-37.6
once or twice weekly… start at dx
Di-Di
Di-Di with growth restoration
Di-Di + condition
TOD
AFS
AFS- complicated
38th week
36 to 37.6
individualized
NST weekly at 36 weeks
diagnosis, complicated
Mo-Di
Mo-di with growth restriction
TOD
AFS
34 to 37.6
32 to 34.6
weekly at 32 weeks
Mo-Mo
TOD
AFS
32 to 34
individualized
CHTN
No meds
With meds
Difficult to control
AFS - controlled
AFS-poor control or other conditions
38 to 39.6
37 to 39.6
36 to 37.6
weekly at 32 weeks
individualized
GHTN/Pre-eclampsia
non severe
AFS
37 weeks
Twice weekly at diagnosis
GHTN/Pre-eclampsia - severe
AFS
34 weeks or at diagnosis
Daily
HELLP syndrome
after maternal stabilization
Pre-eclampsia severe before viability
after maternal stabilization
Pregestational DM
AFS
39th week
twice weekly at 32 weeks
Pregestational DM
poor control or
with vascular compromise or
with prior still birth
before 39th week
36 to 38.6
GDM A2 well controlled
39th week
GDM: poor control
AFS
individualized
twice weekly at 32 weeks
GDM A1
AFS
39 to 40.6
no AFS recommended
HIV
Viral load > 1,000 intact membranes
Viral load <1,000 intact membranes on HRT
38 weeks
39 weeks
Cholestasis
Bile acids >100 MICRO MOLES
Bile acids < 100
AFS
36 weeks
36 to 39.0
twice weekly at diagnosis
Fetal Growth Restriction
1. Uncomplicated
2. Severe
3. Abnormal UA Doppler (increased impedance)
4. Absent UA doppler
5. Reverse UA doppler
AFS
*comanage with MFM
- 38-39.6
- 37 weeks
- 37 weeks
- 33-34.0
- 30-32.0
UAD elevated: twice weekly
UAD absent of additional comp- twice weekly. Comanage with MFM
FGR + maternal condition or olig
Wide range… 34 to 37.6
Decreased FM AFS
NST once at diagnosis
Prior stillbirth >32 weeks AFS
Prior stillbirth < 32 weeks AFS
once weekly, start at 32 weeks
individualized… start within 1 week of the IUFD
Late term AFS
NST @ 41 weeks and AFI
Prior FGR infant in prior pregnancy requiring preterm delivery AFS
NST at 32 weeks, weekly
IVF AFS
NST at 36 weekly
APS or Sickle Cell AFS
SLE
twice weekly at 32 weeks
Renal Disease Cr > 1.4 AFS
twice weekly at 32 weeks
Polysubstance abuse AFS
Etoh> 5 drinks / week AFS
individualized
NST at 36 weekly
Velamentous cord insertion AFS
SUA AFS
NST at 36 weekly
Chronic placenta abruption AFS
once or twice weekly at diagnosis
