molar preg and normal peurperium and postpartum activity

Question 1

How are apgars scored?

Answer 1

5 areas: color, respirations, HR, tone, response to stim.
HR: 0 if none, 1 if 100
Respirations: 0 if none, 1 if poor, weak cry, 2 if strong cry
tone: 0 if poor, 1 if some movement, 2 if vigourous movement
response to stim: 0 if none, 1 if grimace, 2 if cry
color: 0 if blue and pale, 1 if pink torso but blue extremities, 2 if pink all over
should be 7 or more at birth and 9 or more after 5 min

Question 2

How is colostrum different from later breast milk?

Answer 2

rich in proteins, fat, and minerals. contains IgA. after 1 week milk has more water and lactulose

Question 3

When does menstruation return after birth?

Answer 3

6-8 wks if not nursing

Question 4

What are the 4 causes of post-partum hemorrhage?

Answer 4

1. uterine atony (more likley if multiple gestations, prolonged labor, chorioamonitis)
2. trauma to the cervix/birth canal
3. retained placenta
4. coagulopathy

Question 5

What is the difference btw a complete and a noncomplete mole?

Answer 5

complete: 46 XX or 46 XY completely derived from father (empty egg penetrated by sperm); no fetus
incomplete mole: 69 XXY, XXX or XYY. fertilization of egg by 2 sperm or duplication of sperm; fetal parts present.

Question 6

What are risk factors for molar pregnancy?

Answer 6

low SES, smoking, age >40 at time of pregnancy, asian heritage, hx of prior mole

Question 7

How should molar pregnancies be managed?

Answer 7

remove neoplasm with D&C; follow b-hCG for 1 yr, avoid pregnancy for 1 yr

Question 8

What are complications of molar pregnancy?

Answer 8

20% have malignant gestational trophoblastic neoplasm; 5% develop choriocarcinoma