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OB Flashcards

(59 cards)

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1
Q

define spontaneous abortion

A

b4 20 weeks

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2
Q

fetal RF for spont abortion

A

chromosomal abornamlities MC is trisomy

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3
Q

materal RN for spont abortion

A 
-smoking**** 
STIs 
trauma 
BMI under or over 
celiac dz
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4
Q

which type of spont aortion is viable

A

threatened

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5
Q

bloody vaginal discharge
cervical os closed
POC intact

A

thereatened abortion

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6
Q

tx for threatened abortion

A

supportive—observation at home, bedrest, close follow up

serial BHCG to if

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7
Q

POC intact

cervical os dilated without passage of tissue

A

inevitable abortion

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8
Q

some POC expelled

os is dilated

A

incomplete

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9
Q

all POC expelled from uterus

os is usually closed

A

complete

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10
Q

POC intact

cervical os closed

A

missed

***fetus died before 20 weeks and POC remain intrauterine

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11
Q

medical abortion

A

mifepristone (antiprogestin) 1st

misoprostol (prostaglandin) 2nd

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12
Q

mifepristone

A

progesterone recp antagonist

-leads to dilation and softening of cervix and placental detachement

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13
Q

misopristol

A

prostaglandin E1 analog (caues uterine contractions)

-

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14
Q

three times we give RHOGAM

A
  1. at 28 weeks
  2. within 72 hours of birth
  3. after any mixing of blood– ectopic, abortion, amniocentesis etc
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15
Q

define PP hemorrhage

A 
vaginal = >500 
CS= >1000
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16
Q

etiologies for PP hem

and whih is MC

A

FOUR T’s

  1. TONE–uterine atony– MC– uterus cannot contract
  2. TISSUE–retained placental tisssue
  3. TRAUMA–to cervix, perineum or vagina, uterine rupture, lacerations
  4. THROMBIN—coag abnorm (hem A/B, von willie, ITP or DIC)
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17
Q

RF for uterine atony

A 
prolonged labo 
overdistended uterus 
CS 
anesthesia 
retained placenta
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18
Q

soft flaccid boggy uterus with dilated cervix

A

uterine atony

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19
Q

tx for PP Hem

A
  1. uterine massage and compression
  2. IV oxytocin
  3. Metagen (methylergonovine) if not HTN
  4. IM Hemobate (Carboprost tromethamine) if no asthma
  5. TXA
  6. Cytotec or misoprostol
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20
Q

define ectopic pregnnacy

A

implantation outside uterine cavity

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21
Q

locations for ectopic

-mc

A

98% FT—– ampulla

abdomen (`1.4%)

ovary and cervix (.3%)

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22
Q

strongest RF for ectopic

-others

A

previous ectopic **

others: 
PID causing salpingitis 
IUD 
previous tubual suregyre 
endometriosis 
IVF
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23
Q

abd pain, left shoulder pain, vag bleeding

A

Ectopic

***shoulder pain= Kehr sign

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24
Q

US findings for ectpic

Study These Flashcards
A

absence of gestational sac with bHCG >1500 or 2000

25
tx for ectopic
IM methotrexate --destroys trophoblastic tissue Only if beta HCG < 5,000, ectopic mass is < 3.5 cm, no fetal heart tones, hemodynamically stable, no blood disorders, no pulmonary disease, no peptic ulcer, normal renal function, normal hepatic function, compliant pt that can return for follow up RH- mom gets rhogam
26
contra for methrotexate
- currently BF - active pulm dz - allergy
27
mc cause of third trimester bleeding
placenta abruption
28
painful bright red bleeding
placental abruption
29
placental abruption
partial or complete premature separation of placenta from uterus wall -blood can be concealed within uterine cavity or external **BV in decidus basalis
30
MC RF for placental abruption
maternal HTN----chonic, pre or eclp smking prior abruption cocaine
31
sudden onset of painful third trimester vaginal bleeding | severe abd pain
abruption
32
uterus is tender rigid *hypertonic*
abruption
33
what not to do if PT has placental abruption
pelvic exam
34
painless vaginal bleeding in 3rd tri + soft nontender uterus
previa
35
painful vaginal bleeding in third tri + abd pain + firm tender utuerus
aprution
36
tx for abruption
delvery of fetus and placenta= definitive blood type corticosteroids if prematue lungs
37
RF for previa
prior cS multiple gestations multiple induced abortions adv maternal age
38
what is contraindicated to do with a previa case
vaginal exam | --can cause futehr separation
39
time pd for pre eclampsia to coccur
20 weeks gestation to 6 wks PP
40
triad for pre eclampsia
HTN + proteinuria + edema after 20 wks gestation MUST HAVE HTN AND PROTEINURIA the edema is +/-
41
BP 140/90 to 160/110 PU >300 in 24 hrs or +1 edema hands face feet
mild
42
when do we give betamethasone for lung maturtion
26-30 weeks
43
define severe preeclampsia
>160/110 PU >5 grams or +3 cerebral visual change pulm edema
44
tx for severe pre eclampsia
IV MAG | BP meds if >180/110----- methyldopa, labtealol, nifidepine----- hydralazine is apparently alternative
45
HELLP syndrome
heomlytic anemia elevated liver zynes low platetes
46
tx for eclampsia
mag for seizures delivery of fetus BP meds=hydralazine IV or labetalol give lorazepam for seixures if refractory to mag
47
total weight gain range for normal BMI
25-35 pounds
48
obese women preggo weight gain
<15 pounds
49
Naegeles rule
1st day of last menstrual period + 7 days -3 months +1 year= expectant due date
50
triple screen
AFP HCG estriol
51
quad screen
AFP estriol HCG Inhibin A
52
when is chorionic villus sampling done
10-12 weeks
53
amniocenteiss done?
15-18 weeks
54
when is 72 hour glucose test done
26-28 weeks
55
GBS done?
35-37 weeks
56
high AFP
neural tube defect ancephaly spinal bifida
57
ow afp
down syndrome
58
MCC for abnormal AFP
unknown/incorrect dats of LMP
59
trisomy 18
edwards syndrome

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