OB Flashcards
Mesonephric/ Wolffiab duct derivative in female
Gartners duct
Gubernaculum of female
Round ligament
Oocyte transforming growth factors
GDF9
BMP-15
Most potent estrogen
17B Estradiol
Gestational sac completely fills uterine cavity
14-16 weeks
B-HCG max levels during?
8-10 weeks
B-HCG nadir?
16 weeks
hPL detected as early as?
3 weeks
hPL rise until?
34-36 weeks
hPL functions
Maternal lipolysis
Anti insulin/diabetogenic
Angiogenic
Progesterone by corpus luteum
Til 6-7 weeks
Progesterone by placenta
8 weeks
Estriol by 2nd trim
Placental Syncytiotrophoblast
Estrogen by week 1-6 of gestation
Estradiol
Marker of fetal well being
Estriol
Testes descend by?
32
Greatest transverse diameter if head
Bitemporal diameter (8cm)
Biparietal diameter
9.5cm
Occipitofrontal diameter
11.5cm
Greatest circumference- 34.5cm
Suboccipitobregmatic
9.5cm
Smallest circumference
Suboccipitobregmatic 32cm
Paramesonephric ducts in male and female
Male: appendix of testes
Female: FT, Uterus, Cervix, upper 1/3 vagina
Landmark of Pudendal Nerve
Ischial spine
Promotes PG F2a by cervical stretching
Ferguson reflex
Occipitomental diameter
12.5cm
Brow presentation
Mgt?
Expectant mgt
Forceps for molded head
Simpson
Forceps for face presentation
Kielland
When to do elective CS for placenta previa
> 37 weeks
Anesthesia for forceps delivery
Pudendal
When to do elective CS for suspected accreta
> 36 weeks
Define polyhydramnios
AFI >24cm
Single pocket >/= 8cm
>2000ml
Define oligohydramnios
AF
Forceps for rounded head
Tucker Mclane
Forceps for aftercoming head in breech
Piper
Forceps for outlet and low forceps
Simpson
Small accessory lobe of placenta?
At risk for?
Succentriate lobe
Vasa previa
Nearly all membranes covered with villi
Placenta membranacea
Central portion of placenta disc missing
Placenta fenestrata
Fibrin and old hemorrhage in between placenta and amniochorion
Circummarginate placenta
Peripheral chorion is thick and grey white with double fold of chorion and amnion
Circumvallate placenta
Umbilical cord length
40-70cm
Umbilical cord insertion:
Anchors at placenta, more common
Marginal or Battledore placenta
Umbilical cord insertion:
Vessels spread within the membranes at distance from the margin
Velamentous
Mgt of vasa previa
CS
Umbilical cord insertion:
Central insertion but vessels lose their Wharton Jelly
Furcate
Fundic height measured when?
20-34 weeks
Williams
Puerperium
4-6 weeks postpartum
Uterus descent to true pelvis
2nd week postpartum
300grams
Uterus to prepregnancy size
4th week postpartum
100grams
Lochia serosa
Day??
3-4days postpartum
Lochia alba
Days??
10th day postpartum
Retardation of involution of uterus
Subinvolution/ uterine atony
Subinvolution mgt?
Methyelrgonovine
Antibiotics if with metritis
Extrusion of placental site
6 weeks
Return to normal of dilated ureters
2-8 weeks
Blood volume return to prepregnant levels
1 week postpartum
Prepregnancy weight achieved by?
6 months
Rooming in and breastfeeding law
RA 7600
Fundic height measured when?
20-34 weeks
Williams
Puerperium
4-6 weeks postpartum
Uterus descent to true pelvis
2nd week postpartum
300grams
Uterus to prepregnancy size
4th week postpartum
100grams
Lochia serosa
Day??
3-4days postpartum
Lochia alba
Days??
10th day postpartum
Retardation of involution of uterus
Subinvolution/ uterine atony
Subinvolution mgt?
Methyelrgonovine
Antibiotics if with metritis
Extrusion of placental site
6 weeks
Return to normal of dilated ureters
2-8 weeks
Blood volume return to prepregnant levels
1 week postpartum
Prepregnancy weight achieved by?
6 months
Rooming in and breastfeeding law
RA 7600
Fundic height measured when?
20-34 weeks
Williams
Puerperium
4-6 weeks postpartum
Uterus descent to true pelvis
2nd week postpartum
300grams
Uterus to prepregnancy size
4th week postpartum
100grams
Lochia serosa
Day??
3-4days postpartum
Lochia alba
Days??
10th day postpartum
Retardation of involution of uterus
Subinvolution/ uterine atony
Subinvolution mgt?
Methyelrgonovine
Antibiotics if with metritis
Extrusion of placental site
6 weeks
Return to normal of dilated ureters
2-8 weeks
Blood volume return to prepregnant levels
1 week postpartum
Prepregnancy weight achieved by?
6 months
Rooming in and breastfeeding law
RA 7600
CBC during prenatal consult?
First visit
24-28 weeks
OGTT during prenatal consult?
Depends.
Immediately after positive test.
If negative for insulin resistance, on 24-28th week
Gonococcal or chlamydia culture?
29-41 weeks
CBC during prenatal consult?
First visit
24-28 weeks
OGTT during prenatal consult?
Depends.
Immediately after positive test.
If negative for insulin resistance, on 24-28th week
Gonococcal or chlamydia culture?
29-41 weeks
CBC during prenatal consult?
First visit
24-28 weeks
OGTT during prenatal consult?
Depends.
Immediately after positive test.
If negative for insulin resistance, on 24-28th week
Gonococcal or chlamydia culture?
29-41 weeks
CBC during prenatal consult?
First visit
24-28 weeks
OGTT during prenatal consult?
Depends.
Immediately after positive test.
If negative for insulin resistance, on 24-28th week
Gonococcal or chlamydia culture?
29-41 weeks
What drug should be avoided in diabetics during labor
Beta agonist
Can cause sever insukin resistance and glucose intolerance
Dx of hypothyroidism in pregnancy
TSH >10mIU/L
Tx of hypothy
Levithyroxine
Regardless of FT4
Complications with subclinical hypothy
Miscarriage
Placental abruption
Preterm delivery
Dec IQ at age 7-8
Comolications of TPO+
Spontaneous miscarriage
Recurrent miscarriage
Preterm delivery
Dx of hyperthyroidism
TSH
Hyperthyroidsm tx 1st trim
PTU
Hyperthyroidism tx after first trimester
Methimazole
Sertoli cells develop
6-7 weeks
Leydig cell formation
8-9 weeks
Testosterone established
9 weeks
Primordial follicle seen
11-12 weeks
Primordial follicle max devt
20-25 weeks
External genitalia comes from?
Anlagen
Abortion:
Bleeding
Closed os
Threatened ab
Highest risk for ectopic pregnancy
Tubal corrective surgery
Epithelial layer absent in FT
Submucosa
Signs and symptoms of ectopic pregnancy
Pain
Amenorrhea with some vaginal spotting
Pelvic tenderness
BHCG for ectopic pregnancy
> 1500
Indication for methotrexate use in ectopic pregnancy
MC cause of PPH
Uterine atony
Alternative drug in PPH if patient is refractory to oxytocib
Carboptost IM
Definitive tx for uterine rupture
Abdominal delivery
Most important risk factor for puerperal infection
Route of delivery
Gold std for pelvic infections post CS
Clindamycin+Gentamicin
Single most powerful predictor of preterm birth
TVS at 22-25 weeks
Cervix shortening
Antidote for MgSO4 toxicity
Calcium gluconate
Anti hypertensive with tocolytic effects DOC
Nifedipine
DOC during preterm labor
Ampicillin and Gentamicin
Corticosteroids to be given during what time?
24-34 weeks AOG
Risk factor for HTN
primiparity
Mode of delivery in severe pre ec at
34 week
Vaginal delivery
CS
Therapeutic level of MgSO4
4-7 mEq/L
MgSO4 levels
Patellar reflex disappears?
Respiratory depression?
Cardiac arrest?
Patellar reflex disappears 8-10
Respiratory depression 12-15
Cardiac arrest 24
Anti HTN DOC
Hydralazine
DOC for chronic hypertension
methyldopa
SE of hydralazine
Neonatal thrombocytopenia
Timing of delivery of eclampsia
34 weeks
Anesthesia type in preggy with asthma
Epidural anesthesia
Heart disease in congenital rubella
PDA
Pulmonary artery stenosis
Time when VarIG is to be given to babies
Mothers w/ varicella 5 days before and two days after delivery
MC perinatal infection
CMV
First line for GBS prophylaxis
Penicillin G
Neonatal tx for GBS
Ampicillin
Malaria prophylaxis in pregnancy
Chloroquine
Only prophylaxis for chloroquine resistant p falciparum
Mefloquine
Triple ARV therapy in HIV
Tenofovir, efavirenz, lamivudine
