OB Flashcards
excessive/inadequate preg weight gain?
excessive: > 1.g kg/mo
inadequate:
how much wt gain if underweight and preg?
12-18kg
how much wt gain if normal wt and preg?
11-16kg
how much wt gain if overwt and preg?
7-11 kg
how much wt gain if obese and preg?
7 kg
folic acid supplementation amts in preg?
0.4 mg/d if no hx of NTD
4 mg/d if hx
recommended supplementation in preg?
folic acid
iron
calcium
vit d and B12 if vegetarian
renal flow change in preg?
increases 25-50%
GFR change in preg?
increases to 50 and then plateaus
HR change in preg?
increases 20%
BP change in preg
decreases 10% by 34wks GA, then back to normal
stroke vol change in preg?
increases until 19wks, then plateaus
cardiac output change in preg?
rapid rise by 20% then gradual 10% rise by 28 wks
pulm changes in preg?
tidal volume increases 30-40%
minute volume increases 40%
expiratory reserve decreases
RR and VC unchanged
hematologic changes in preg?
increase in blood volume by 50% (2nd tri)
hematocrit decreases
fibrinogen increases
what prenatal testing at first visit?
CBC, Rg, type and screen
UA and cx, rubella, HBV, RPR/VDRL, gonorrhea and chlamydia, PPD, HIV, Pap
HbA1c and sickle testing if needed
genetic screening if indicated
when do triple screen?
9-14 weeks
what’s on triple screen?
PAPP-A
nuchal translucency
bHCG
when do quad screen?
15-22 weeks
what’s on quad screen?
MSAFP
estriol
HCG
inhibin A
when do anatomic screen?
18-20 weeks
when do GDM screen?
24-28 weeks
when do RhoGAM for Rh- women?
28-30 weeks
when do GBS screen?
35-40 weeks
when to repeat G/C, HIV, RPR tests in preg screening?
34-40 weeks if high risk
quad screening in Downs?
MSAFP and estriol DECREASED
inhibin and HCG INCREASED
quad screening in trisomy 18?
everything down
timing of CVS vs amniocentesis?
CVS: 10-12 weeks
amnio: 15-20 weeks
risks of CVS?
1% risk of fetal loss
limb defects if done at
risks of amniocentesis?
PROM
chorioamnionitis
fetal-maternal hemorrhage
indications for amnio?
> 35 yo at delivery
abnl quad screen
Rh-sensitized pregnancy
L:S or phosphatidylglycerol detection
when do CS for HIV+ preg?
VL > 1000
toxo ppx in preg?
spiramycin in 3rd tri
marked variability in FHR?
(> 25 bpm)
fetal hypoxia
sinusoidal variability in FHR?
serious fetal anemia
early decels mean?
head compression
late decels mean?
uteroplacental insufficiency
variable decels mean?
cord compression
how many accels in normal NST?
> 2
positive oral glucose challenge test?
> 140
–> then get 3 hr OGTT
tx HTN in preg?
no ACEi or diuretics (uterine ischemia)
–> methyldopa, labetalol, nifedipine
picket fence fever post partum?
septic pelvic thrombophlebitis
dx: BCx and CT
tx: ABx and anticoag
marker of epithelial ovarian tumor?
CA-125
marker of endodermal sinus ovarian tumor?
AFP
marker of embryonal carcinoma ovarian tumor?
AFP, hCG
marker of choriocarcinoma?
hCG
marker of dysgerminoma ovarian tumor?
hCG
marker of granulosa cell ovarian tumor?
inhibin