OB Flashcards
Which diagnosis? “Copper penny” lesions on hands/soles
Syphilis
Which diagnosis? “Strawberry Cervicitis”
Trichomonas
DEXA scan indicated at age __.
65
Most common form of inherited mental retardation
Fragile X Syndrome
Which defects? Valproic acid (4)
NTDs, cardiac defects, limb defects, facial clefts
Which defects? Androgens
Virilization of females (labial fusion)
Which defects? Fetal hydantoin syndrome (6)
IUGR, microcephaly, facial defects, digital hypoplasia, developmental delay, hirsutism
Which defects? Methotrexate (2)
skeletal defects, limb defects
Which defects? Retinoid acid (2)
NTDs, facial defects
Which defects? ACEIs/ARBs (5)
Skull defects, limb defects, renal dysgenesis/failure, oligohydramnios, pulmonary hypoplasia
NSAIDs should not be used after ___WGA
32
Which defects? Alcohol (4)
IUGR, microcephaly, midface hypoplasia, CNS damage
Which defects? Cocaine (2)
Risk of placental abruption, hypo perfusion in utero
Down Syndrome Quad Screen
High hCG, high Inhibin A, low estriol, low AFP
PAPP-A is ___ in all trisomies
decreased
Trisomy 18 Quad Screen
Low hCG, low estriol, low AFP
___ WGA when fundal height is at level of umbilicus
20
AMA = age over ___ at delivery
35
Complications of gonococcal infection during pregnancy (2)
Preterm labor, neonatal blindness
Complications of chlamydia infection during pregnancy (2)
Neonatal blindness, pneumonia
Components of biophysical profile (5)
NST, fetal movement, fetal tone, fetal breathing, AFI
Indication for umbilical artery doppler velocity
IUGR
Arrest of Active Phase
4 hours with no cervical change (6 hours if inadequate contractions)
Indications for GBS prophylaxis in GBS-unknown case (3)
Rupture membranes 18 hours, fever during labor, Preterm labor
Recurrent late decelerations are suggestive of _____.
Fetal acidemia
Which diagnosis? Fetal tachycardia with minimal variability followed by pale, lethargic neonatal with fever
Chorioamnionitis
Complications of chorioamnionitis (3)
Preterm delivery, encephalopathy, cerebral palsy
Most common cause of postpartum fever
Endometritis (polymicrobial)
Which diagnosis? severe discomfort/pain, burning pain in breasts during feeding, nipples pink/shiny/peeling
Candida
Which diagnosis? Non-erythematous fluctuant mass
galactocele
Lactation reduces maternal risk for ____ (6)
endometrial/breast/ovarian cancers, osteoporosis, diabetes, weight retention
Contraindications to lactation
Infant classic galactosemia; Maternal HIV, HSV, TB, or specific substance/medication (ab)use
____ abortion: vaginal spotting during the first half of pregnancy – cannot determine viability of pregnancy
threatened
____ abortion: abortion less than 20 weeks with cramping contractions, cervical dilation, and no passage of tissue
inevitable
____ abortion: abortion less than 20 weeks with cramping contractions, passage of tissue, and continued cervical dilation
Incomplete
____ abortion: abortion less than 20 weeks with cramping contractions that resolve, accompanied by passage of tissue and cervical dilation during the cramping
Complete
Management for completed abortion
Follow hCG levels until negative
Management of septic abortion (3)
Maintain BP, Abx, D&C (4 hours after abx)
When to deliver: Pre-gestational DM
38-39wks
Complications of syphilis for fetus/neonate (7)
hepatomegaly, rhinitis, skin lesions, keratitis, Hutchinson teeth, Saber shins, deafness
Complications of HSV for fetus/neonate (3)
skin infection, eye infection, encephalitis
Complications of Hepatitis C for fetus/neonate (3)
preterm delivery, cholestasis of pregnancy, GDM
Complications of Parvovirus B19 for fetus/neonate (2)
Fetal anemia, hydrops
Complications of CMV for fetus/neonate (6)
Microcephaly, periventricular calcifications, deafness, chorioretinitis/blindness, seizures, pneumonia
Complications of Rubella for fetus/neonate (4)
Cataracts, deafness, cardiac defects, thrombocytopenia purpura
Complications of Toxoplasmosis for fetus/neonate?
Hydrocephalus, intracranial calcifications, chorioretinitis/blindness
Most common perinatal infection worldwide
CMV
Complications of Bacterial Vaginosis for fetus/neonate
Preterm labor
Which diagnosis? Sudden dyspnea/hypoxia, hypotension (cardiogenic shock, coagulopathy (DIC); progresses to cardiac failure
Amniotic fluid embolism
Thyroid medication C/I in 1st trimester
Methimazole (fetal scalp defects, aplasia)
Thyroid medication with higher risk of hepatotoxicity
PTU
Which diagnosis? Yellow or yellow-brown solid ovarian mass consisting of large cells that may cause fetal virilization; typically regress after pregnancy
Luteoma
Which diagnosis? Intensely pruritic disease with erythematous patches and development of vesicles and bullae; more prominent on limbs than trunk
Herpes gestationis
Which diagnosis? Severe pruritis typically more on extremities than trunk, including involvement of palms/soles
ICP
When to deliver: Chronic HTN
38-39 WGA
When to deliver: Gestational HTN
Term (37 WGA)
Pre-eclampsia diagnostic criteria: Plt
Less than 100
Pre-eclampsia diagnostic criteria: Proteinuria per day
Greater than 300mg
Pre-eclampsia diagnostic criteria: Urine prot/cr ratio
Greater than 0.3
Pre-eclampsia diagnostic criteria: LFTs
2x nl
Pre-eclampsia diagnostic criteria: Renal insufficiency
Cr greater than 1.1
Pre-eclampsia diagnostic criteria: Alternative severe clinical features (3)
Pulmonary edema, visual disturbances, cerebral disturbances
C/I to expectant management for pre-eclampsia (7)
Oliguria, non-reassuring FHT, eclampsia, visual disturbances, thrombocytopenia, elevated liver enzymes, ability to control BP
Pre-eclampsia delivery before 34 WGA
Mag sulfate, corticosteroids, delivery in 48 hours
Pre-eclampsia delivery after 34 WGA
Mag sulfate and deliver
Which diagnosis? Malaise, anorexia, nausea, persistent vomiting, epigastric/RUQ late in pregnancy
HELLP
Diagnostic procedure for fetal anemia
Middle cerebral artery peak systolic flow
Definition of Prolonged latent phase
14 hours (multips) / 20 hours (nullips)
When to Deliver: placenta accreta
34-35 WGA
Preterm Labor Management (4)
Tocolytics, Steroids (before 34WGA), Ampicillin (GBS prophylaxis), Magnesium sulfate (before 32WGA)
Intra-amniotic infections demonstrate ____ IL-6 and ___ glucose.
increased; decreased
Magnesium sulfate should be given for deliveries prior to ___ WGA.
32
Greatest risk factor for endometritis
C-Section
Endometritis: fever most common on post-op day __
2
C-Section surgical site infection: fever most common on post-op day __
4
Which diagnosis? postpartum fevers refractory to abx
Septic Pelvic Thrombophlebitis (Tx w/anticoagulation)
Most common cause of fever on 1st postpartum day
Lungs
When to deliver: post-term if cervix is favorable
Induction at 41 WGA
Umbilical artery doppler showing increased systolic to diastolic ratio is suggestive of ____
IUGR
When to deliver: IUGR with reverse end-diastolic flow
Before 32 WGA
______: maternal thighs sharply flexed against maternal abdomen, which straightens the sacrum with the lumbar spine and rotates the pubic symphysis anteriorly
McRoberts Maneuver