OB Flashcards
What titers should you check on an initial prenatal visit?
Rubella
Hep C in high risk patients
What labratory test can you order to determine the likelyhood of premature labor?
In a patient who presents with preterm contractions you can order fetal fibronectan if the patient is between 24-33 weeks gestation and has <3 cm dilation
What is the significance of late decelerations in fetal heart rate?
Late decelerations in the fetal heart rate (occuring after the contraction are significant for placental insufficiency and is a sign of fetal compromise.
What are the components of a biophysical profile?
a BPP consists of the following:
Fetal Movement (>3 discrete movements)
Fetal Tone (extension of a limb and returning it to flexion- opening hands)
Breathing movements (at least on episode lasting 30 seconds)
amniotic fluid volume (a vertial pocket >2 cm)
Each category is worth 2 points if present, 0 if absent.
Normal BPP 8-10
What is the diagnostic criteria for preeclampsia?
Preeclampsia =
new onset HTN (>140/90) plus proteinuria or elevated urine protein: creatanine ratio (>0.3) occurring at >20 wks gestation
or
new onset HTN with
low platelet count, serum creatinine >1.1
liver transaminases >2x upper limit of normal
pulmoinary edema
cerebral or visual symptoms
What is a feared sequela of UTIs in pregnant women?
UTIs, even in asymptomatic patients, can cause preterm birth in pregnant women.
What is the treatment for a UTI in pregnant women?
Treat all UTIs in pregnant with fosfomycin, ampicilin, or nitrofurantoin.
Fosfomycin, however, requires a single dose and is the shortest course of treatment
What is the first diagnostic step for a patient who presents with 3rd trimester bleeding?
The first diagnostic step in a patient with third trimester bleeding
is an US
*any woman who presents with bleeding >20 weeks should be evaluated for placenta previa by ultrasound
What is the viral load cut off for a ceasarian delivery in an HIV positive woman?
a patient should have a c-section if the viral load is >1000
what is the definition of preeclampsia without severe features?
Preeclampsia without severe features is
hypertension + proteinuria
Treatment of preeclampsia without severe features is the induction of labor if the patient is >37 weeks
What do you do if you can’t see the strings for an IUD?
do an US to assess for the location of the IUD
what are possible complications of pre-eclampsia?
pre-eclampsia can lead to placental insuffiency which can lead to oligohydraminos
What is the treatment for postpartum endometritis?
Postpartum endometritis = postpartum fever + fundal tenderness
clindamycin + gentamycin
Look for risk factors like prolonged labor, c-section, prolonged rupture of membranes or maternal diabetes
birth injury
presents with a bump
does not cross suture lines
cephalohematoma
complications of cephalohematoma include:
skull fracture, anemia, and hyperbilirubinemia
birth injury
scalp swelling that is boggy
swelling crosses the suture lines
caput succedaneum
