OB Flashcards
Term:
37- 42 weeks
abortion date
< 20 weeks
embryo
0-8 weeks
fetus
9-40 weeks
neonate ages
0- 28 days
infant dates
0-1 year
EDD nagles rule
LMP + 7 days (minus 3 months)
gestational age
day of last menstarl period
1st trimester
0-12 weeks
2nd trimester
12-28 weeks
3 rd trimester
28 - 40 weeks
what is a darkening of the face during pregnancy
malasma
TV and O2 during prenancy
increase
Co2 during pregnancy
decrease
Q during pregnancy
increase
SVC during pregnancy
decrease
low amount of folic acid
.4 mg (average 1.0)
Beta Hcg 2X every
48 hours
the corpus lutum produces
progesterone
blue cervix
chadwick sign
softening of cervix
goodells signs
what do you want on initial visit
CBC blood type (RH) STI Hep B PAP (if they need one)
when can you hear the heart beat on US
roughly 6 weeks
genetic screen 1st trimester
US: nuchal translucenecy (T-21)
Blood: increased HcG (T-21)
2nd trimester genetic screen
- Quad screen
1. HcG
2. AFP (twins, neural tube defects)
3. Estrol
4. inhibin
what do you do if quad screen is +
amniocentesis
frequency of visits
0-28: monthly
28- 36: bi weekly
36- Birth: weekly
heart tones date and rate
10-12 weeks 120- 160
when do you do a cervical exam
37 weeks
when should you expect fetal movement
18 weeks (1st time)
how much fetal movement
5X every hour
fundal height 12 weeks 20 36
12: pubic symphasis
20: umbilicus
36 weeks: drops
what 3 labs at 26 weeks
- Diabetes
- RH
- STI
what labs at 35 weeks
- Hemoglobin
- Hct
- Strep B
1 hr glucose
50 g < 130 : normal
3 hr glucose
100g
- fasting
- 1,2, 3 hr
> 2 : abnormal
how do you treat group B strep
ampcillin
How many calories a day
350
whar fish do you want to avoid
big fish
How much caffene
< 200 mg
undercooked meat
listeria
toxoplasmosis
soft cheeses
brucelliosis
2st stage of labor
dialation to delivery
1st stage of labor
labor to dialation
3rd stage of labor
deleivery to placenta
fetal monitoring
Inc 15 beats in 15 seconds
variable deceleration
cord compression
late deceleration
fetal hypoxia
dysfunctional labor what is it and what the tx
- Hypocontractile uterus
- < 3 10 min
- Tx: pitocin (oxytocin)
what is an abortion
loss of pregnancy prior to 20 weeks
what is the MC complication in early pregnancy
abortion
what are the types of abortion
- Thretened
- Inevitable
- Incomplete
- complete
- Missed
- Septic
elective abortin medications
Day 1: mifepristone
Day 3: Misoprostol
Only if < 70 days
Surgical abortions 1st trimester
suction and curettage
surgical abortions 2nd trimester
Dialation and evacualtion
what medication for ectopic
methotrexate
4 types of gestatiional trophobastic disease
- Hydadifrom mole
- invasive mole
- placental mole
- Choriocarcinoma
sperm fertilized egg without DNA
hydadiform mole
Mole: pregnancy invade myometreum:
Invasive mole
Placental Mole:
following full term pregnancy
AUB
absent heart sounds
preeclampsia like symptoms
Gestational trophoblastic disease
snow storm on US
- Increased B HcG
Gestational trophoblastic disease
premature separation of placenta > 20 weeks
placental Abruption
painful bleeding and contractions
placental Abruption tx
C section
abnormal location of placenta
Placenta Previa
(painless vaginal bleeding > 20 weeks)
- no cervical exam they can bleed
- no sex
what is a risk factor for premature rupute of membranes
bacterial vaginosis
_ gush of yellow fluid
- Ferning
- Inc AFP
premature rupute of membranes
postpartum hemmorage values
vaginal > 500
C section > 1000
Treatment for post partum hemmorage 3
- uterine massage
- Oxytosin
- misoprostol
4
dizygotic twins are also called
faternal (lamda sign)
monozygotic twins are called
identical (T sign)
when are most twins born
premature
what us twin transfunction syndrome
1 twin takes the others blood
Cervical incompatance
< 20 mm
< 25mm no preterm deleivery
tx: cervicak cerclavge
Chronic HTN
> 140/90
pregnancy induced HTN
> 140/90 after 20 weeks
pre elamspia
> 140/ 90 after 20 weeks with protein
Elampsia
pre elampsia with seizures
- HTN
- epigastic pain
- hyperreflexia
Elampsia
complications with elampsia
Hemolysis
Elevated liver enzymes
Low Platelets
when do you treat pregnancy HTN
labatalol
nefiedipine
methaldopa
what is gestational DM
increased insulin and insulin resistance
what is the blood sugar goal for pregnancy
fasting:< 100
2 hr: < 120
when do you give rhogam
28 weeks and 72 hrs post
what are the risks to fetus with RH
anemia and hyperbilirubinemia
what is it called when the cord is compressed by the baby and how do you treat it
- cord prolapse
- C section
what are your top three reasons to do a C section
- fetal distress
- breach
- transverse lie
what is it called when the cervix fails to dialate and what is the tx
dystonia
oxytocin
what is TORCH
T:Toxoplasmosis O: Other Syphlyis R: Rubells C: CMV H: herpes
Toxoplasmosis
- corioretinitis
- hydocephalmus
- intracranial calcifications
Toxoplasmosis tx triad
pyrimetherine
sulfudiazine
folic acid
treatment for syphlyis
Pen G
- Hearingloss
- Blueberry muffin rash
Rubella
- Microcephally
- Chorioretrnitis
- intracranial calcifican
- CMV
what is the key for depression
anhedonia