OB Basics

Question 1

US vs LMP EDC?

Answer 1

After 15 wks:

1st US EGA Is ahead if LMP EGA by > range, use EDC and no F/U necessary

If 1st US EGA is behind LMP EGA by > range, recommended f/u US in 3-4 wks to confirm linear growth

Question 2

Rhophylac?

Answer 2

For Rh neg

• 28 wks
• w/in 72 hours after delivery of Rh + infant
• trauma/bleeding
• amniocentesis/CVS
• ectopic termination, TAB,SAB

Question 3

Biophysical profile of baby

Answer 3

• reactive NST
• fetal breathing
• fetal Movement
• muscle tone
• amniotic fluid (2cm by 2 cm pocket)

Question 4

Interpretation of biophysical profile

Answer 4

8-10: risk of fetal asphyxia w/in one week if no intervention is 1/1000

8: fetal asphyxia 89/1000
6: repeat test in 24 hours

0-4: 91-600/1000

Question 5

Interpretation of tracing

Answer 5

Cat. I, II, III

Question 6

Category I

Answer 6

Baseline: 110-160
Moderate variability 
Absence of any late or variable decels
\+/-Early decels 
\+/- Acela

** nml tracings which are strongly predictive of nml fetal acid base status

Question 7

Cat 2

Answer 7

Indeterminate tracings, although not predictive of abnormal fetal acid base status- require re-eval and co to her surveillance

• Baseline: tachycardia or bradycardia not accompanied by absent baseline variability
• Baseline FHR variability: minimal baseline, absent baseline variability not accompanied by -recurrent decels, marked baseline variability
• absence of induced acels after fetal stimulation
• periodic or episodic decels
  
  • recurrent variable decels accompanied by minimal or mid baseline variables
• prolonged decels > 2 mins but < 10 min
• recurrent late decels w/ mid baseline variability
• variable decels with other characteristics, such as slow return too baseline, over shoots or shoulders

Question 8

Cat 3

Answer 8

Abnormal tracings which are predictive of abnormal fetal acid base status- need prompt evaluation and initiation of attempts to resolve FHR pattern ( maternal o2, change in maternal position, discontinued labor stimulation, to if maternal hypotension, or additional efforts

• absent baseline HR variability along with:
• recurrent late decel
• recurrent variable decel
• bradycardia
• sinusoidal pattern

Question 9

Intra- uterine resuscitation

Answer 9

* O2
A
-IVF bolus
- reposition mom
-stop pitocin
-SQ TERB
-amnioinf