OB complications Flashcards
Suspected ectopic bHCG magic number?
1500, If lower, repeat in 2 days. If higher, TVUS should show IUP so it is bad if you can’t see baby
B hCG should double every 2 days if normal
What if bHCG goes up but not as much as you hope on subsequent measurements in suspected ectopic?
Do D&C to treat failed pregnancy or further suggest ectopic
When can you treat ectopic with methotrexate?
Stable patient
MUST FOLLOW TO zero bHCG
Tx of Inevetable abortion?
D&C or misoprostol or expectant
Missed abortion tx?
D&C misoprostol or expectant
Male baby can cause oligohydramnios by what?
Posterior urethral valves
Concern with zygotes splitting 8-12 days?
Mono mono babies can wrap each other’s cords
What is the issue with twin steal syndrome?
Monochorionic
VAcular anastomosises and they gdont share
days 4 or later sw itching
Med needed to decreases complications in PCOS?
DEFINITELY OCP b/c unopposed estrogen with nonovulation
dONT DO DIGITAL EXAM FOR BLEEDING! Duh
Do ultrasound for dx of placenta previa
Accrete usually treated how?
C section followed by hysterectomy
Bleeding after rupture of membranes suspect what?
VASA PREVIA. Dx with ultrasound
DIC can happen with abruption
makes sense
Placental abruption tx?
EMERGEMCY C SECTION
PROM is what?
premature rupture of membrane, before membranes
Water broken before contractions
Complication of PROM?
Infection
Cord prolapse
Placental abruption
Preterm labor
PROM management?
More than 34 weeks? labor induced
Less than 34 weeks: admission with steroids for fetal lung maturity
Antibiotics with gent
Expectant labor
Fetal fibronectin is what?
done to see if in labor
Why do you give mag sulfate at less than 32 weeks for preterm labor?
Neuro protection: less cerebral palsy
doubles as tocolytic
Types of tocolytic classes?
beta 2 agonists
CCB’s nifedipine
Magnesium sulfate
Indomethacin not used often
Gestational trophoblast disease associated with what lab?
Increased HCG
Complete mole is from what?
COMPLETELY dad. One sperm duplicated. So can be XX or YY
Which moles are worse? (meaning bigger, more hCG, more invasive mole, more risk of choriocarcinoma?
COMPLETE MOLES are completely worse
Preggers with hyperemesis gravidum and signs of hyperthyroidism?
Also could have early preeclampsia
Think MOLE b/c common alpha subunit
Tx of moles?
D&C
Follow hCG levels
Methotrexate fi they don’t get to zero
ask to wait at least 6 months to preggers again to make sure it is not a mole
Problems with invasive moles?
invade through uterine wall and can cause uterine rupture and hemorrhage
Choriocarcinoma mets to where?
lung
Persistent bleeding after delivery with vaginal bleeding is possibly from what?
Choriocarcionma
Pulm symptoms after pregnancy remember to consider what?
Choriocarcinoma
Suspect choriocarcinoma after preggers, how do you check?
hCG
Pelvic exam for vaginal mets
US for masses of utrine with necrosis and hemorrhage
CXR FOR METS TO LUNG
Needs chemo: methotrexate
Surgery
