OB Gen Flashcards
2 cells involved in follicular phase
Thecal and granulosa cells
Average of menstrual cycle
28 +- 7days
Responsible for ovulation and follicular rupture
LH
Formation of spinnbarkeit
Ovulation
Process where the remains of the graffian follicle becomes corpus hemorrhagicum and final matures to Corpus Luteum
Luteinization
Causes mittelschmerz
Corpus hemorrhagicum
Chemotactic activating factor for neutrophils
IL-8 is chemotact8
Day of menses that endometrium has been restored
5th day
Most important factor in the recovery of endometrium after menses
Slight increase in estrogen
Earliest histological evidence of progesterone action
Basal vacuolation
Decidual layers
Basalis, capsularis, parietalis
Zygote cytoplasm is successively cleaved to form what?
Blastula
At 32 cell stage the blastomeres form what?
Morula
Occurs when fluid secreted within the morula forms the blastocyst cavity
Blastocyst formation
Forms the yolk sac
Hypoblast
Blastocyst implants at around 7 days post conception usually where?
Posterior superior wall of uterus
Process that estalishes the 3 primary germ layers
Gastrulation
Forms the primitive ectoderm
Epiblast
Normal amniotic fluid by term
840 ml
Preferred precursor of progesterone biosynthesis by the trophoblast
Maternal plasma LDL cholesterol
Type of estrogen that is a marker of fetal well being
Estriol
Fetal period begins when?
8 weeks after fertilization or 10 weeks after onset of last menses
Commences beginning of 3rd week after ovulation and fertilization and lasts up to 8 weeks AOG
Embryonic period
By how many weeks does the uteus become an abdominal organ
12 weeks
Poor pap smear quality during pregnancy
Arias stella reactiob
Wt gain during pregnancy
211; 2 11 11, 1st, 2nd, 3rd tri ; Total-24
Only coagulation factors not increased during pregnancy
11 and 13
Change in heart rate during prenancy
Increase in heart rate by 10
Change in BP
Decrease in diastolic BP
4 periods of increased cardiac output in pregnancy
28th AOG, labor, immediately postpartum, 1st week postparum
Change in GFR during pregnancy
Increases by 50%
Positional change of appendix during pregnancy
Upward and lateral
Gums become hyperemic and soften
Epulis
Pituitay enlargement is approximately
135%
Impaires neutrophil activation during prenancy
Relaxin
HCG is detectable in maternal blood and urine how man days after ovulation?
8-9
Fetal heart beat is detected via steth at how many weeks?
16-19 weeks
Braxton hicks occurs at how many weeks
28 weeks
Spontaneous bleeding occurs with platelet of how much
20,000
Platelet is given at what number
50,009
Prenatal visits:
Every 4 until 28; then every 2 until 36; weekly thereafter
Asymptomatic bacteruria urine culture growth
> 100,000
Required iron supplementation
27-30 mg
N36
Travel is allowed up to how many weeks
Unsafe vaccinations during pregnancy
MMR polio varicella yellow fever
Management for candidiasis
Miconazole, clotrimazole, nystatin
Uterine size correlates well at what aog
20-31 weeks
Uterus is palpable at level or just above of symphysis
12 weeks
Uterus palpable midway between symphysis pubis and umbilicus
16 weeks
Uterus palpable at level of umbilicus
20 weeks
Discrepancy in fundal size
3cm
Norml fetal movement
8-10 kicks/ 2hrs
Normal NST
Reactive: 2 or more accelerations occuring within 20 minutes that peak at 15 bpm or more above baseline, each lasting 15 secs or more
Test measuring utero placental function
Contraction stress test
Normal CST
3 contractions in 10 minutes= no late decelerations: NEGATIVE
BPP: 5 components
Fetal heart acceleration, breathing, movement, tone, amniotic fluid volume
BPP of normal non asphyxiated fetus
10, 8 normal AFV
Normal AFV:
Single vertical pocket >2cms
Umbilical cord compression may cause fetal tachy/bradycardia?
Brady
Single most important indicator of an adequately oxyenated fetus
Baseline or beat to beat variability
Moderate(normal variabilty)
6-25 beats/min
Early decelerations signify
Head compression
Variable compressions signify
Umbilical cord compression
Late decelerations signify
Uteroplacental insufficiency
Most common isolated structural defects
Congental heart defects
AFP level that indicates fetal risk for neural tube defect
> 3.5
Banana sign is found in?
NTD(elongation and downward displacement of the cerebellum)
Lemon sign found in?
NTD(frontal bone scalloping)
Triple serum makers?
AFP, hCG, estriol
Triple serum marker elevated in trisomy 21
hCG
Best predictor of resorption of ectopic pregnancy
hCG level of <1000
A viable pregnancy has a hCG of
1500
Most identified risk factor for ectopic pregnancy
Previous PID
Highest relative risk factor for ectopic pregnancy
Documented tubal pathology
Most frequent sx of extopic pregnancy
Abdominal pain
Gold standard for dx of ectopic pregnancy
Laparoscopy
Single best prognostic indicator of successful tx with methotrexate jn ectopic pregnanch
Hcg <1000
Act by drawing water from proteoglycan complexes causing the complexes to dissociate and thereby allowing the cervix to soften and dilate
Laminaria digita/ japonica
Most commonly used cerclage,
Mc donald
Earliest sign of pregnancy seen woth TVS
Intradecidual sign
Anechoic sac without distinct chorionic ring(4 weeks)
Intradecidual sign
Single placental “mass”, a triangular projection of placental tissue beyond placental surfaces could be seen extending between layers of the intertwin membrane
Twin Peak Sign
Lung compliance: increase or decrease
No change
Progesterone inc sensitivity to CO2 leading to a decrease or increase in tidal volume?
Increase
Serum crea: inc or decrease
Decrease
Screening for congenital abnormalities
A baby evolving inside (AFP, B HCG, Estriol, Inhibin) - check for Down’s (arrange alphabetically and down,up,down,up)
Five cranial signs of NTDS
Small berries, vines, lemons ,bananas, mangoes(small BPD, ventriculomegaly, frontal bone scalloping-lemon sign, banana sign, effacement of custerna magnus)
BPP
My Big FAT profile is a 10 (movement, breathing, FHR, AFV, Tone) 10 is perfect score
TV ultrasonographic cervical finding that correlates with preterm delivery
Funneling
Diaphragm rises by
4cm
Fetal head is partially flexed with anterior fontanel or bregma presenting
Sinciput
Demonstrates adequacy of pelvic inlet
Engagement (u get engaged when u are adequate)
DOC for pregnant women with chlamydia
Erythromycin
Tobacco pouch apperance
Endometrial TB