OB goes on Flashcards
The normal and predictable sequence of sexual maturation proceeds with
breast budding–>
adrenarche (hair growth)–>
a growth spurt–>
then menarche.
menarche is usually at age
~12
body weight of __________- pounds is needed before menses begins
85 to 106
There are two weird critical elements for secondary sexual characteristics:
sleep and optic exposure to sunlight.
______________– is characterized by premature menses before breast and pubic hair development.
McCune Albright Syndrome
______________ occur in 25-35% of females with Mullerian agenesis.
Renal anomalies
Lady who cant pee after labor w/ ab pain
epidural–> bladder not working–> urine dribble
Bladder atony- over full
Temporary and reversible
When do you give rhogam
28- 32 weeks in Rh- mom
After delivery if baby is Rh +
When cant you dilate and evacuate a baby
over 24 weeks
do a vaginal delivery instead
Compare complete vs incomplete abortion
complete: whole baby out
incomplete: bleeding, open os, some fetal parts remain
What do you call pulling a baby out by his feet
internal podalic version
Breech baby
Placenta location where you have to do a c-section
less than 2 cm from os
___________` is the most common abnormal karyotype encountered in spontaneous abortuses,
Autosomal trisomy
accounting for approximately 40-50% of cases.
The risk of developing microcephaly and severe intellectual disability is greatest between ?
eight and 15 weeks gestation.
never seen with doses even exceeding 50 rad at less than eight weeks or greater than 25 weeks gestation.
. The FVL mutation is associated with obstetric complications including ?
stillbirth, preeclampsia, placental abruption and IUGR
Ultrasound criteria for a missed abortion are
a CRL of > 7 mm with no cardiac activity
benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor.
meigs syndrome
________________- is the most common risk factor for protraction and/or arrest disorders in the first stage of labor.
Hypocontractile uterine activity
Hypocontractile uterine activity is the most common risk factor for protraction and/or arrest disorders in the ______________
first stage of labor.
Arrest of labor is diagnosed at cervical dilation ≥6 cm in a patient with ruptured membranes and
No cervical change for ≥4 hours despite adequate contractions
No cervical change for ≥6 hours with inadequate contractions
Arrest of the second stage of labor was defined as no progress (descent or rotation) for:
●Nulliparous women with an epidural: ≥4 hours
●Nulliparous women without an epidural: ≥3 hours
●Multiparous women with an epidural: ≥3 hours
●Multiparous women without an epidural: ≥2 hours
Time from onset of labor to complete cervical dilation.
First stage normal labor
Time from complete cervical dilation to fetal delivery
second stage of labor
- can also be viewed in terms of fetal rather than maternal changes, ie, changes in fetal station and descent.
Time between fetal delivery and placental delivery.
third stage of labor
For management of slow labor progression over 2 hours, in the active phase (cervix ≥6 cm), we administer
oxytocin
increase the frequency and strength of this patient’s contractions. If the patient does not have cervical change once she is having more frequent contractions on oxytocin, it would be reasonable to place an IUPC (intrauterine pressure catheter) to assess the strength of the contractions.
_____________ is typically used for cervical ripening and labor induction
Misoprostol
women with cervical dilation <6 cm are considered to be
in latent phase
cervical dilation above 6 cm = the active phase
We manage second stage arrest with ?
an operative delivery
Avoid operative delivery in the second stage as long as?
the fetus continues to descend and/or rotate to a more favorable position for vaginal delivery and the fetal heart rate pattern is not concerning.
cytotec is
misoprostol
______________ are all associated with breech presentation.
Prematurity multiple gestation genetic disorders polyhydramnios hydrocephaly anencephaly placenta previa uterine anomalies uterine fibroids
A prolonged latent phase is defined as
> 20 hours for nulliparas and >14 hours for multiparas, and may be treated with rest or augmentation of labor
not yet reached the active phase (more than 4-6? cm)
What size baby is likely to have shoulder dystocia
4500 g
Optimal position for delivery
OA
back of baby’s head against front of moms body
can you push the baby head back in
yes- its called zavenoli procedure
________________ are all associated with an increased incidence of shoulder dystocia.
Fetal macrosomia maternal obesity diabetes mellitus postterm pregnancy hx of shoulder dystocia prolonged second stage of labor
In secondary arrest of dilation, no further cervical change in the active phase for over four hours. _________ is often recommended in this situation.
Amniotomy
How does a vesicovaginal fistula present?
painless loss of urine into the vagina often after pelvic surgery
What is one situation where you cannot use OCPs
In migraine
Aside from OCPs, what can treat PMS
SSRI- daily or only in luteal phase
What symptoms are present in bladder cancer
hematuria
↑ ua frequency
urge incontinence
When can you give prenatal steroids
23-34 weeks
obstetric complication in which fetal blood vessels cross or run near the os
Vasa praevia- umbilical cord inserts into the membranes.
rare
Fresh frozen plasma contains :
fibrinogen, clotting factors V and VIII.
Cryoprecipitate contains
fibrinogen, factor VIII and von Willebrand’s factor.
Common presenting signs of an abruption include
abdominal pain, bleeding, uterine hypertonus and fetal distress.
Common Risk factors of an abruption include
Risk factors include smoking, cocaine use, chronic hypertension, trauma, prolonged premature rupture of membranes, and history of prior abruption.
Smoking increases the risk of several serious complications of pregnancy, including
placental abruption, placenta previa, fetal growth restriction, preeclampsia and infection.
Threatened abortion occurs during?
the first trimester.
