Ob/Gyn Flashcards
Why do pregnant women get Anemia?
Due to the dilution effect: RBC rises 30%, but body volume rises 50%
What are the degrees of Vaginal Lacerations?
1st Degree: Skin
2nd Degree: Muscle
3rd Degree: Anus
4th Degree: Rectum
What is Vernix?
Cheesy baby skin. (protects the baby’s skin from the outside world and helps with passage through the birth canal)
What is Meconium?
Green baby poop (first poop)
What is Lochia?
Endometrial slough. (normal discharge and uterus after birth)
What is normal blood loss during a Vaginal Deliver?
500 mL
What is normal blood loss during a C-section?
1000 mL
How do you treat A1 Gestational DM?
Diet
How do you treat A2 Gestational DM?
Insulin
What are Identical Twins?
Eggs split into perfect halves “Monochorionic”
What are Fraternal Twins?
Multiple eggs fertilized by different sperm
What is Ovarian Hyperstimulation syndrome?
Weight gain and enlarged ovaries after clomiphene use for infertility
Who Makes the Trophoblast?
Baby
Who makes the Cytotrophoblast?
Mom production of GnRH, CRH, TRH, and Inhibin
Who makes the Syncytiotrophoblast?
Mom and baby production of HCG and HPL
When does Implantation occur?
1 week after fertilization
When is Beta HCG found in Urine?
2 weeks after fertilization
When is B-HCG found in Blood?
8-10 days after fertilization
What makes Progesterone in >10 weeks gestation?
Placenta
What is the function of B-HCG?
Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)
What makes B-HCG?
Placenta (synctiotrophoblast)
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
What is the fucntion of AFP?
Regulates intravascular volume
What is the function of HPL?
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
What is the function of Inhibin?
Inhibits FSH so there is no menstruation
What is the function of Cortisol in Pregnancy?
Decreases immune rejection of the baby out of mom and for lung maturation
What is the function Oxytocin?
Milk and baby ejection
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
When can you first detect fetal heart tones?
Week 20
When can you tell the sex of the baby by US?
Week 16
What does an AFI <5 indicate?
Oligohydramnios (Cord compression)
What does an AFI >20 indicate?
Polyhydramnios (DM)
How fast should fundal height change?
Uterus grows 1 cm/week
What is the Pool Test?
Fluid in the vagina
What is Ferning?
Estrogen crystallizes on slide. (Amniotic fluid)
What is Nitrazine?
Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
What is the risk of Amniocentesis?
Abortion (2% risk)
What is a Biophysical Profile (BPP)?
By US look for: Non-stress test AFI Fetal heart tone Fetal Activity Breathing Movement
What is a normal BPP?
> 8-10
How much weight should a woman gain during Pregnancy?
1 lb/ week
When should Intercourse be avoided during Pregnancy?
Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes
What are the Leopold Maneuvers?
To determine the position of the baby Feel the fundus Feel the baby's neck Feel the pelvic inlet Feel the baby's head
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
What is Stage III of Labor?
Delivery of the placenta
How do you monitor Baby’s Heart Rate?
Doppler or scalp electrode
How do you monitor the Uterus?
Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
What is a Vertex Presentation?
Posterior Fontanel (triangle shape) presents first (normal)
What is a Sinciput Presentation?
Anterior Fontanel (Diamond shape) presents first
What is Face Presentation?
Mentum Anterior preform forceps delivery
What is a Compound Presentation?
Arm or hand on head, vaginal delivery. (Mean’s Prolapse of fetal extremity with presenting part)
What is a Complete Breech?
Butt down, thighs, and legs flexed
What is a Frank Breech?
Butt down, thigh flexed, legs extended (Pancake)
What is a Footling Breech/Incomplete breech?
Butt down. Thigh flexed, one toe is sticking out of the cervical OS
What is a Double Footling Breech?
Two feet sticking outside the cervical OS
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?
No, they must have C-Section for all future pregnancies
Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?
Yes, 70% are okay, Potential for uterine wall rupture
What is Early Deceleration?
Normal due to head compression
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
What is Variable Deceleration?
Cord Compression
What is increased beat-to-beat variability?
Fetal Hypoxia
What is Decreased beat-to-beat variability?
Acidemia
What are the SYmptoms of Pre-eclampsia?
Headaches, changes in vision, and epigastric pain
What is Pre-Eclampsia?
Ischemia to the placenta causes HTN greater than 140/90
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
What is HELLP Syndrome?
Hepatic injury causing:
H- Hemolysis
EL- Elevated Liver Enzyme
LP- Low Platelets
What is Eclampsia?
HTN with seizures
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
What is Endometritis?
Postpartum uterine tenderness
What is an Incomplete Molar Pregnancy?
2 Sperm + 1 egg (69, XXY) mom “cooks the parts” has embryo parts
What is a complete molar pregnancy?
2 Sperm and no egg (46, XX) both are paternal, bunch of graps, dad eats grapes, no embryo
(GROSS!)