OB/GYN Flashcards
Prepubertal vaginal bleeding Ddx
Vulvovaginitis Foreign body Trauma Urethral prolapse Sexual abuse Hormone secreting tumor
Premenopausal nonpregnant women ddx
Ruptured ovarian cyst
Ovarian torsion
PID
Dysfxnal uterine bleeding
Peri-post menopausal women bleeding ddx
Endometrial CA*
Anticoagulation
Hormonal therapy
First tri bleeding ddx
Implantation
Miscarriage
Ectopic preg
2nd, 3rd tri bleeding ddx
Placenta previa
Placental abruption
Painless vaginal bleeding during pregnancy =
Placenta previa
Normal fetal HR
120 - 160 bpm
Lack of variability or HR < 120 for over 10 mins in fetal HR =
Distress
Late decelerations and sinusoidal pattern =
Distress
Placental abruption
Usually happens in 3rd tri
Uterine bleeding, pain, fetal distress
Placental abruption risk factors
HTN, trauma, polyhydramnios, smoking, cocaine.
Placental abruption tx
Tocolysis w/ mag sulfate
Stabilize mom
MIld preeclampsia
2 BP measurements > 140/90
Proteinuria >.1g/l
S/S of preeclampsia
Blurred vision, AMS, HA
Oliguria
RUQ pain
Preeclampsia tx
If >37 wks deliver
Severe preeclampsia
SBP> 160, DBP> 110
Proteinuria >5gm in 24 hrs
Severe preeclampsia tx
Admit
Mag sulfate to prevent seizures
Induce
S/S magnesium level is okay
Respirations >12/min
>100cc urine/hr
Ecclampsia
The occurance of 1 or more seizure in preeclamptic women.
Protect airway
Lower BP
Variable decels are?
Cord compression
Death in utero
In 2nd and 3rd tri
Usually CC is decreased movement
The longer the fetus is in, the higher the risk of coagulopathy
Shoulder dystocia mgmt
Distended bladder may be drained
McRoberts maneuver
SUprapubic pressure
A women with HSV-2 needs a c-section if?
Prodromal sx or active infxn
