Ob-Gyn Brainscape Flashcards - uWise Abnl Obstetrics
MTX tx pre-reqs for (suspected) ectopic?
stable, not ruptured, mass <3.5 w/ FHR), nl LFTs, nl BUN/Cr, nl white count, able to f/u
define: recurrent abortion
refers to three successive spontaneous abortions
define: missed abortion
fetal demise without cervical dilatation or passage of products of conception
define: incomplete abortion
passed some, but not all, of the products of conception
When should a cerclage be placed in a woman w/ a h/o cervical insufficiency?
14 weeks GWA
Use of ACE inhibitors during pregnancy causes?
oligohydramnios, fetal growth retardation and neonatal renal failure, hypotension, pulmonary hypoplasia, joint contractures and death
Timing of glucose challenge?
patients of average risk screening is performed at 24 – 28 weeks while those at high risk (severe obesity and strong family history) screening should be done as soon as feasible.
SSRI contraindicated in preg?
paroxetine
First line imaging for suspected appendicitis in preg?
graded compression u/s
Percentage of women w/ gHTN who will go on to develop Pre-E?
25%
protein cut-offs for Pre-E and E?
> 300mg/day = mild; 5000mg/day (i.e. 5g/d) = severe
What is a therapeutic mag level for tx of pre-eclampsia?
between 4-7 mEq/L.
Contraindications to expectant mgmt for severe Pre-E remote from term?
thrombocytopenia, maxed out on 2 BP agents w/o ctrl, non-reassuring fetal surveillance, LFTs > 2X nl, eclampsia, persistent CNS sx and oliguria
HELLP stands for?
hemolysis, elevated liver enzymes & low plts
When to start anti-HTNive in preg?
pressures persistently greater than 160 systolic and 105 diastolic
Goal diastolic in anti-HTNive tx in preg?
90-100 mmHg
First line agents and dosing for HTN in preg?
hydralazine (a direct vasodilator) 5 mg IV followed by 5-10 mg doses IV at q20-min (maximum dose = 40 mg); or labetalol (combined alpha & beta antagonist) 10-20 mg IV followed by 20 mg, then 40 mg, then 80 mg IV q10-min (maximum dose = 220 mg)
Non-invasive test of fetal anemia?
Middle cerebral artery peak systolic velocity
What is the ratio of RhoGAM to # of cc’s of fetal blood neutralize?
10mcg : 1 cc
Current recommendation for RhoGAM prophylaxis?
Rh- women w/o evidence of Rh immunization is prophylactically at 28-wks (after an indirect Coombs’ test) and w/in 72hrs of: delivering an Rh+ baby, OR following spontaneous OR induced abortion, following antepartum hemorrhage and following amniocentesis or chorionic villus sampling
Test to determine amount of fetal blood that entered mother’s bloodstream s/p abruption?
Kleihauer-Betke test
What is seen in the amniotic fluid of a fetus w/ erythroblastosis fetalis?
bilirubin, can do OD test to determine [bili] and thus severity of crisis
Placentation and amniotic sacs in monozygotic twins
If division occurs on post-conception days 1-3 (pre-morula) –> monochorionic monoamniotic; days 4-8 –> monochorionic diamniotic; days 9+ dichorionic diamniotic
Placentation and amniotic sacs in dizygotic twins
Always dichorionic diamniotic