Ob-Gyn Brainscape Flashcards - uWise - Normal Obstetrics
What are the IOM recommendations for wt gain in pregnancy (by BMI class)?
underweight (BMI 30 kg/m2) total weight gain 11 - 20 pounds
D/o to screen for in Ashkenazi Jewish populations seeking pre-conception genetic counselling?
Fanconi anemia, Tay-Sachs disease, Cystic Fibrosis, and Niemann-Pick disease are all autosomal recessive conditions that occur at an increased incidence in Jews of Ashkenazi descent
Fetal malformations associated w/ valproate?
neural tube defects, hydrocephalus and craniofacial malformations
What aneuploidy screening has the highest detection rate?
Sequential screen: (first trimester NT and PAPP-A + second trimester quad screen)
What is the risk of fetal loss w/ CVS?
risk of fetal loss associated with CVS is approximately 1% (unrelated to prior miscarriage rate)
What is the most common form of inherited mental retardation?
Fragile-X syndrome
“wnl” cut-off for 1hr glucose challenge in preg?
???
Risk factors associated w/ GDM vs. pre-preg DM?
IUGR is typically seen in women with pre-existing diabetes and not with gestational diabetes. Shoulder dystocia, metabolic disturbances, preeclampsia, polyhydramnios and fetal macrosomia are all associated risks of gestational diabetes.
Folic acid doses for no risk vs. high risk?
0.4mg QD or 4.0mg QD
RDA of protein for preg women?
appx 70 gm/day
Recommended weight gain during pregnancy for underweight (BMI < 18) women?
28-40 lbs
Recommended weight gain during pregnancy for normoweight (BMI 18.5-24.9) women?
25-35
Recommended weight gain during pregnancy for overweight (BMI 25-29.9) women?
15-25
Recommended weight gain during pregnancy for obese (BMI > 30) women?
11-20
Is ibuprofen safe to take in pregnancy?
Yes, until 32 weeks gestation at which time the ductus arteriosus is maturing
What are labor warning signs?
ctx q5min x1hr; SROM; FM < 10/2hrs; or VB
Ob R.O.S.?
LOF? VB? FM? h/a? RUQ pain? visual changes? n/v? weight loss?
Mnemonic for interpreting fetal tracings?
V: Variable decelerations C: Cord Compression
E: Early decelerations H: Head compression/movement
A: Accelerations O: Okay-it’s a good thing!
L: Late decelerations P: Placental insufficiency
Signs of Trisomy 21
flattened nasal bridge, small size and small rotated, cup-shaped ears, sandal gap toes, hypotonia, a protruding tongue, short broad hands, Simian creases, epicanthic folds, and oblique palpebral fissures
wide-spaced nipples and lymphedema are signs of?
Turner Syndrome
Large plethoric twin
Think incr risk of polycythemia d/t twin-twin transfusion syndrome
Metabolic disturbances commonly seen in babies born to mothers w/ DM or gDM?
hypoglycemia, polycythemia, hyperbilirubinemia, hypocalcemia and respiratory distress
Initial Mgmt of baby born to HIV+ mother?
Start AZT immediately and begin testing at 24 hrs
APGAR
Appearance, Pulse, Grimmace (reflex), Activity and Respirations
Definition of PPH
EBL > 500 mL (vag) or > 1000 mL (section)
DDx for pp fever?
UTI, lower genital tract infx, wound infx, pulm infx, thrombophlebitis, and mastitis
Cut-off between PP blues and PP depression?
Two weeks
How to inhibit lactation in a woman who does not want to breastfeed PP?
breast binding, ice packs and analgesics
Usual suspect organism in mastitis in breast-feeding woman?
strep from baby’s mouth
S/Sx of candidial mastitis?
HPI: severe pain worse with feeding; P.E.: tips of nips are pink and shiny w/ periph peeling
Signs that baby is gettting enough milk?
3-4 stools in 24 hours, six wet diapers in 24 hours, weight gain and sounds of swallowing
suckling incr release of ______ which causes the breast to incr _______
oxytocin; milk letdown
ref range for progesterone in a healthy pregnancy?
> 25 ng/mL
