OB/GYN pretest Flashcards
rate of twins?
1/250
results of 2 vessel cord?
<1% singleton 2.5% of SAB increased in diabetic moms
t/f: hydropnephrosis/ hydroureter is benign in pregnancy?
true. gravid uterus compresses structures, progesterone relaxes things
how is glucose filtration affected during pregnancy?
GFR is increased, and glucose filtration is decreased
whats a succenturiate placenta?
accessory lobe located away from the main placenta –> can give way to PPH
whats a fenestrated placenta?
middle is missing
define: OB conjugate
shortest distance between promontory of sacrum and symphysis pubis ~10.5 cm
types of pelvic shapes
what is meant by “mentum transverse”
chin is presenting part
what does a saltatory pattern on fetal heart tracing represent?
brief acute hypoxia that is seen in second phase of labor
- characterized by increased variability
- be wary of progression to acidosis
who can attempt TOLAC?
pt with history of low transverse
diagnostic tests that arereassuring for fetal lung status?
1) + phosphatydal glyercol in amniotic fluid
2) ratio > 2/1 of L/s in blood
increased systolic:diastolic cord doppler can signs of….
IUGR
preE
progesterone value that indicates a viable fetus?
a non viable fetus?
<5ng/ml vs >25ng/ml
nl weight gain ranges during pregnancy?
normal weight= 25-35 lbs
underweight= 40
obese= 15
basic phys of LE in pregnancy
increase venous pressure due to compression of IVC + decreased plasma osmolality due to dilutional affect
what are indications to proceed with NSVD with breech presentation? what about “stargazer?
frank breech
flexed head
nl fluid
weight between 2500-3800
“stargazer= extended neck= CS!!
signs of fetal metabolic acidosis
tachy
0 variability
lates
***signs for emergent section
what is the appropriate amount of fetal kicks?
~10/2hr
treatment for any imbedded placenta (acc-per)
hyst
when do you see ACUTE polyhydramnios?
before 28 weeks, with preterm labor
what are complications of polyhydramnios
placental abruption
uterine dysfuntion
PPH
indications for cerclage?
hx of >3 2nd/3rd tri losses or hx of preterm deliveries
***cervical length < 25 mm is sketchy
when is indomethacid contraindicated?
after 34 weeks
-oligohydramnios –> can decrease fetal urine
whats a vasa previa? what are the consequences?
when fetal vessels overlie the os due to valementous cord insertion
can cause rapid exsanguination of fetus (baby doesn’t have a lot of blood to loose to begin with)
post delivery risks for IUGR babies?
hypoxia at birth due to placental insufficiency
multiorgan thrombosis due to polycythemia as comp for hypoxia
whats the anti-D titer indicative of fetal hemolytic dz?
1:16
order of major congenital malformations in patients with preexisting DM?
CARDIAC >> msk > nervous system
whats the one diabetic seq that WORSENS in pregnancy?
proliferative neuropathy
how is hyperthyroidism treated in pregnancy? effects to baby?
treated with thionimides (PTU) –> crosses placenta –> babies can have goiter and hypothyroidism
how do you treat ITP in pregnant women with counts >50,000 and asymptomatic?
you dont.
best diagnostic test for suspected DVT?
compression US
stillborn with hydrops, petechiae/ purpuric lesions and hypertrophic placenta?
syphillis
**parvo does not have hypertrophic placenta or skin findings
are neonates more at risk from mom with crhonic hep B or acute hep B?
ACUTE!!
timing of GBS meningitis vs listeriosis?
GBS iswithin one week, listeria withini 3-4
montevideo units indicative of appropriate labor contractions?
200MVU, and they should have 3 contractions in 10 minutes, so each should be about 70mmHG in intensity
corneal abrasions more likely in…..
forceps over vacuum delivery
a third degree tear goes through the rectal ______ but not the rectal _______
sphincter, mucosa
how are you “supposed” to handle a prolonged latent phase
pain management so ideally they can go to sleep and wake up in the active phase
is external cephalic version appropriate in labor/after broken membranes
no, uterus is too contracted and broken membranes put at risk of cord prolapse
when do you use internal podalic version?
in the delivery of the second twin
most common uro finding in MS?
detrusor HYPERREFLEXIA
cause of fetal demise in Factor V leiden mutation?
uteroplacental artery microthrombosis build up
whats greatest risk for pre-eclamptic babies?
restricted growth
tests to do for reccurrent second tri losses?
cervical length for cervical insufficiency
hysterosalpingogram to look for uterine anomolies
nuchal trans
achondroplasia moms and risk
spinal stenosis can make an epidural difficult and c/s are common due to distorted shape of pelvis
-achondroplasia fetus’ should be by c section
most common anomalies from fetal alcohol syndrome?
cardiac and joint problems
what does cloramphenicol cause? what do sulfa drugs do?
chlor= grey baby syndrome
sulfa= kernicterus
