OB-Gyne Flashcards
Weight of non-pregnant uterus
~70 grams
60 grams (williams)
Total volume if uterus at term
5L-20L
(500-1000x its capacity)
Normal (10 mL)
Weight of term uterus
1100 grams
Original shape of uterus
Pear shaped/piriform
Shape of uterus after 12 weeks
Spherical
Piriform-> globular -> spherical
How many weeks AOG will you expect the fundic height to be at the level of umbilicus
20
Dextrorotation of uterus upon ascent >12 weeks AOG is caused by
Rectosigmoid on the left side of the pelvis
Uterine blood flow near term
450-650 mL/minute
Substances that regulates uteroplacental blood flow in pregnancy
Constricts
Cathecolamines
Angiotensin 2
Dilates
Nitric oxide
Beading or crystallization is caused by what hormone
Progesterone
Ferning, observed in amniotic leaking is caused by what hormone
Estrogen
Increased vascularity of vagina resulting a violet color
Chadwick’s sign
Increased production of lactic acid from glycogen in the vaginal epitheliumby action of ____
Lactobacillus acidophilus
pH of vagina
3.5-6
Irregular brownish patches on face and neck.
Mask if pregnancy
Chloasma
“Melasma gravidarum”
Risk factors for striae gravidarum/stretch marks
Weight gain
Younger maternal age
Family history
Hormones that enhances Melanocyte stimulating hormone in pregnancy
Estrogen
Progesterone
Average weight gain during pregnancy
12.5 kg
Dilutional anemia is observed in pregnancy. The average hemoglobin level at term is ___
12.5 g/dL
Total Iron requirement for pregnacy
27 mg elemental iron per day
60-100 mg if large woman or multigestational pregnancy
Whole pregnancy breakdown: 1000 mg -300mg (fetus) -200 mg (fetus) -500 mg (rbc)
Blood loss for delivery
Singleton NSD: 500-600 mL
Twins or CS: 1000 mL
In pregnancy is a hypercoagulable state, all clotting factors increases except
XI and XIII
In supine position, this structure is compressed by the enlarged uterus
IVC
Compression of the IVC by the enlarged uterus in supine position causes what syndrome
Supine Hypotensive Syndrome (IVC syndrome)
What is responsible for hyperemesis gravidarum
Beta-hcg
Only FDA approved treatment for hyperemesis
Doxylamine + Pyridoxine
Pregnancy is diabetogenic
What is the action of the ff
HPL:
ESTROGEN/PROGESTERONE/CORTISOL:
PLACENTAL INSULINASE:
HPL: anti insulin
ESTROGEN/PROGESTERONE/CORTISOL: promites insulin resistance
PLACENTAL INSULINASE: insulin degradation
Oral hypoglycemic used in pregnancy
Glyburide
Crown Rump Length
6-12 weeks AOG
BPD, Femur length, Abdominal circumference
13 weeks
Fundic height
20 weeks
FHT
10-12 weeks
Quickening
17-18 weeks
Standard for diagnosing pregnancy
Beta-hCG
Gestational sac is visible on TVS by
5 weeks AOG
Accompanied with hcg of 1000-1500 mIU/mL
Folic acid
0.4 mg/day for all women
400 mcg/ day can prevent NTD
4mg/day if with history of NTDs
Iron
30 mg/day of elemental iron or 150 mg Iron Sulfate
Calcium
1300 mg/day if <19 yo
1000 mg/day if >19 yo
Vitamin D
400 IU/day
Vitamin B12
2ug/day
CVS change in pregnancy
⬆ HR, BP, SV, CO
⬇ PVR
Factors that crosses the placenta
IgG
TORCHES
Quad Screening
MSFAP
Inhibin A
Estriol
Beta-hCG
Elevated MSAFP >2.5 is associated with
Open NTD (anencephaly, spina bifida) Abdominal wall defects Multiple gestation Incorrect gestational dating Fetal death Placental abnormalities
Reduced MSAFP <0.5
Trisomy 21
Trisomy 18
Fetal demise
Incorrect gestational dating