OB Lecture 1- Keppler Flashcards
In a woman of childbearing age with new onset amenorrhea, what should you do?
Check a urine pregnancy test
What is the GS to confirm EDD (estimated due date)?
U/S
What should you measure on U/S to confirm estimated due date?
○ Crown Rump Length (CRL): 6-12 weeks
○ Biparietal Diameter (diameter of the head)(BPD): 13-20 weeks
How do you calculate gestational age?
well, term is 40 weeks and so you count from the time elapsed since the LMP
Why is the embryo (first 2-10 weeks) extremely important?
This is when organogenesis happens
-Important for considering teratogenesis of toxin exposure
True or false: The further a pregnancy progressed, ultrasound becomes more accurate in predicting the due date?
F- An early ultrasound provides the most accurate estimate of due date. Ultrasound is less accurate as the pregnancy
progresses and in the 3rd trimester has a 3 week margin of error.
What is Naegle’s Rule?
LMP + 7 days, - 3 months, + 1 year
A patient’s last menstrual period was November 18, 2019. Using Naegle’s rule, what was her due date?
August 25, 2020
Naegle’s Rule: LMP + 7 days, - 3 months, + 1 year
Toxin exposure in the fetal period poses less risk of congenital malformations because?
The fetal organs have already formed,
for the most part
Organogenesis happens in the embryonic period.
What is the fetal period?
Fetus: 11-40+ weeks
○ Things get bigger
○ Lung development
○ Brain development
What does Gx = P a b c d mean?
G-gravita (TOTAL # of pergnancies) T-term P-preterm A-abortions L-living
An abortion is considered how many weeks?
<20 weeks
What is the neonate period?
Birth-28 days
What is the infant period?
Birth - 365 days
What is the perinatal period?
28 weeks GA - 7 days postpartum
What is the perterm period?
20 weeks GA - 36 6/7 weeks GA
What is the postterm period?
> 42 weeks GA
Which of the following represents the neonatal period? Perinatal period?
A. Onset of labor to delivery
B. 28 weeks gestation to one week postpartum
C. Delivery to 24 hours of life
D. Delivery to 28 days of life
B. 28 weeks gestation to one week postpartum
D. Delivery to 28 days of life
What happens to the CO, SV and HR in during maternity?
They all increase
What happens to the peripheral vascular resistance and BP during maternity?
All decrease
T/F: there is an increase in clotting factors during pregnancy?
True- Increase in clotting factors: fibrinogen, VIII
Assuming the normal volume of blood in a non-pregnant adult female is 4 liters, how much blood loss would she need during a postpartum hemorrhage to lose half her blood volume? A. 1.5 liters B. 2 liters C. 3 liters D. 1 liter
C. 3 liters ← Volume increases 50%, so 4 x 1.5 = 6 liters. Half of this is 3 liters.
Blood volume increases by ______% during maternity
50
A pregnant patient presents at 23 weeks with acute right flank pain. An abdominal ultrasound shows moderate right hydronephrosis. Is this diagnostic of kidney stones?
A. Yes
B. No
C. Maybe
C. Maybe
She may or may not have a stone. Mild to moderate hydronephrosis is common in pregnancy so diagnosing a renal stone is challenging. A CT would be a better study, however this is generally avoided if possible to prevent ionizing radiation to the fetus.
T/F: Ultrasound becomes less accurate as the pregnancy progresses.
T
An early ultrasound measurement of CRL helps establish the EDC within ____
days.
5-7
The EDC is calculated as _____ weeks after LMP?
40
How is G4P3004 possible?
Somebody had twins!
Which increases VTE risk more: BCPs or pregnancy?
Pregnancy (8x vs 3x)
T/F: Ultrasound is more accurate at predicting the EDC as the pregnancy
progresses?
False - it’s the opposite
