OB Lecture 1- Keppler

Question 1

In a woman of childbearing age with new onset amenorrhea, what should you do?

Answer 1

Check a urine pregnancy test

Question 2

What is the GS to confirm EDD (estimated due date)?

Answer 2

U/S

Question 3

What should you measure on U/S to confirm estimated due date?

Answer 3

○ Crown Rump Length (CRL): 6-12 weeks

○ Biparietal Diameter (diameter of the head)(BPD): 13-20 weeks

Question 4

How do you calculate gestational age?

Answer 4

well, term is 40 weeks and so you count from the time elapsed since the LMP

Question 5

Why is the embryo (first 2-10 weeks) extremely important?

Answer 5

This is when organogenesis happens

-Important for considering teratogenesis of toxin exposure

Question 6

True or false: The further a pregnancy progressed, ultrasound becomes more accurate in predicting the due date?

Answer 6

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.

Question 7

What is Naegle’s Rule?

Answer 7

LMP + 7 days, - 3 months, + 1 year

Question 8

A patient’s last menstrual period was November 18, 2019. Using Naegle’s rule, what was her due date?

Answer 8

August 25, 2020

Naegle’s Rule: LMP + 7 days, - 3 months, + 1 year

Question 9

Toxin exposure in the fetal period poses less risk of congenital malformations because?

Answer 9

The fetal organs have already formed,
for the most part

Organogenesis happens in the embryonic period.

Question 10

What is the fetal period?

Answer 10

Fetus: 11-40+ weeks
○ Things get bigger
○ Lung development
○ Brain development

Question 11

What does Gx = P a b c d mean?

Answer 11

G-gravita (TOTAL # of pergnancies) 
T-term 
P-preterm
A-abortions
L-living

Question 12

An abortion is considered how many weeks?

Answer 12

<20 weeks

Question 13

What is the neonate period?

Answer 13

Birth-28 days

Question 14

What is the infant period?

Answer 14

Birth - 365 days

Question 15

What is the perinatal period?

Answer 15

28 weeks GA - 7 days postpartum

Question 16

What is the perterm period?

Answer 16

20 weeks GA - 36 6/7 weeks GA

Question 17

What is the postterm period?

Answer 17

> 42 weeks GA

Question 18

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

Answer 18

B. 28 weeks gestation to one week postpartum

D. Delivery to 28 days of life

Question 19

What happens to the CO, SV and HR in during maternity?

Answer 19

They all increase

Question 20

What happens to the peripheral vascular resistance and BP during maternity?

Answer 20

All decrease

Question 21

T/F: there is an increase in clotting factors during pregnancy?

Answer 21

True- Increase in clotting factors: fibrinogen, VIII

Question 22

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

Answer 22

C. 3 liters ← Volume increases 50%, so 4 x 1.5 = 6 liters. Half of this is 3 liters.

Question 23

Blood volume increases by ______% during maternity

Answer 23

50

Question 24

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

Answer 24

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.

Question 25

T/F: Ultrasound becomes less accurate as the pregnancy progresses.

Answer 25

T

Question 26

An early ultrasound measurement of CRL helps establish the EDC within ____
days.

Answer 26

5-7

Question 27

The EDC is calculated as _____ weeks after LMP?

Answer 27

40

Question 28

How is G4P3004 possible?

Answer 28

Somebody had twins!

Question 29

Which increases VTE risk more: BCPs or pregnancy?

Answer 29

Pregnancy (8x vs 3x)

Question 30

T/F: Ultrasound is more accurate at predicting the EDC as the pregnancy
progresses?

Answer 30

False - it’s the opposite