OB Lecture- Keppler 2 Flashcards
What is a good rule to live by in pregnancy?
“If it happened before, it is more likely to happen again”
True or false: Clinical pelvimetry can accurately predict a woman’s likelihood of delivering vaginally?
B. False ← The best predictor is a trial of labor
True or false: Most tests done in pregnancy are diagnostic tests?
B. False ← Most tests are screening tests
Which of the following complications from prior pregnancies do not predict an increased risk of recurrence in the current pregnancy? A. Preeclampsia B. Gestational diabetes C. Labor dystocia D. Postpartum hemorrhage E. None of the above
E. None of the above ← I challenge you to think of a complication in pregnancy that does not increase the risk of the same complication
in future pregnancies
What are two things that are NOT normal in pregnancy?
○ Vaginal bleeding
○ Severe pain
What are three things to put on the ddx for first trimester bleeding?
○ Ectopic pregnancy
○ Spontaneous abortion (miscarriage)
○ Gestational trophoblastic disease
What are three things to put on the ddx for 2nd and 3rd trimester bleeding?
○ Preterm labor / labor
○ Placental abruption
○ Placenta previa / vasa previa
WHat amount of weight gain is normal in pregnnat women?
25-35 lbs
Is exercising when pregnant ok?
Yes! Recommend 30 min daily
Benefits: ○ Less weight gain ○ Better conditioning ○ Decreases morbidity ○ Improved sleep ○ Risk of GDM decreased?
What are three important supplements to take in pregnancy?
● Iron: 30 mg (60-120 if anemic)
● Calcium: 1200 mg
● Folate: 400 mcg
○ 4 mg if has a history of neural tube defects (NTD), or using anticonvulsants
Is sex ok in pregnancy?
● Does not increase risk to uncomplicated pregnancies
Is travel ok in pregnancy?
● No consensus on what restrictions are appropriate
● Some airlines may require MD note
● Red flag for high risk pregnancy
DVT, separation from primary provider and Zika/Covid are all risks though
Which of the following is not a common complaint of pregnant patients? A. Breast tenderness B. Dysuria C. Nausea D. GERD
B. Dysuria ← Usually suggests underlying pathology like UTI or vaginitis
True or False: Bleeding is always considered abnormal in pregnancy?
A. True ← But is actually quite common and most causes are fairly benign
For which class of drugs should you increase the Folate micronutrient supplementation in pregnancy? A. Anticholinergics B. Antihypertensives C. Anticonvulsants D. Antidepressants
C. Anticonvulsants ← Primarily to decrease risk of neural tube defects
What is the highest teratogenic risk for pregnant women?
During organogenesis (2-10 weeks)
What are some common and safe meds used in pregnancy?
○ Acetaminophen
○ Antihistamines
○ H2 blockers
○ Topical treatments like inhaled corticosteroids for asthma
○ Some BP medications - labetalol, nifedipine (other’s contraindicated)
What meds are contraindicated in pregnancy?
○ Many anticonvulsants
○ Renal medications (e.g. ACE inhibitors, ARBs, diuretics)
○ NSAIDs (premature closure of ductus arteriosis)
○ Retinoids
○ Certain antibiotics (e.g. doxycycline)
What is bad about taking opoids in pregnancy?
Do not seem to increase risk of fetal malformation. However, maternal and fetal withdrawl risk
True or False: Opiates in pregnancy increase risk of teratogenesis if given in during embryogenesis?
B. False ← Evidence does not support this
Which of the following medication classes is not generally contraindicated in pregnancy?
A. Antihistamines
B. Retinoids
C. Antihypertensives acting on the kidneys (ACE / ARB, diuretics)
D. NSAIDs
A. Antihistamines ← Used commonly for allergies, nausea
Which of the following is a risk of tobacco use in pregnancy? A. Preeclampsia B. Preterm labor C. Gestational diabetes D. Large for gestational age fetus
B. Preterm labor ← Others include miscarriage, placental abruption, SGA fetus, fetal demise
How frequent are prenatal visits recommended?
Monthly through 32 weeks after establishes care
● Then, every 2 weeks until reaches term
● Then, weekly through delivery
What post-term visits are recommended?
● If post-term, usually starting 41 weeks, may recommend twice weekly
surveillance visits until delivery
○ Most practices recommend delivery at / after 41 weeks if hasn’t labored spontaneously
True or False: The frequency of prenatal visits remains relatively constant throughout the pregnancy?
B. False ← Duh! A Softball
What routine labs are indicated at onset of pregnancy care?
Routine labs at onset of care include CBC, STI and infectious disease screening,
Rubella immune status, and blood type and antibody screen.
