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OB > OB Test 2: Infection, Contraception & Infertility > Flashcards

OB Test 2: Infection, Contraception & Infertility Flashcards

0
Q

What are toxoplasmosis, where can you get it and what does it cause?

A

Protazoa, not an STI but can cross the placenta
Found in cat feces and raw meat
Cn cause fetal damage, heart defects, stillborns and abortions

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1
Q

What are TORCH infections?

A 
Toxoplasmosis
Other (hepititis) 
Rubella
Cytomegalovirus 
Herpes
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2
Q

What can rubella cause and why don’t we give it to post partum mothers

A

Still born, heart ducts, congenital cataracts

It is a viral vaccine so it can cross the placenta so teach mothers to not get pregnant within 6 months of the vaccine

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3
Q

What does cytomegalovirus cause and how can you prevent it?

A

CMV crosses the placenta and causes disability, hearing loss, hepatosplendmegaly, jaundice

Prevention through really good hand washing

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4
Q

How is herpes spread, what does it mean for birth and how can a newborn get it?

A

Virus from active lesions
Must have a C section
Can get it from amniotic fluid or vaginal birth

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5
Q

What is the transmission of HIV/AIDS?

A

Across the placenta, breastmilk and during labor or birth.

Avoid vaginal births, scalp electrodes and forceps

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6
Q

What are the transmission rates of HIV/AIDS.

A

20% of infants with c-section

1-2% with meds

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7
Q

HIV/AIDS maternal antibodies?

A

Antiviral drugs during pregnancy, don’t breastfeed

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8
Q

What is contraception? What is the difference between birth control and family planning?

A

The intentional prevention of pregnancy during sexual intercourse
Birth control are methods and devices that prevent conception
Family planning is deciding when to conceive

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9
Q

Why are pharmacological contraception methods?

A

Hope

Coitus interruptus: abstinence only good if practiced

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10
Q

Wha are the types of fertility awareness?

A

Rhythm method: relying on avoiding intercourse during fertility cycle. Not too reliable

Symptoms-based methods

  • basal body temperature: ovation temperature
  • cervical mucous: changes at ovulation to thin slippery and clear
  • sympto-thermal: combining signs of temp and mucous
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11
Q

What are barriers to conception?

A

Spermicide

  • foams, cream, film
  • nonoxynol-9 interefere with sperm movement
  • increased HIV transmission
  • timing: important, has to be placed up by cervix before sex
  • failure rate: 29%

Condoms

  • failure rate: 5%
  • barrier against STI

Diaphragm

  • barrier of rubber, cap filled with spermicide anchored by cervix, fitted by physican
  • failure rate 16%
  • kept in 6 hours after

Cervical caps

  • sized and filled with spermicide
  • left in 6 hours after.
  • failure rate 32%
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12
Q

What is the correct condom use?

A
  • pinch top to get air out so semen won’t break condom

- petrollium jelly breaks down the latex

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13
Q

What is toxic shock syndrome?

A

Comes when keep barriers in
Dont use during me station
Only keep things in for 6 hours

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14
Q

What is the action of combined estrogen-progestin contraceptives?

A

GNRH not released so interrupts menstration cycle and interferes with endometrium development

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15
Q

What are the side effects of combined estrogen-progestin contraceptives?

A

Thromboembolism, heart attack, hypertension, if smoker less then 35, stroke

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16
Q

What are the products and failure rates of combined estrogen-progestin contraceptives and what does it interfere with

A

Oral
Transdermal: every day for 3 weeks then out for 1 week
Vagina, ring: removed on fourth week

Failure rate of 8%

Interferes with lactation

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17
Q

What is the action of progesterone only contraception?

A

Inhibits ovulation and thickens cervical mucous

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18
Q

Why is the side effect of progestin-only contraception?

A 
Irregular vaginal bleeding 
No menses
Weight gain
Decreased libido
Headaches
Decreased bone density
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19
Q

What are the products and failure rate of progstin-only contraception? Does it interfere with lactation?

A

Oral mini pill: 10% fail rate
Injectable Devo-Provera: one every 3 months, failure rate 3%
Implantable-implanon: thin rod under skin and releases every 3 years

Don’t interfere with lactation

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20
Q

What is emergency contraception action and products?

A

Used within 120 hours of unprotected sex
Action: alters sperm motility and endometrium. Inhibits egg release if prior to ovulation
Products:
-“plan B” is high dose progestin only
- high doses of combined oral contraceptives

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21
Q

Intrauterine device products, years of protection. And insertion?

A

Flare rate <1%
Products:
-paragard: copper T acts as spermicide for 10 year protection
-mirena: progestin, 5 year protection

22
Q

What are the types of sterilization?

A

Tubal ligation
Vasectomy
Reversal: reanastomosis

23
Q

What is tubal ligation?

A

Clamp, cotorize, cut out a piece or apply bands
Goal is to occlude tubes, done easily in c-section or laporodomy
Fill abdomen with gas and after may have shoulder pain so give analgesic

24
Q

What is a vasectomy?

A

Out patient procedure with local anesthetic
Have to do sperm count twice
Sperm absorbed in the body
Failure rate is 0.15%

25
Q

How do you reverse sterilization?

A

Stitch tubes back together

Increase risk of ectopic pregnancy

26
Q

What is infertility? Primary and secondary?

A

The inability to conceive after 1 year of unprotected sexual intercourse

Primary: never been pregnant
Secondary: pregnant once and not again, can’t carry fetus to term

27
Q

What are the psychosocial effects of infertility?

A

Major life stressor
Attitude of health care provider
Religious considerations
Cultural considerations

28
Q

What are requirements for pregnancy?

A 
Ovulation
Sexual intercourse
Sperm placed near cervix
Viable oocyte and sperm
Prepared endometrium

Average sex from 2-3 times a week

29
Q

What are associated factors to pregnancy?

A

Abnormal reproductive system development
Abnormal hormonal control
Blockage: scarring

30
Q

How do you assess ovulation and a hormone analysis?

A

Assessment of ovulation: basal body temperature, cervical mucous change
Hormone analysis: endometrial biopsy

31
Q

How do you do tubal patency assessment?

A

Hysterosalpingograohy

Laparoscopy

32
Q

What is hysterosalpingography?

A

Inject opaque dye to see if tubes are open
Is there a problem with sperm getting to the egg
May cause referred shoulder pain

33
Q

What is laparoscopy?

A

Abdomen inflated with CO2
Post-procedural pain
Can see endometriosis

34
Q

What are female factors to fertility?

A

Congenital abnormalities

  • DES exposure
  • bicornuate uterus

Ovarian
- hormonal balance: amennorreic, dysmenorrhea indicated ovulation

35
Q

Medication for infertility?

A

Ovulation stimulants

  • Clomid: increase FSH and LH
  • repronex: pro lactation secretion
  • parlodel: interferes with prolactin.

Hormone replacement therapy
- GnRH and Progrsterone

Antibiotics

36
Q

What are tubal factors?

A

Inflammation and infection: biggest cause blockage in Fallopian tubes
Endometriosis
Treatment: Prevention, electrocotory
Prevention

37
Q

What are uterine factors?

A 
Congenital defects
Adhesions and scarring
Tumors, fibrosis, polyps
Assessment
Treatment

Scar prevents implantation

38
Q

Vaginal & cervical factors?

A

Ph < 4 in vagina
Ph > 7 at cervix
Cervical competence fall open
Isoimmunization: immunized to self

Trichinosis increases acidity
Stress, antibiotics and diabete changes bodies pH

39
Q

What is treatment?

A

Prevention
Good hygiene: maintain vaginal and cervical pH
Treat chronic cervicitis: freeze abnormal tissue, burn it away
Artificial insemination
Desensitization

40
Q

What is male infertility?

A

Sperm must be normal, motile, adequate in number and placed near cervix

41
Q

What is male infertility congenital defects?

A

Hypospadius: surgical correction

42
Q

What is male infertility and substance use?

A

Alter morphology and amount of sperm

43
Q

What is male infertility related to blockage?

A

Infections

44
Q

What are male infertility hormones?

A

Hypothalamus
Pituitary
Testicular
Adrenal

45
Q

With male infertility how do you do semun analysis?

A

2-3 times

2-5 mL of ejaculate, 50% active

46
Q

Wha is the post coital test

A

After intercourse women vaginal contents are examined to see if tbe are penetrated

47
Q

What is the treatment of male infertility?

A

Prevvention and treatment of STI

surgical repair and lifestyle changes

48
Q

What are the reproductive alternatives?

A 
IVF
GIFT
Micro manipulation
Therapeutic insemination
Surrogates
Adoption
49
Q

What is IVF?

A

In vitriol fertilization

  • ovulation is stimulated
  • graafian follicle are aspirated and placed in tissue culture and mised with sperm
  • progesterone injections to prepare endometrium
  • blastocyst transferred to uterus to implant
50
Q

What is GIFT?

A

Gamete intrafallopian tube transfer

Ovum and sperm placed in Fallopian tube to combine. Not outside body

51
Q

What is micromanipulation?

A

Intra cytoplasmic soerm injection

ICSI

52
Q

What is therapeutic insemination?

A

Husband or donor inseminated woman

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