OBGYN 1 Flashcards
risk factors for cervical insufficiency
LEEP procedure cone biopsy of cervix prior obstetrical trauma multiple gestation Mullerian anomalies history of preterm birth or 2nd trimester pregnancy loss
risk factors for abrupt placentae
maternal trauma chronic HTN or preeclampsia or eclampsia maternal smoking maternal cocaine use history of external cephalic version
risk factors for uterine rupture
multiparity
advanced maternal age
previous c section or myomectomies
risk factor for polyhydramnios
fetal malformations and genetic disorders
maternal DM
multiple gestastion
fetal anemia
sxs of abrupt placentae
hemorrhage
uterine tenderness
contractions
cool extremities
management of hemorrhagic shock due to abruptio placentae
fluid resuscitation with crystalloids
left lateral decubitus position
timing of giving anti-D Ig
28-32 weeks if Rh neg mom
and within 72 hrs of delivery if Rh positive infant of Rh neg mom
gold standard for evaluating cervix for possible cervical incompetence
transvaginal ultrasound
indications for tamoxifen (SERM)
ADR of tamoxifen
indications:
- prevent breast cancer
- adjuvant tx of breast cancer
ADRs:
- hot flashes
- venous thromboembolisms
- endometrial hyperplasia and ca
indications for raloxifene (SERM)
ADR of raloxifene
indications:
- prevent breast cancer
- postmenopausal osteoporosis
ADRs:
- hot flahses
- venous thromboembolism
palpable breast mass, next step in less than 30 year old vs over 30 year old
less than 30: ultrasound
over 30: mammo and ultrasound
complications of placental abruption
DIC
hypovolemic shock
hypoxia of fetus
preterm delivery
definition of large for gestational age
more than 4 kg
maternal hyperglycemia in 1st trimester affects fetus in what ways
congenital anomalies
- congenital heart defects
- NTD
- small left colon syndrome
spontaneous abortion
to confirm dx of ectopic pregnancy…
pos hCG
transvaginal ultrasound shows adnexal mass and empty uterus
process in HELLP syndrome that causes RUQ or epigastric pain
liver swelling and dissension of hepatic capsule
all women should be screened for what STDs
and what STDs should be screened for ppl with high risk
syphilis (with RPR or VDRL)
HIV
Hep B
chlamydia
gonorrhea
Hep C
normal internal female genitalia clitoromegaly high FSH/LH, low estrogen delayed puberty polycystic ovaries
aromatase deficiency
early puberty delayed menarche cafe au lait spots polyostotic fibrous dysplasia autonomous endocrine hyperfunction
McCune Albright syndrome
how to confirm intrauterine fetal demise
real time ultrasound
next step after induction of labor of intrauterine fetal demise
get autopsy of fetus and placenta to figure out why fetal demise occurred
indications for c section
breech
non reassuring fetal heart tracing
history of multiple c sections
less than 32 weeks pregnant and unfavorable cervix
when need to do corticosteroids for fetal lung maturity
under 34 weeks
cause of low back pain in 3rd trimester
lumbar lordosis
relaxation of ligaments supporting pelvic girdle
how many weeks can you start external cephalic version
37 weeks
CI to external cephalic version
hyperextended head oligohydramnios placental abnormalities fetal or uterine anomaly multiple gestations
what diabetes meds can be given to pregnant patients
insulin
metformin
glyburide
mothers with DM in second and third trimesters have babies with what complications
polycythemia
organomegaly
birth injugies like brachial plexus, clavicle, asphyxia
hypoglycemia
some supportive treatments for hyperemesis gravidarum
ginger
pyridoxine B6
definition of arrest of labor
at least 6 cm dilated with ruptured membranes and one of the following
- no cervical change for 4 hours with adequate contractions
- no cervical change for 6 hours without adequate contractions
