OBGYN Flashcards
the fetus is most vulnerable to teratogens at what point in pregnancy?
3-6 week embryo (5-8 weeks post LMP)
folic acid antagonists
(e.g., valproate, carbamazepine).
criteria for anemia in pregnancy
Hb < 11 mg/dL is anemia in pregnancy
what is preterm labor
Defined as labor <37 weeks with regular contractions and cervical change
management of delivery of baby <34 weeks
i.e. very preterm
Corticosteroids – lung maturation
Tocolytic drugs – delay delivery at least 48 hours for max steroid impacts
Group B strep prophylaxis/antibiotics if (+)
Magnesium sulfate – up to 32 weeks for neuroprotection
Wait for natural labor progression unless complication arise
at what point is it indicated to induce labor and how?
Labor induction using prostaglandins (as early as 41 weeks and 6 days)
what abx are indicated for management of chorioamnionitis
Ampicillin + gentamicin
what medication is indicated for management of primary HSV infection in pregnant mother
acyclovir followed by suppressive therapy from 36 weeks onward. cesarean delivery for active lesions
risk factors for postpartum hemorrhage
hx of prior bleeds, augmented labor, chorioamnionitis, macrosomia, obesity, multiple gestation pregnancy (twins), preeclampsia, prolonged labor
what is the #1 reason for maternal morbidity and death worldwide
postpartum hemorrhage
defined as losing >500ml after vaginal delivery or >1000ml after C-section
what is the microbial profile and virulence factors of group B strep (streptococcus agalactiae)
Gram positive, non-motile, non-spore forming, facultative anaerobe, cat negative, beta hemolysis
Virulence factors: capsule, pilli, sialic acid, beta hemolysin
normal range for amniotic fluid index
5-24cm
what cervical dilation size is c/w active labor
> 3cm dilation
commonest drug used to induce labor
misoprostol (PGE analog)
what labs confirm DIC
low platelets, elevated d-dimer, elevated PT/PTT, decreased fibrinogen
what is the time range for normal delivery in weeks
37-42
if <37 it’s preterm but we don’t intervene unless <34
if >40 it’s late but not considered post-term pregnancy unless >42 weeks
oxytocin is synthesized where?
hypothalamus – then goes to post. pit. for storage
what is your differential list for vaginal bleeding in early pregnancy
- spontaneous abortion
- ectopic pregnancy
- torsion (less likely to p/w bleeding)
risk factors for ectopic pregnancy
History of PID (e.g., salpingitis) Previous ectopic pregnancy Endometriosis Kartagener syndrome Exposure to diethylstilbestrol (DES) in utero Bicornuate uterus Smoking Advanced maternal age Intrauterine device In vitro fertilization Hormone therapy
On US, compared to the endometrium, the myometrium is _____-echoic
Hypoechoic (darker)
what medication is safe to use during pregnancy for treatment of DVT
Heparin is the most appropriate pharmacotherapy in this pregnant patient with a deep vein thrombosis (DVT). During pregnancy, levels of clotting factors increase (fibrinogen, thrombin), while levels of anticoagulants (protein S) decrease, resulting in a hypercoagulable state. Pregnancy is also associated with decreased physical activity, a general risk factor for DVT. Moreover, the pressure of the gravid uterus on the inferior vena cava can impede venous return and predispose to DVT. Heparin is safe during pregnancy, as it does not cross the placental barrier.
what is the classic presentation and etiology of Potter’s sequence
low-set ears, flat nose, micrognathia, foot clubbing, and respiratory distress
etiology: oligohydramnios
Pulmonary retention of amniotic fluid - is it associated with oligo or polyhydramnios
no, neither
Pulmonary retention of amniotic fluid is the cause of transient tachypnea of the newborn and results in neonate respiratory distress in the first 1–2 days of life. It is typically seen in mature newborns delivered by cesarean section and is not associated with bilateral renal agenesis. Moreover, transient tachypnea of the newborn usually resolves within 24–48 hours.
target blood glucose levels (fasting and postprandial)
fasting: 70-95
postprandial: 140 or less
