OBGYN #2 Flashcards
What is a spontaneous abortion?
Pregnancy that ends before 20 weeks gestation
MC etiology of spontaneous abortion
Chromosomal abnormalities
Symptoms of threatened abortion
- Products of conception intact
- Cervical Os closed
Symptoms of inevitable abortion
- POC intact
- Cervical OS dilated
Symptoms of incomplete abortion
- Some POC expelled from uterus
- Cervical OS dilated
For a missed abortion, the cervical OS is _____ and POC are _____
Closed
Intact
For a medical abortion what two medications are used and is safe up to 10 weeks?
Mifepristone followed by Misoprostol 24-48 hours later
For a medical abortion, what medications are used and is safe up to 7 weeks?
Methotrexate followed by Misoprostol 3-7 days later
What methods are used for surgical abortion?
-Dilation and curettage or dilation and evacuation
How to tell, on diagnostics, if a mother is having multiple gestations
-Elevated levels of beta-hCG and maternal serum alpha-fetoprotein
Fundal Height Measurement
- 12 weeks: above pubic symphysis
- 16 weeks: midway between pubis and umbilicus
- 20 weeks: at umbilicus
- 38 weeks: 2-3 cm below xiphoid process
Gravida: ______
Para: ______
Abortus: ______
- Number of times pregnant
- Number of births
- Number of pregnancies lost for whatever reason
What is Naegele’s Rule?
1st day of LMP + 7 days - 3 months
The first trimester consists of weeks ______
1-12 of pregnancy
Tests done in 1st trimester
-Chromosomal screening test: Free beta-HCG, PAPP-A, Biochemical screening, US, chorionic villous sampling, nuchal translucency US
PAPP-A is low with
Down’s Syndrome
In a nuchal translucency US, is increased thickness, what test is done?
Chorionic villous sampling or amniocentesis
Transvaginal US can detect fetal heart activity as early as
5-6 weeks after LMP
Second Trimester consists of weeks
13-27
What tests are done in second trimester?
- Triple screening: Alpha-fetoprotein, unconjugated estriol, and Beta-HCG
- Gestational Diabetes screening: 24-28 weeks
- Amniocentesis: if age > 35, prior pregnancy loss, abnormal tests (15-18 weeks)
Two MC types of neural tube defects
-Spina Bifida and Anencephaly
What is anencephaly?
-Failure of closure of portion of neural tube that becomes cerebrum
What is spina bifida?
-Incomplete closure of embryonic neural tubule leads to non-fusion of some of the vertebrae and some overlying the spinal cords.
What is the MC type of spina bifida
With myelominingocele. Often leads to disability
How to tell on screening tests that a baby may have a neural tube defect
-Increased maternal serum alpha-fetoprotein followed by amniocentesis showing increased alpha-fetoprotein and increased acetylcholinesterase.
Third trimester of pregnancy consists of weeks
28 until birth
Tests done in the third trimester
- Rh antibody test
- Hemoglobin and Hematocrit
- Group B Strep Screening
- Biophysical Profile (fetal tones, amniotic fluid levels, etc.)
- Non-Stress Testing
Regarding the non stress test, what is a good prognosis and means fetal well being?
- 2 or more accelerations of fetal heart rate > 15 bpm
If positive screening for Group B Strep, prophylactic ABX given during labor (within 4 hours of delivery). What medication is given?
IV Penicillin G
Toxic Shock Syndrome is caused by exotoxins produced by _____
Staph A
50% of toxic shock syndrome is associated with
tampon use
Symptoms of toxic shock syndrome
- Sudden onset of high fever
- Skin: Erythroderma (diffuse erythematous macular rash)
- Hypotension, abdominal tenderness
- Headache, myalgias, n/v
Treatment for Toxic Shock Syndrome
- Supportive
- Aggressive IVF replacement
- ABX (Clindamycin + Vanco/Linezolid)
