OBGYN 2 Flashcards
indication for antibiotics after delivery
foul smelling lochia
tender uterus
when do you do Kleihauer Betke test
after delivery to see if you need higher dose of Rh Ig
ovarian torsion vs ruptured ovarian cyst
ovarian torsion has nausea and vomiting
ruptured ovarian cyst happens with strenuous physical activity and may have light vaginal bleeding
who should be offered cell free DNA testing of maternal plasma
women at least 35 at increased risk of aneuploidy and at least 10 weeks gestation
abnormal cell free fetal DNA testing, next step in 1st vs 2nd trimester
1st trimester 10-12 wks: fetal karyotyping with chorionic villus sampling
2nd trimester 15-20 wks: amniocentesis
Downs syndrome tests for people who don’t have high risk in 1st vs 2nd trimester
1st: combined test of plasma protein A, beta hCG, and nuchal translucency
2nd: quad screen of maternal serum AFP, beta hCG, unconj estriol, inhibit A
tx of genital warts
trichloroacetic acid
or podophyllin
loss of fetal station
uterine rupture
symmetric vs asymmetric fetal growth restriction
symmetric is fetal
- genetic disorders
- congenital heart disease
- intrauterine infection
asymmetric is maternal
- vascular disease (HTN, DM)
- antiphospholipid antibody syndrome
- autoimmune (SLE)
- cyanotic heart disease
- substance abuse
workup of adnexal mass in postmenopausal woman
transvaginal US and CA125
NST is nonreactive. Next step?
BPP or CST (but CST CI if have CI to labor like placenta previa)
how long should NST be done to account for fetal sleep cycle
at least 40 min
when to use umbilical artery flow velocimetry
when monitoring growth restricted fetuses (less than 10th percentile)
what does it mean to have a BPP score of 0-4/10? management?
fetal hypoxia due to placental dysfunction (placental insufficiency)
deliver
management of incomplete, inevitable, or missed abortion
hemodynamically unstable: dilation and suction curettage
hemodynamically stable: can do expectant management, prostaglandins, or surgical evacuation
management of septic abortion
blood and endometrial cultures
broad spectrum antibiotics
surgical evacuation
thyroid levels in pregnancy vs pre pregnancy
fT4 and fT3 incr
TSH decr
cause of late decels
uteroplacental insufficiency (see placental calcifications)
causes of variable decels
cord compression
cord prolapse
oligohydramnios
when should you do something about variable decels
when associated with at least 50% of contractions
pruritic vaginal area with white, cigarette paper quality
- dx
- next step
- tx
lichen sclerosus
punch biopsy
topical corticosteroids
clotrimazole cream used for
vaginal candidiasis
after how many weeks gestation should you try to convert a breech baby? and what is it called? what are CIs?
37 weeks
external cephalic version
placental abnormalities, fetopelvic disproportion, hyperextended fetal head
age cutoff for premature ovarian failure
less than 40
differential for nonreactive NST
fetal sleep cycle
fetal hypoxia from placental insufficiency
fetal cardiac or neurologic abnormalities
indication for magnesium sulfate
less than 32 weeks gestation for neuroprotection
fetal viability starts at how many weeks
23 weeks
indication progesterone supplementation
16-36 weeks gestation in pregnant with singleton and history of preterm delivery
things to give in a preterm labor if less than 34 weeks (preterm is technically less than 37)
corticosteroids (lung maturity)
magnesium (neuroprotection)
tocolytic
weeks that indicate preterm labor
less than 37
