OBGYN-2 Flashcards
___________ is used in pregnancy to treat migraine headaches.
Amitriptyline
The most common cause of sepsis in pregnancy is ___________
acute pyelonephritis.
When do obese women with Family Hx of DM-2 get oral glucose test
ASAP
Only normal risk women get screened 24-28 weeks
Do you treat mitral prolapse in prego?
yes if they have symptoms
One SSRI ____________ has been changed to a category D drug because of the increased risk of fetal cardiac malformations and persistent pulmonary hypertension.
paroxetine (Paxil)
How do you treat pruritus gravidarum (mild variant of intrahepatic cholestasis of pregnancy) s/s= pruritus.
Ursodeoxycholic acid
The classic signs of magnesium toxicity include
muscle weakness
loss of deep tendon reflexes
nausea
respiratory depression.
magnesium sulfate overdose treatment
calcium gluconate
Twenty-four hour urine protein values greater that _____ are required for the diagnosis of mild preeclampsia.
300 mg
UA protein greater than ________ is required for the diagnosis of severe preeclampsia
~5000 mg (or 5 g)
or
~SBP >160 or DBP >110)
___________ is often the antihypertensive agent of choice for controlling elevated blood pressures in the acute setting of preeclampsia
Hydralazine
____________ is the treatment of choice for eclampsia,
Magnesium sulfate
HELLP acronym
hemolysis, elevated liver enzymes, low platelets” and can lead to swelling of the liver capsule and possibly liver rupture.
Define preecampsia
new onset htn (140/90+) x 2 w/ proteinuria or end organ damage AFTER 20 weeks
When do you start anti-htn in preeclamps
htn >160/110 + and get ultrasound
when do you deliver sever preecamps babies
deliver after 34 weeks
The use of middle cerebral artery peak systolic velocity in the management of fetuses at risk for anemia because of red cell alloimmunization has emerged as the best test for the noninvasive diagnosis of____________
fetal anemia.
The use of _____________ in the management of fetuses at risk for anemia because of red cell alloimmunization has emerged as the best test for the noninvasive diagnosis of fetal anemia.
middle cerebral artery peak systolic velocity
Fetal hydrops is easily diagnosed on ultrasound, defined as a collection of fluid in two or more body cavities, such as _________________.
ascites, pericardial and/or pleural fluid and scalp edema
Placentomegaly (placental edema) and polyhydramnios are also seen on ultrasound
At 28-weeks gestation, ____________ is routinely administered after testing for sensitization with an indirect Coombs’ test.
300 micrograms of Rh-immune globulin
*Administration is given following amniocentesis at any gestational age.
The current recommendations for Rh-negative women without evidence of Rh immunization is prophylactically at:
- 28-weeks gestation (after an indirect Coombs’ test)
- within 72 hours of delivering an Rh-positive baby
- following abortion
- following antepartum hemorrhage
- following amniocentesis or chorionic villus sampling.
If the father of the fetus is known to be Rh-negative, ____________ is not necessary since the fetus will be Rh-negative and not at risk for hemolytic disease.
RhoGAM
IgM antibodies and do not cross the placenta, therefore are not associated with isosensitization or hemolytic disease of the fetus.
Lewis antibodies
Amniotic fluid ________, an acute-phase reactant, is associated with spontaneous preterm delivery
ferritin
Values in Zone 3 of the Liley curve indicate the presence of severe hemolytic disease, with hydrops and fetal death likely within 7-10 days, thus demanding immediate delivery or fetal transfusion.
Intravascular transfusion into the umbilical vein is the preferred method.
Maternal plasmapheresis is used in severe disease when intrauterine transfusions are not possible.
Ultrasound markers suggestive of dizygotic (non-identical) twins include
- a dividing membrane thickness greater than 2 mm, twin peak (lambda) sign
- different fetal genders
- two separate placentas (anterior and posterior).
The risk for development of cerebral palsy in twin infants is _____________ vs singletons.
five to six times higher
Fifty-eight percent of twins deliver prematurely, with an average gestational age at delivery of __________
35 weeks
The incidence of _____________ is increased in twins, particularly monozygotic twins, compared to singletons.
congenital anomalies
Adequate weight gain in the first 20-24 weeks of pregnancy is critical for women carrying multiples and may help to reduce the risk of having preterm and low-birth weight babies because ______
early weight gain aids in development of the placenta, possibly improving its ability to pass along nutrients to the babies.
Twin-twin transfusion syndrome is the result of an intrauterine blood transfusion from one twin to the other. It most commonly occurs in ____________
monochorionic, diamniotic twins
Clues to the presence of the twin-twin transfusion syndrome include______
large weight discordance
polyhydramnios around the larger (recipient) twin
oligohydramnios around the smaller (pump) twin.
Monozygotic conceptions may have either monochorionic or dichorionic placentation, depending upon the time of division of the zygote. Dizygotic conceptions always have __________.
dichorionic placentas
Monozygotic conceptions may have____________, depending upon the time of division of the zygote. Dizygotic conceptions always have dichorionic placentas.
monochorionic or dichorionic placentation
Diamniotic dichorionic placentation occurs with division prior to the morula state ______
(within three days post fertilization).
Diamniotic monochorionic placentation occurs with division between days ____________
four and eight post fertilization.
. Monoamniotic, monochorionic placentation occurs with division between days_________
eight and 12 post fertilization.
Superfecundation is___________
the fertilization of two different ova at two separate acts of intercourse in the same cycle.
Excessive volume can lead to _______________ for the recipient twin in twin-twin syndrome.
cardiomegaly, tricuspid regurgitation, ventricular hypertrophy and hydrops fetalis.
Although the recipient twin is plethoric, it is not macrosomic.
prematurity consequences are increased risk of
respiratory distress syndrome (RDS) intracranial hemorrhage cerebral palsy blindness low birth weight.
fetal sonogram means?
ultrasound
fetal doppler means?
heart beat
