OBGYN #5 Flashcards
Fundal Height Measurement and time frame
- 12 weeks: above pubic symphysis
- 16 weeks: between pubis and umbilicus
- 20 weeks: at umbilicus
- 38 weeks: 2-3 cm below xiphoid process
What is Ladin’s Sign
Uterus softening after 6 weeks
What is Hegar’s Sign?
uterine isthmus softening after 6-8 weeks gestation
What is Goodell’s Sign?
Cervical softening due to increased vascularization at 4-5 weeks gestation
What is Chadwick’s Sign?
Bluish coloration of the cervix and vulva at 8-12 weeks
Fetal heart tones are heard at about _____ and the normal rate is ______
10-12 weeks
120-160 bpm
Serum B-hCG can detect pregnancy as early as ____ days after conception
Urine B-hCG can detect pregnancy as early as _____ days after conception
5
14
What is Naegele’s Rule?
First day of LMP + 7 days - 3 months
Risk factors for gestational diabetes
- Family HX of gestational diabetes
- Spontaneous abortion
- History of infant > 4,000g at birth (8.8 pounds)
- Multiple gestations
- AA
What is the pathophysiology of gestational diabetes
-Maternal insulin resistance in women with undiagnosed beta cell dysfunction exacerbated by placental release diabetogenic hormones (human placental lactogen), growth hormone, and corticotropin-releasing hormone
Fetal complications of gestational diabetes
- Macrosomia (excessive birth weight)
- Shoulder dystocia
- Preterm labor
- neonatal hypoglycemia
- Congenital malformations
What is the chance that the mother develops type 2 Diabetes mellitus after pregnancy if she has gestational diabetes?
50%
What is the 2 step approach to screening for gestational diabetes?
- Step 1: 50 gram 1 hour glucose challenge test at 24-28 weeks gestation. If positive (>130-140), patients go on to 3h glucose tolerance test
- Step 2: 100 gram 3 hour oral glucose tolerance test (GOLD STANDARD). Threshold for glucose levels are 2 of the 4: fasting > 95, 1 hour > 180, 2 hour > 155, 3 hour > 140.
Lifestyle modifications for gestational diabetes
Diabetic diet and exercise (walking) is the initial treatment of choice
-Pregnant patients are NOT told to lose weight. Daily finger sticks overnight and after each meal.
What is the first-line medical treatment of choice and why? What is the goal of treatment?
Insulin (doesn’t cross the placenta)
-Goal of treatment is fasting glucose < 95