OBGYN #5 Flashcards

1
Q

Fundal Height Measurement and time frame

A
  • 12 weeks: above pubic symphysis
  • 16 weeks: between pubis and umbilicus
  • 20 weeks: at umbilicus
  • 38 weeks: 2-3 cm below xiphoid process
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2
Q

What is Ladin’s Sign

A

Uterus softening after 6 weeks

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3
Q

What is Hegar’s Sign?

A

uterine isthmus softening after 6-8 weeks gestation

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4
Q

What is Goodell’s Sign?

A

Cervical softening due to increased vascularization at 4-5 weeks gestation

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5
Q

What is Chadwick’s Sign?

A

Bluish coloration of the cervix and vulva at 8-12 weeks

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6
Q

Fetal heart tones are heard at about _____ and the normal rate is ______

A

10-12 weeks

120-160 bpm

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7
Q

Serum B-hCG can detect pregnancy as early as ____ days after conception

Urine B-hCG can detect pregnancy as early as _____ days after conception

A

5

14

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8
Q

What is Naegele’s Rule?

A

First day of LMP + 7 days - 3 months

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9
Q

Risk factors for gestational diabetes

A
  • Family HX of gestational diabetes
  • Spontaneous abortion
  • History of infant > 4,000g at birth (8.8 pounds)
  • Multiple gestations
  • AA
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10
Q

What is the pathophysiology of gestational diabetes

A

-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

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11
Q

Fetal complications of gestational diabetes

A
  • Macrosomia (excessive birth weight)
  • Shoulder dystocia
  • Preterm labor
  • neonatal hypoglycemia
  • Congenital malformations
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12
Q

What is the chance that the mother develops type 2 Diabetes mellitus after pregnancy if she has gestational diabetes?

A

50%

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13
Q

What is the 2 step approach to screening for gestational diabetes?

A
  • 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.
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14
Q

Lifestyle modifications for gestational diabetes

A

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.

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15
Q

What is the first-line medical treatment of choice and why? What is the goal of treatment?

A

Insulin (doesn’t cross the placenta)

-Goal of treatment is fasting glucose < 95

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16
Q

If the patient refuses insulin therapy or won’t comply with insulin, what are safe medication alternatives?

A

Glyburide or Metformin

17
Q

What Vitamin should be supplemented to a baby if he/she is breastfeeding?

A

Vitamin D

18
Q

What is morning sickness and when does it occur?

A

Nausea and vomiting up until 16 weeks (most common in first trimester)

19
Q

What is hyperemesis gravidarum?

A

Severe, excessive form of morning sickness (nausea, vomiting) associated with weight loss and electrolyte imbalance. Develops during 1st or 2nd trimester and lasts > 16 weeks gestation

20
Q

What labs are shown with hyperemesis gravidarum?

A
  • Hypokalemia

- Metabolic alkalosis from vomiting

21
Q

Management of morning sickness and Hyperemesis Gravidarum

A
  • Lifestyle modifications: initial management of choice. Ginger, fluids, avoid spicy foods
  • Pyridoxine (B6) + Doxylamine is first line medical management
  • If no relief, use antihistamines
  • IV rehydration, electrolyte repletion