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#DAY4_OBSTETRICS/GYNECOLOGY > Obstetric Hemorrhage, Cardio, Pulmo > Flashcards

Obstetric Hemorrhage, Cardio, Pulmo Flashcards

1
Q

Happens when there is premature separation of a normally implanted placenta

A

Abruptio placenta

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2
Q

Immediate event that can cause hemorrhage and subsequent abruptio placenta

A

Preeclampsia

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3
Q

This dangerous drug can cause vasoconstriction with resultant placental separation

A

Cocaine

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4
Q

Virchow’s triad in placental abruption

A

VIA Vaginal bleeding Increased uterine tone Abdominal pain

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5
Q

Diagnostic test for abruptio placenta where you put a blood sample in a test tube and positive if a clot forms within 6 minutes or forms and lyses within 30 minutes

A

Clot observation test

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6
Q

Most common obstetric cause of DIC

A

abruptio placenta

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7
Q

This intervention can be diagnostic and therapeutic in abruptio placenta

A

Amniotomy

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8
Q

What is the boundary threshold for a low lying placenta?

A

2cm

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9
Q

Most common pathophysiology of placenta previa

A

Defective decidual vascularization

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10
Q

Management of placenta accreta

A

Classical CS, hysterectomy

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11
Q

Septic abortion and chorioamnionitis are associated with what coagulation pathway?

A

Intrinsic pathway (endothelial damage)

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12
Q

Abruptio, amniotic fluid embolism, retained dead fetus and saline induced abortion is associated with what coagulation pathway?

A

Extrinsic

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13
Q

Syndrome characterized by widespread systemic activation of coagulation

A

DIC

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14
Q

The combination of nifedipine snd what other tocolytic agent can cause dangerous neuromuscular blockade?

A

Magnesium sulfate

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15
Q

Only well accepted risk factor of gestational hypertension

A

Primiparity

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16
Q

Classic presentation of placenta previa

A

Painless vaginal bleeding

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17
Q

Management of placenta previa is the placental edge is >2cm from os

A

Trial of labor

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18
Q

Management of placenta previa is the placental edge is <2cm from os

A

Vaginal delivery if possible

19
Q

Classification of placenta accreta if it invades the myometrium

A

Increta

20
Q

Classification of placenta accreta if it penetrates the myometrium and through the serosa

A

Percreta

21
Q

2 most important risk factors in placenta accreta

A

Placenta previa Prior CS

22
Q

Hypertension without proteinuria occurring after 20 weeks AOG and BP returns to normal levels 12 weeks postpartum

A

Gestational hypertension

23
Q

BP 140/90 prior to pregnancy or before 20 weeks AOG and persists 12 weeks postpartum

A

Chronic hypertension

24
Q

What is the underlying etiology of proteinuria is seen with preeclampsia?

A

Increased capillary permeability

25
Q

Renal change that occur in gestational hypertension

A

Glomerular endotheliosis

26
Q

Mechanism in preeclampsia is placental implantation with replacement of ________ endothelium with trophoblasts

A

Spiral arteriole

27
Q

Prevention of preeclampsia syndrome

A

High dose calcium Low dose aspirin

28
Q

Management of severe preeclampsia if <34 weeks

A
  • Expectant management <34 weeks
    • Admit to hospital at maternal ICU
    • Maternal-fetal evaluation for 24 hours
    • Magnesium sulfate for 24 hours
    • Antihypertensives for BP >160/110 or MAP >125
    • Sonological monitoring:
      • Assess fetal size by US every 2 weeks
      • BPS + AFI at least twice weekly
      • Umbilical artery Doppler – once a week
  • NST - daily
29
Q

Management of severe preeclampsia if <23 weeks

A

Terminate pregnancy

30
Q

Management of severe preeclampsia if 23-32 weeks

A
  • Steroids (24-34 weeks AOG)
    • Betamethasone 12 mg/IM q24 hours for 2 doses
    • Dexamethasone 6 mg/IM q12 hours for 4 doses
  • Antihypertensives if needed
  • daily evaluation of maternal-fetal condition
  • Delivery if with indications
  • Delivery at 32-34 weeks
31
Q

Known fetal side effect of hydralazine

A

Thrombocytopenia

32
Q

Drug of choice for severe hypertension in pregnancy

A

Hydralazine

33
Q

Drug of choice for gestational/chronic hypertension in pregnancy

A

Methyldopa

34
Q

Side effect of labetalol

A

Fetal growth restriction

35
Q

What is the target magnesium level in eclampsia prophylaxis?

A

4.8-8.4 mg/dl

36
Q

Drug of choice for prevention of convulsions in severe preeclampsia

A

Magnesium sulfate

37
Q

Preferred mode of delivery for cardiovascular disorders

A

Vaginal Epidural anesthesia

38
Q

For patients with congenital heart disease, what is the most common adverse event encountered in pregnancy?

A

Arrhythmia

39
Q

Most common etiology of CAP in pregnancy

A

Strep pneumoniae

40
Q

Most frequent complication of pneumonia in pregnancy

A

PROM

41
Q

Initial monotherapy for CAP

A

Macrolides

42
Q

Fetal response to maternal hypoxemia

A

Decreased CO

43
Q

Management of severe preeclampsia if >34 weeks

A

stabilize mother and deliver

  • Mode of delivery
    • >34 weeks: vaginal delivery if maternal, fetal and cervical conditions are favorable
    • <32 weeks: consider CS due to reduced success in induction

#DAY4_OBSTETRICS/GYNECOLOGY (22 decks)

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