Obstetrics Flashcards
1
Q
Why do pregnant women get anemia?
A
Dilutional effect
RBC rises 30% but volume rises 50%
2
Q
What are the degrees of vaginal lacerations?
A
1st degree: skin
2nd degree: muscle
3rd degree: anus
4th degree: rectum
3
Q
What is vernix?
A
Cheesy baby skin
4
Q
What is meconium?
A
Green baby poop
5
Q
What is Lochia?
A
Endometrial slough
6
Q
What is normal blood loss during a vaginal delivery?
A
500 mL
7
Q
What is normal blood loss during a C-section?
A
1 L
8
Q
How do you treat A1 gestational DM?
A
Diet
9
Q
How do you treat A2 Gestational DM?
A
Insulin
10
Q
What are identical twins?
A
Egg split into perfect halves
“Monochorionic”
11
Q
What are fraternal twins?
A
Multiple eggs fertilized by different sperm
12
Q
What is Ovarian hyperstimulation syndrome?
A
Weight gain and enlarged ovaries after Clomiphene use
13
Q
Who makes the trophoblast?
A
Baby
14
Q
Who makes the cytotrophoblast?
A
Mom =>
GnRH
CRH
TRH
Inhibin
15
Q
Who makes syncytiotrophoblast?
A
Mom and baby =>
hCG
HPL
16
Q
When does implantation occur?
A
1 week after fertilization
17
Q
When is ß-hCG found in urine?
A
2 weeks after fertilization
18
Q
What is function of estrogen?
A
Muscle relaxant
Constipation
Incr protein production
Irritability
Varicose veins
19
Q
What is the function of progesterone?
A
Incr appetite
Incr acne
Dilutional anemia
Quiescent uterus
Pica
Hypotestosterone
Melasma
20
Q
What makes progesterone <10 week gestation?
A
Corpus luteum
21
Q
What makes progesterone >10 week gestation?
A
Placenta
22
Q
What is the function of ß-hCG?
A
Maintains corpus luteum
Sensitizes TSH receptor => acts hyperthyroid (to incr basal metabolic rate)
23
Q
How fast should ß-hCG rise?
A
Doubles every 2 days until 10 weeks
(When placenta is fully formed)
24
Q
What is the function of AFP?
A
Regulates fetal intravascular volume
25
What is the function of HPL?
Blocks insulin receptors
-> sugar stays high
(Baby’s stocking up on stuff needed for the journey)
26
What is the function of inhibin?
Inhibits FSH => no menstruation
27
What is the function of oxytocin?
Milk ejection
Baby ejection
28
What is the function of cortisol in pregnancy?
Decreases immune rejection of baby
Lung maturation
29
What are the thyroid hormone levels during pregnancy?
Elev TBG => elev bound T4
Normal free T4 levels
Elev Total T4
30
When can you first detect fetal heart tones?
Week 20
31
When can you tell the sex of a fetus by U/S?
Week 16
32
What does an AFI <5 indicate?
Oligohydramnios
(Cord compression)
33
What does an AFI >20 indicate?
Polyhydramnios
(DM)
34
How fast should fundal height change?
Uterus grows 1cm/wk
35
What is the Pool Test?
Fluid in vagina
36
What is Ferning?
Estrogen crystallizes on slide
37
What is Nitrazine?
Shows presence of amniotic fluid
38
What is the risk of chorionic villus sampling?
Fetal limb defects
39
What is the risk of amniocentesis?
Abortion (2% risk)
40
What is a normal biophysical profile?
>8
41
What is a biophysical profile?
“Test the Baby, MAN!”
- Tones of the heart
- Breathing
- Movement: BPD, HC, AC, FL
- AFI
- Non-stress test (normal = “reactive”)
42
What pelvis types are better for vaginal delivery?
Gynecoid
Anthropoid
43
What pelvis types will need C/S?
Platypelloid
Android
44
How do you predict a due date with Nägele’s Rule?
9 months from last menses and then add 1 week
45
Why is Nägele’s Rule inaccurate?
B/c it does not start from ovulation date
46
How do you correct Nägele’s Rule for cycles >28 days?
Add x days if cycle is x longer
47
How much weight should a pregnant woman gain?
1 pound/week
48
When should intercourse be avoided during pregnancy?
3rd trimester b/c PGF in semen may cause uterine contractions
49
What are the Leopold maneuvers?
1) Feel fundus
2) Feel baby’s back
3) Feel pelvic inlet
4) Feel baby’s head
50
What is Stage I of labor?
Up to full dilation
1) Latent phase (<20h)
- contractions -> 4cm cervical dilation
2) Active phase (<12h)
- 4-10 cm cervical dilation
- 1 cm/hr
51
What is Stage II of labor?
Full dilation -> delivery
Station 0: baby above pelvic rim
(most uteri are anteverted)
1. Engage
2. Descend
3. Flex head
4. Internal rotation
5. Extend head
6. Externally rotate
7. Expulsion: LOA most common presentation
52
What is Stage III of labor?
Delivery of placenta
D/t PGF
Blood gush -> cord lengthens -> fundus firms
53
How do you monitor baby’s HR?
Doppler
Scalp electrode
54
How do you monitor uterus?
Tocodynamics
Uterine pressure catheter
55
What Bishop’s score predicts delivery will be soon?
>8
56
What are Braxton-Hicks contractions?
Irregular contractions w/ closed cervix
57
What is a vertex presentation?
Posterior fontanelle (triangle shape) presents first
Normal
58
What is a sinciput presentation?
Anterior fontanelle (diamond shape) presents first
59
What is a face presentation?
Mentum anterior -> forceps delivery
60
What is a compound presentation?
Arm or hand on head -> vaginal delivery
61
What is a complete breech?
Butt down, thighs and legs flexed
62
What is a Frank breech?
Butt down, thigh flexed, legs extended (~ pancake)
63
What is a Footling breech?
Butt down, thigh flexed, one toe is sticking out of cervical os
64
What is a double footling breech?
Two feet sticking out of cervical os
65
What is a Transverse Lie?
Head is on one side, butt on the other
66
What is Shoulder Dystocia?
Head out, shoulder stuck
67
Can you try vaginal delivery on a woman who has had a Classic Horizontal C/S previously?
No, must have C/S for all future pregnancies
68
Can you try vaginal delivery on a woman who has had a low transverse C/S previously?
Yes
69
What is early deceleration?
Normal
Due to head compression
70
What is late deceleration?
Uteroplacental insufficiency b/c placenta cannot provide O2/nutrients
71
What is variable deceleration?
Cord compression
72
What is increased beat-to-beat variability?
Fetal hypoxemia
73
What is decreased beat-to-beat variability?
Acidemia
74
What is Pre-eclampsia?
Ischemia to placenta
=> HTN (>140/90)
75
What is the treatment for pre-eclampsia?
Delivery
76
What is HELLP syndrome?
Hepatic injury causing
- Hemolysis
- Elevated Liver enzymes
- Low Platelets
77
What is eclampsia?
HTN & seizures
78
What are the symptoms of eclampsia?
HA
Changes in vision
Epigastric pain
79
What is the treatment for eclampsia?
4 mg magnesium sulfate as seizure prophylaxis
80
What is chorioamnionitis?
Fever
Uterine tenderness
Decr fetal HR
81
What are the symptoms of amniotic fluid emboli?
Mom just delivered baby and has SOB
-> PE, death
(Amniotic fluid in the lungs)
82
What is endometritis?
Post-partum uterine tenderness
83
What is an incomplete molar pregnancy?
2 sperm + 1 egg
(69, XXY)
Has embryo parts
84
What is a complete molar pregnancy?
2 sperm + no egg
(46, XX -> both paternal)
No embryo
85
What is pseudocyesis?
Fake pregnancy w/ all the signs and symptoms
86
What is the most common cause of 1st trimester maternal death?
Ectopic pregnancy
87
What is the most common cause of 1st trimester spontaneous abortions?
Chromosomal abnormalities
88
What are the most common causes of 3rd trimester spontaneous abortions?
Anti-cardiolipin Ab
Placenta problems
Infection
Incompetent cervix
89
What is a threatened abortion?
Cervix closed
Baby intact
(Tx: bed rest)
90
What is an inevitable abortion?
Cervix open
Baby intact
(Tx: cerclage = sew cervix shut until term)
91
What is an incomplete abortion?
Cervix open
No fetal remnants
(Test: ß-hCG)
92
What is a missed abortion?
Cervix closed
No fetal remnants
(Tx: D&C)
93
What is a septic abortion?
Fever >100F
Malodorous discharge
94
What is placenta previa?
Post-coital bleeding
Placenta covers cervical os
Ruptures placental arteries
95
What is vasa previa?
Placenta aa. hang out of cervix
96
What is placenta accreta?
Placenta attached to superficial lining
97
What is placenta increta?
Placenta invades into myometrium
98
What is placenta percreta?
Placenta perforates through myometrium
99
What is placenta abruptio?
Severe pain
Premature separation of placenta
100
What is velamentous cord insertion?
Fetal vessels insert b/w chorion and amnion
101
What is a uterus rupture?
Tearing sensation
Halt of delivery
102
What is an Apt test?
Detects HbF in vagina
103
What is Wright’s stain?
Detects nucleated fetal RBC in mom’s vagina
104
What is a Kleihauer-Bette test?
Detects percentage of fetal blood in maternal circulation (dilution test)
105
What is maternity blues?
Post-partum crying
Irritability
106
What is post-partum depression?
Depression >2 weeks
107
What is post-partum psychosis?
Hallucinations
Suicidal
Infanticidal
