Obstetrics Flashcards
MCV in hemodilutional anemia
normal
Cause of hemodilutional anemia
greater increase in blood volume than RBC mass
Define phsyiologic dyspnea of pregnancy
seen in the third trimester.
Possibly caused by changes in diaphragm positioning, or altered respiratory center sensitivity.
Changes in PFTs during pregnancy
- increased in tidal volume
- no change in RR
- Increased minute ventilation
- Increased inspiratory capacity (due to increase tidal volume).
Pulmonary edema during preterm labor
often as a result of the use of multiple tocolytics
Cause of increased CO during pregnancy =
Increased HR AND stroke volume
Etio of increased rate of right sided hydronephrosis =
Compression by markedly dilated R-renal vain complex which lies across the ureter AND compression by the uterus
Recommended weight gain during pregnancy
Underweight - 28-40 Lbs
Normal - 25-35
Overweight - 15-25
Obese - 11-20
Blood tests for African American couples for preconception care
- CBC
- Hb electrophoresis (rule out all thalasemmias and sickle cell)
Issue with sickle cell and peripheral blood smear
- often negative in carriers
- sometimes negative in patients with disease
Fetal anomalies associated with type 1 diabetes
cardiac anomalies
neural tube defects
5 tests available to check for trisomy 18 and 21 ranked by best detection rate:
(1) Sequential Screen
(2) Serum Integrated Screen
(3) First trimester combined test
(4)
Gestational age at which you detect neural tube defects by US
16 to 18 weeks
Caudal regression syndrome seen in…
offspring of poorly controlled diabetics
Anticoagulation during pregnancy
LMW heparin is best
Warfarin is a teratogen
Glucosuria an issue?
Not really, many patients can present with +1 glucose in the urine
Signs of maternal dehydration
Tachycardia
Ketonuria
Contraction frequency concerning for labor picking up
contractions every 5 minutes for an hour
If an intrauterine pressure catheter is placed, and a significant amount of vaginal bleeding is noted…
the possibility of placenta separation or uterine perforation
In this case, withdrawing the catheter, monitoring the fetus and observing for any signs of fetal compromise would be the most appropriate management.
