obstetrics Flashcards
fetal heart tones
doppler= week 10
also it is the same week in witch B-hCG peaks
Gestational Sac
visible at week 5 by vaginal ultrasound
B-hCG=1000-1500
prenatal visits
week 0-28=
weeks 29-35=
weeks 36-birth=
week 0-28= every 4 weeks
weeks 29-35=every 2 weeks
weeks 36-birth= every week
CMV
petechial rash + periventricular calcificacions
(toxoplamosis calcificacions are intracranial calcifications and no rash)
TOXOPLASMOSIS
- hydrocephalus
- intracranial calcifications
- chorioretinitis
- Ring-enhancing lesions on MRI
fetal cardiac tone
US=6-7 weeks
doppler=10 week
nonviable pregnancy
gestational sac >25mm without a fetal pole or absence of fetal cardiac activity when CRL>7mm on transvaginal ultrasound
early deceleration
head compression
late deceleration
uteroplacental insufficiency and fetal hypoxemia
variable deceleration
umbilical cord compression
biophysical profile
Test the Baby MAN
- fetal Tone
- fetal Breathing
- fetal Movement
- Amniotic fluid volume
- Nonstress test
confirmatory 3 hour (100mg) glucose test (GTT) values fasting= 1h= 2h= 3h=
fasting=>95
1hour=>180
2hour=>155
3hour=>140
2 or more is positive
MILD PRECLAMSIA
BP>140/90 on two occasions>6 hours apart.
proteinuria(>300mg/24h or 1 to2 + urine dispsticks)
edema
SEVERE PRECLAMSIA
BP 160/110 in tow occasions>6 hours apart
PROTEINURIA >5g/24hours or 3-4 + urine dipsticks) or oliguria(
polyhydramnios
AFI>25
oligohydramnios
AFI
breastfeeding contraindications
HIV infection
Active HBV and HCV
somo drugs(tetracyclines,chloramphenicol)
morning sickness causes
increase in beta-HCG
first sign of pregnancy
goodell sign (4 weeks) softening of the cervix
gestational sack shoul be seen with what level of B-HCG
1500 IU/mL and 5 week
metotrexate contraintidications in ectopic pregnancy
fetal heartbeat ectopic is 3.5 or larger hepatotoxicity noncompliant patient inmmunodeficiency
prolonged rupture of membrane
> 24h before delivery
PROM prophilaxis
ampicilina + azithromycin
if alergic to peniciline change it for cefazolin or clindamicin.
early decelerations
head compression
variable decelerations
umbilical cord compression
late decelerations
fetal hypoxia
prolongated latent stage
> 20h for primipara
>14 h for miltipara
first symptom of pregnancy in women with regular menstruation
amenorrhea
chloasma
16 weeks
linea nigra in pregnancy
second trimester
pregnancy quickening
16-20 weeks
cervica culture for chlamydia and gonorrhea, as wellas culture for group B strep
36 weeks
- treatment if positive (chlamydia and gonorrhea)
- prophylactic antibioic during labor
abortion definition
before 20 weeks or a fetus less than 500gr.
septic abortion treatino
D & C and IV antibioitcs(levoflox and metronidazol)
labor should NOT be stopped with tocolytics and delivert should occur
- severe preclamsia
- maternal cardiac diseas
- maternal cervical dilation of more than 4 cm
- maternla hemorrhage
- fetal death
- chorioamnionitis
corticosteroid indication in pregnancy
from 24-34 weeks
tocolytic of choise
Mg sulfate (CHECK FOR DEEP TENDON REFLEXES) -TOX:flushing,headaches,diplopia and fatigue, WATHC OUT can lead to respiratory arrest.
when does a patient is considered sensitized for RH
titer leve more than 1:4
antibody titer greater than 1:16 in a mother
do regular amniocentesis, if hematocrit is low perform an intrauterine transfusion
macrosomia
over4500gr
most dangerous decelerations
Late decelerations
Fetal hypoxemia,uteroplacental insufficiency
variable compressions
umbilicar cord compression
prolonged latend stage
more than 20 in promipara
longer thant 14 hours multipara
TX:REST AND HYDRATATION
protracted cervical dilatation(slow dilatatation during active phae)
less than 1.2 in primipara
less than 1.5 per hour in multipara
when to perform external cephalic version
after week 36
endometritis treatment
- genta-clinda (for anaerobeous)
* if fever spikes add ampicilin, if allergic use metronidazol
1 hour 50g glucose load test ,abnormal value
-above 140 , DO A TOLERANCE TEST(100gr)
fetal acidemia on fetal scalp sampling (below 7.2)
immediate delivery
