Obstetrics Flashcards
How often to bHCG levels double?
48 hours
At what bHCG value is gestational sac seen and at what week?
5 weeks
1000-1500
What are the nutritional supplements recommended for pregnant women?
Folic acid: 0.4 or 4 if woman has hx of NTD
Iron 30 mg
Calcium
Complete vegetarians: vitamin D, vitamin B12
Which disease should be detected at first visit?
rubella HbSAg Syphillis HIV Pap smear Hep B Hep C
At what week does FTCS happen?
What is in the FTCS
9-14 weeks
PAPP-A, NT, free bHCG
When is second trimester combined screening happen?
What is in it?
15-22 weeks Alpha feto protein AFP Estrodiol bHCG inhibin A
When does U/S happen for anatomic screening?
18-20 weeks
When does the glucose challenge happen?
24-23 weeks
What is elevated alpha AFP associated with?
Open neural tube defects (anencephaly, spina bifida)
Abdominal wall defects
Multiple gestation
Incorrect gestational dating
What is associated with low alpha AFP?
Trisomy 18
Trisomy 21
Fetal demise
Incorrect gestational dating
What is high/low in the quad screen for trisomy 21?
AFP low
Estriol low
Inhibin high
bHCG high
When can CVS be done?
10-12 weeks
When can Amniocentesis be done?
15-20 weeks
What are the risks of CVS?
Risk of fetal loss high
What are the risks of amniocentesis?
PROM
Chorioamnionitis
Fetal maternal hemorrhage
When can free cell DNA be done?
10 weeks
What is the management of termination of pregnancy in the first trimester?
up to 49 days: mifepristone + oral misoprostol OR IM methotrexate + oral/vaginal miso
surgical up to 13 weeks
What is the management of termination of pregnancy in the second trimester?
D&E
How long is First stage of labour?
6-18
2-10
How long is the second stage of labour?
0.5-3 hours
How long is the 3rd stage of labour?
0-0.5
Late deceleration causes
Uteroplacental insufficiency
Fetal hypoxemia
Early deceleration causes?
Head compression from uterine contraction
Causes of variable deceleration?
Umbilical cord compression
Treatment of hyperemesis gravidum?
Vitamin B6
Doxylamine PO
Promethazine or dimenhydrinate PO or rectal administration
If severe: metoclopramide, ondansetron
If dehydrated: IV fluids, IV nutritional supplementation…
What are the complications of pregestational diabetes for mom?
PE Macrosomia leading to need for C-section Preterm labour Infection Polyhydramnios PPH Maternal mortality
What are the complications of pregestational diabetes for bb?
Macrosomia or IUGR Cardiac and renal defects NTD Hypocalcemia Polycythemia Hyperbilirubinaemia Hyperglycaemia RBS Birth injury
What is contraindicated for treatment of gestational or chronic HTN?
ACE
Diuretic
What is the classic triad of Pre-eclampsia?
HTN (140/90)
Proteinuria
Edema
occurring at > 20 weeks gestation