Obstetrics Questions Flashcards
cardiomyopathy
- treatment
- definition
- metoprolol is essential, reduced mortality
- defined as CHF in pp period (up to 5 months pp)
- metoprolol reduced preload and afterload, reducing pumonary edema in the context of CHF
Breast feeding
- calories needed to support
- 1800 kcal a day
- 500 kcal needed extra to support breast feeding
eclamptic seizure area of brain most likely involved?
occipital (visual disturbances)
HSV diagnosis details
Neonatal HSV too
- PCR can detect lower viral DNA concentrations than cultures
- with active sores you want viral culture + PCR
- neonatal: usually aquirred through intrapartum. Disease of eyes, skin, mouth (45%), CNS (30%), Disseiminated disease (25%). treat allwith acyclovir 20 mg/kg IV q8h (14 vs 21 days if advanced)
fetal blood volume
- 78 mL/kg fetus
- 125 mL/kg fetus + placenta
fetal dysmaturity syndrome
- related to term and postterm dates
- placental insufficient related
- the weight starts to lag behind
- also associated with loss of fetal hair, decreased vernix, and long finger nails
chronic Hep B most likely aquired through
- neonatal/perinatal period than in adulthood
- therefore more likely to carry long-term health risks
- complications of chronic B infection include: cirrhosis, end stage liver disease, liver cancer
Rhogam should be given…
with in 72 hours of sensitizing event, though can be given up to 28 days q
use of sequential operative methods, risk for what
- higher rates of subdural, cerebral, and subarachnoid hemorrhage, facial nerve injurty, brachial plexus injuryt, anal sphincter tears, low pH
- it is not associated with urinary incontinence
cytstic hygroma most associated with
Turner (45X)
- other associated findngs: coarctation of the aorta
sheild chaped chest
short statures
Reasons to use metformin in obstetrics
- safety of compliance issues
- pt refuses insulin
- cannot afford insulin
Do not use metformin for
- chronic kidney disease
-
congenital varicella syndrome fetal features
Chicken pox, maternal pruritis, vesicular rash, no lab testing needed
- microcephaly
- skin scaring
- limb hypoplasia
- chorioreintis
MC sx of abruption
toco, contractions
positive contraction stress test:
- late deceleratins 50%
- equivocal - occasional late decels or variables
fetal alcohol syndrome features
- thin vermillion border
- SHORT palpebral fissures
- smooth philtrum
- growth restriction
- CNS issues (abnormal reflexes)
2nd degree and 4th degree break down
2nd: come back in 2 weeks
4th: immediate repair assuming no infection
most likely maternal platelet count in fetuses affected by neonatal alloimmune thrombocytopenia (NAIT)
- mom makes antibodies to baby’s platelets.
- can affect first pregnancy
- normal platelets maternally numbers because it’s no about maternal thromocytopenia
- diagnosed retrospectively after birth with ooozing penises, or US with intracranial bleeding, hemorrhage
- IVIG at 12-20 weeks
lupus quiet for how many months prior to pregnancy to reduce poor outcomes?
- 6 months
- active lupus at time of conception and hx nephritis or lupus pneumonitis
anti lewis antibody
- lewis lives, kell kills
- made by IgM type, which is massive, and prevents it from crossing the placenta
- also baby have poor expression of the antigen, so it’s not that triggering
- therefore not associated with erythroblastosis fetalis
DIC labs positive
- low fibrinogen
- thrombocytopenia
- increased PTT/PT
- elevated D-Dimer
- decreased factors that promot clotting (5 and 7)
thrombocytopenia is pregnancy
- most common is none
- the following common symptoms: ecchymoses, epistaxis (nose bleed), gingival bleeding, petechiae, heavy menstrual bleeding is common
matnernal untreated hyperthyroidism effect on baby
treatment of hyperthroidism
- hydrops
- spontaneous abortion
PTU and methimazole
- 1st PTU: hepatotoxicity
- 2nd Methimazole: aplasia cutis and esophageal/choanal atresia
protein C or S decreases in pregnancy
- protein S decreases in pregnancy
- protein S is responsible for stopping the clot (anticoagulant), therefore increased risk for VTE
obesity increaes risk offffff
neural tube defect
gastroscoscesis
pudenal nerve roots are
- S2-4 (vagina and peritoneum)
- ass hole is S5
can’t use warfarin, teratogenic
weeks 6-12w
SVT first line treatment
digoxin
minimal amount of fetal-maternal hemorrhage that can cause RhD alloimmunization
0.1 mL
most important consideration when determining a breastfed infants risk of CNS depression from maternal opioid use
relative infant dose in miligrams per kilogram
infectious mastitis
