Oh god make it stop- OB Flashcards
_________ is a tocolytic used to delay the progression of labor to allow for the benefit of betamethasone to hasten pulmonary maturation.
Nifedipine
__________ are medications used to suppress premature labor.
Tocolytics
Intra-amniotic infection rx
Intra-amniotic infection cannot be cured without delivery
Indomethacin is contraindicated at ?
33 weeks due to risk of premature ductus arteriosus closure.
associated with oligohydramnios.
Magnesium sulfate works by ?
competing with calcium entry into cells.
Terbutaline is a ?
beta-adrenergic agent. Side effects include tachycardia, hypotension, anxiety and chest tightening or pain.
Terbutaline is bad when?
used over 48-72 hours.
mom is tachy cardiac
mom is diabetic
When is Mg sulfate great
under 32 weeks EGA when delivery is likely
Who gets progesterone therapy
hx of preterm birth
short cervix
High levels of magnesium sulfate may cause
respiratory depression (12-15 mg/dl) or cardiac depression (>15 mg/dl)
Prior to developing respiratory depression diminished or absent deep tendon reflexes (areflexia).
Fetal fibronectin is good because
has a negative predictive value of 99.2% in symptomatic women — 99 out of every 100 patients with a single negative test result will not deliver in the next 14 days
what ratio helps you ddx preeclampsia
protein/ creatinine >0.3
or 24 protein > 300
Can you ddx appendicitis w/ ultrasound
YES! esp helpful in a prego
if US fails, then MRI
When is Ca- 125 diagnostic
in a post menopausal lady.
Postmenopausal lady w/ ovarian cyst and negative Ca-125 managment
Observation
Chorioamnionitis rx
deliver the baby vaginaly (unless there was some other reason you were gonna do c-section)
Most common side effect to fluoxetine
insomnia
SSRIs and breast feeding
Current recommendations state that SSRI medications can be safely used during lactation.
Third trimester maternal use of SSRIs has been associated with what in baby
abnormal muscle movements (extrapyramidal signs or EPS) withdrawal symptoms --> agitation abnormal muscle tone tremor sleepiness severe difficulty breathing difficulty in feeding.
Premenstrual Dysphoric Disorder
severe form of PMS that includes physical and behavioral symptoms that usually resolve with the onset of menstruation.
occur in the luteal phase and are absent in the beginning of the follicular phase.
Post partum blues symptoms
insomnia easy crying depression, poor concentration irritability labile affect and anxiety Symptoms often last a few hours per day and are mild and transient.
The primary risk factor for preterm rupture of membranes is
genital tract infection, especially associated with bacterial vaginosis.
Variable decelerations are a result of ?
cord compression
Antibiotic therapy with _________ given to patients with PPROM has been found to prolong the latency period by 5-7 days, & ↓ incidence of maternal amnionitis and neonatal sepsis.
ampicillin and erythromycin
ampicillin and erythromycin for PPROM has been found to?
prolong the latency period by 5-7 days
↓ incidence of maternal amnionitis and neonatal sepsis.
Maternal signs of _____________ are indications for delivery vaginally (unless c/s for other reason)
chorioamnionitis or other evidence of intra-amniotic infection
A ___________ is an indication of intra-amniotic infection on amniocentesis
low amniotic fluid glucose
_______________- med has been shown to reduce the risk of premature labor.
17 alpha-hydroxyprogesterone
administered weekly (16-20 weeks) until 36 weeks gestation.
Vitamin deficiency of ________ have been associated with an increase in PMS.
A, E and B6
during the luteal phase of the menstrual cycle.
1-_____is characterized by mild to moderate symptoms,
2- ______is associated with severe symptoms that seriously impair usual daily functioning and personal relationships.
1- PMS
2- PMDD
Symptoms of __________ can mimic typical symptoms of PMS,
hypothyroidism
Psych drug Rx for PMS
SSRI effective in alleviating PMS and PMDD symptoms. Patients can take the medication either every day or for 10 days during the luteal phase.
Risk factors for PMS include
a family history of premenstrual syndrome (PMS) and Vitamin B6, calcium, or magnesium deficiency.
______________- are significant risk factors for developing premenstrual dysphoric disorder (PMDD).
Previous anxiety, depression or other mental health problems
Methylergonovine is an ergot alkaloid, which is a ?
potent smooth muscle constrictor.
vasoconstrictive agent a
should be withheld from women with hypertension and/or preeclampsia.
Postpartum hemorrhage is defined as bleeding in excess of
500 cc after a vaginal delivery or in excess of 1000 cc after a Cesarean delivery.
uterotonics and used to increase uterine contractions and decrease uterine bleeding are?
. Methylergonovine, prostaglandins and oxytocin
___________ has been shown to be effective in the management of unresponsive uterine atony.
A uterine compression suture such as a B-Lynch
Septic pelvic thrombophlebitis is diagnosed how?
exclusion
CT may also help
Septic pelvic thrombophlebitis rx
treatment requires addition of anticoagulation to antibiotics and resolution of fevers is generally rapid
Septic pelvic thrombophlebitis s/s
non specfic
high fever
all other causes ruled out
_________ are the most common source of fever on the first postpartum day
The lungs, esp if you had anesthesia for delivery
