Pathologic Obstetrics Flashcards
Criteria for Chorioamnionitis
Maternal fever >/= 38 plus one of the ff -fetal tachycardia -uterine tenderness -purulent or foul-smelling discharge -leukocytosis -elevated ESR
presents with vaginal bleeding, uterine enlargement, acute abdomen due to tumor perforation, bleeding from metastatic sites
Gestational Trophoblastic Neoplasia
Classic presentation of placenta previa
Painless vaginal bleeding
Most common obstetric cause of DIC
Abruptio Placenta
Gestational HTN is defined as
HTN without proteinuria occuring after 20 weeks gestation and BP levels return to normal 12 weeks postpartum
Preeclampsia mild is defined
(without severe features)
BP ≥ 140/90 beyond 20 wks AOG associated with ANY of the ff:
-with or without proteinuria (NEW criteria)
-impaire liver function
Preeclampsia severe is defined as
(with severe features)
BP ≥ 160/110 beyond 20 wks AOG
Associated with ANY of the ff:
-RUQ/epi pain, thrombocytopenia: Plt <100,000/mL, impaired liver func: transaminase 2x above normal; renal insufficiency:serum crea>1.1 or 1.2 mg/dL in the absence of renal dse or oliguria <400-500 mL/day, pulmonary edema, cerebral disturbance (severe headache, altered mental status), visual disturbance
Eclampsia is defined as
occurence of convulsions, not caused by incidental neurologic dse, in a woman with preeclampsia
Chronic HTN is defined as
BP ≥ 140/90 prior to pregnancy before 20 wks AOG and persists after 12 wks postpartum
also
HTN first dx after 20 wks and persistent 12 wks postpartum
Chronic HTN with superimposed preeclampsia is defined as
pre-existing chronic HTN with new-onset proteinuria and signs and sx of various end-organ dysfunction
Prevention of pre-eclampsia syndrome
High-dose Ca: 1.5-2g/day before 32 weeks
Low dose aspirin: 60-80 mg/day to start on 2nd trimester
When to consider hospitalization and delivery for gestational HTN?
- AOG ≥ 40 wks
- AOG ≥ 37 wks if (NBF): NR NST, bishop score >5, fetal weight <10th percentile
- AOG ≥ 34 wks with (CRAVL): criteria for severe pre-eclampsia, ROM, Abn BPS, VB, labor)
Weekly check-up for GHTN should include
BP, Plt ct and liver enzymes, NST, fetal growth every 2-3 wks
Antidote fot MgSO4 overdose
Calcium gluconate IV (10 mL of 10% solution)
Level of MgSO4 that can prevent convulsion
4-7 mEq/L