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Ob/Gyn > Pregnancy and Prenatal Care > Flashcards

Pregnancy and Prenatal Care Flashcards

1
Q

Chadwick sign

A

Bluish discoloration of the vagina and cervix

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2
Q

Goodell sign

A

Softening and cyanosis of the cervix at or after 4 weeks

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3
Q

Ladin sign

A

Softening of the uterus after 6 weeks

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4
Q

Cardiovascular changes in pregnancy

A
  • Increased cardiac output (30-50%)
  • (+)SV, followed by (+)HR
  • (-)SVR due to elevated progesterone
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5
Q

Pulmonary changes in pregnancy

A

(+)Tidal volume

(-)Expiratory reserve volume

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6
Q

What facilitates oxygenation and ventilation of the fetus?

A

(-)PaCO2 (arterial), creating CO2 gradient b/w mother and fetus

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7
Q

Hyperemesis gravidarium (define, 2 features)

A
  • Severe morning sickness
  • Weight loss (> 5% pre-pregnancy weight)
  • Ketosis
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8
Q

GI changes in pregnancy (3)

A
  • Prolonged gastric emptying (reflux)
  • Decreased GE sphincter tone (ptyalism)
  • Decreased large bowel motility
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9
Q

Renal changes in pregnancy (3)

A
  • Increased GFR (50%)
  • Decreased BUN and creatinine (25%)
  • Increased RAAS activation, but normal serum Na
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10
Q

Hematologic changes in pregnancy (3)

A
  • Dilutional anemia
  • Elevated levels of fibrinogen, factors VII-X
  • Normal clotting and bleeding times
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11
Q

What produces increased estrogen in pregnancy, and from what is it derived?

A
  • Produced primarily by the placenta

- Derived from circulating precursors in plasma from maternal adrenal glands

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12
Q

Effects of Human Placental Lactogen (hPL) (2)

A
  • Lipolysis (increased circulating free FAs)

- Insulin antagonist (diabetogenic, +protein synthesis)

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13
Q

Urine tests in pregnancy (3)

A
  • Glucose
  • Protein (preeclamsia)
  • Leukocyte esterase
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14
Q

Elevated/decreased maternal serum AFP is associated with:

A
  • Elevated: neural tube defects

- Decreased: aneuploidies (Down syndrome)

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15
Q

Components of the quad screen:

A
  • Estriol
  • AFP
  • Inhibin A or B
  • B-hCG
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16
Q

Treatment offered to patients who are Rh negative

A

Rho-GAM (good for 12 weeks)

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17
Q

Third-trimester labs (3-5):

A
  • Hematocrit (near nadir)
  • RPR/VDRL
  • Glucose loading test
  • High risk: GC/CT
  • Group B strep
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18
Q

Components of the biophysical profile (5):

A
  • Amniotic fluid volume
  • Fetal tone
  • Fetal activity
  • Fetal breathing movement
  • Nonstress test (NST)
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19
Q

Risk factors for ectopic pregnancy (6):

A
  • Prior ectopic pregnancy (10% for one, 25% for two)
  • History of STIs or PID
  • Previous surgery (tubal, pelvic, abdominal)
  • Assisted reproduction
  • IUD
  • Smoking
20
Q

Causes of vaginal bleeding in the first trimester (5):

A
  • Spontaneous abortion (SAB)
  • Postcoital bleeding
  • Ectopic pregnancy
  • Lesions/lacerations
  • Extruded molar pregnancy
21
Q

Diagnosis for rupture of membranes (3)

A
  • Pool: inspection for fluid
  • Nitrazine: alkaline on pH paper
  • Fern: microscopy
22
Q

Bishop score

A

Five elements of cervical examination

  • Dilation
  • Effacement
  • Fetal station
  • Cervical position
  • Consistency of the cervix
23
Q

Methods for induction of labor (4):

A
  • Oxytocin
  • Prostaglandins
  • Manual dilation of the cervix
  • Artificial ROM (amniotomy)
24
Q

Early decelerations indicative:

A

Compression of the fetal head during contraction, causing increased vagal tone

25
Variable decelerations are indicative of:
Umbilical cord compression
26
Late decelerations indicate:
Uteroplacental insufficiency
27
Three signs of placental separation:
1. Cord lengthening 2. Gush of blood 3. Uterine fundal rebound All must be noted prior to delivery of the placenta
28
Major causes of antepartum hemorrhage (3):
- Placenta previa (20%) - Placenta abruption (30%) - Uterine/fetal vessel rupture - Non-OB: cervical pathology, vaginal lacs, etc.
29
The greatest risk from having placenta previa is:
Placenta accreta
30
Sinusoidal pattern on FHM suggests:
Fetal anemia
31
A succenturiate lobe increases the risk for development of :
Vasa previa
32
Use of betamethasone in labor:
- Used in conjunction with tocolytics (+48 hrs) | - Decreases incidence of RDS and other preterm complications
33
Mechanism by which B2 mimetics inhibit contractions:
- Stimulate B2 receptors, causing increased ATP production | - ATP is converted to cAMP, which sequesters Ca
34
Options for tocolysis (4):
- B2 agonists - Magnesium - CCBs - Prostaglandin inhibitors
35
How do antibiotics affect the latency period in PPROM?
Extend the latency period. Use ampicillin +/- erythromycin.
36
Pre-uterine causes of fetal bradycardia (6):
- Seizure - PE - Amniotic fluid embolus - MI - Respiratory failure - Epidural or spinal placement
37
Uteroplacental causes of fetal bradycardia (3):
- Placental abruption - Uterine tetanic contraction - Uterine rupture
38
Post-placental causes of fetal bradycardia:
- Cord prolapse - Cord compression - Fetal vessel rupture (e.g. vasa previa)
39
Risk factors for shoulder dystocia (4):
- Prior shoulder dystocia - Macrosomia - Diabetes/obesity - Post-term pregnancy
40
Maneuvers for shoulder dystocia (5):
- McRoberts maneuver - Suprapubic pressure - Rubin maneuver - Wood's corkscrew maneuver - Delivery of posterior arm/shoulder
41
McRoberts maneuver:
Sharp flexion of maternal hips
42
Rubin maneuver
Compression of shoulder towards anterior chest
43
Common causes of decreased growth potential (4):
- Genetic abnormalities - Chromosomal (trisomy) - Teratogens, drugs, radiation - TORCH infections
44
Common causes of IUGR (2):
- Maternal (HTN, anemia, CKD, DM) | - Placental (previa, abruption)
45
Methods for estimating neonatal risk of delivery (4):
- NST - Oxytocin challenge - BPP - Umbilical doppler
46
Screening for fetal anemia if Rh+
MCA Doppler (anemic fetuses have increased cerebrovascular flow)

Ob/Gyn (13 decks)

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