Pregnancy, Childbirth and Puerperium II Flashcards
Postpartum urinary retention is typically related to bladder […].
Postpartum urinary retention is typically related to bladder atony.
temporary and reversible; confirmed by > 150 mL of urine upon urethral catheterization
Preeclampsia is defined as hypertension with […] or […] after the 20th week of gestation.
Preeclampsia is defined as hypertension with proteinuria or end-organ dysfunction after the 20th week of gestation.
patients with evidence of end-organ damage have preeclampsia with severe features
Preeclampsia is defined as hypertension with proteinuria or end-organ dysfunction after the […] week of gestation.
Preeclampsia is defined as hypertension with proteinuria or end-organ dysfunction after the 20th week of gestation.
patients with evidence of end-organ damage have preeclampsia with severe features
Preterm labor refers to regular contractions causing cervical dilation and/or effacement at
Preterm labor refers to regular contractions causing cervical dilation and/or effacement at < 37 weeks gestation.
Risk factors for placenta accreta include history of […] or […] and advanced maternal age.
Risk factors for placenta accreta include history of cesarean delivery or dilation & curettage and advanced maternal age.
Second stage arrest of labor is defined as no fetal descent after pushing for > […] hours (nulliparous) or > […] hours (multiparous).
Second stage arrest of labor is defined as no fetal descent after pushing for > 3 hours (nulliparous) or > 2 hours (multiparous).
Spontaneous abortion is unprovoked pregnancy loss at
Spontaneous abortion is unprovoked pregnancy loss at < 20 weeks gestation and is a common cause of first trimester bleeding.
Spontaneous abortions are most commonly the result of […] abnormalities.
Spontaneous abortions are most commonly the result of fetal chromosomal abnormalities
also associated with congenital abnormalities.
(e.g. teratogens) and mullerian anomalies (e.g. uterine septum)
Symptomatic maternal luteoma puts a female fetus at a high risk of […].
Symptomatic maternal luteoma puts a female fetus at a high risk of virilization.
Symptoms of magnesium toxicity include somnolence, respiratory […], and […]-reflexia.
Symptoms of magnesium toxicity include somnolence, respiratory depression, and hypo-reflexia
more mild symptoms include nausea, flushing, and headache
Symptoms of magnesium toxicity include […]-calcemia and cardiac arrest.
Symptoms of magnesium toxicity include hypo-calcemia and cardiac arrest.
more mild symptoms include nausea, flushing, and headache; hypocalcemia due to temporary suppression of PTH
Systemic lupus erythematosus flare during pregnancy is distinguished from preeclampsia by the presence of […] on urinalysis and classic symptoms of SLE (e.g. joint pain, malar rash).
Systemic lupus erythematosus flare during pregnancy is distinguished from preeclampsia by the presence of RBC casts on urinalysis and classic symptoms of SLE (e.g. joint pain, malar rash).
other findings consistent with SLE flare include decreased complement levels and increased ANA titers
The diagnosis of ectopic pregnancy is made by a pregnancy test combined with […].
The diagnosis of ectopic pregnancy is made by a pregnancy test combined with transvaginal ultrasound.
typically presents with a triad of vaginal bleeding, lower abdominal pain, and adnexal tenderness
The first-trimester combined test analyzes the risk for fetal trisomy 18 & 21 by measuring maternal serum pregnancy-associated plasma protein and […], as well as […] translucency on ultrasound.
The first-trimester combined test analyzes the risk for fetal trisomy 18 & 21 by measuring maternal serum pregnancy-associated plasma protein and beta-hCG, as well as nuchal translucency on ultrasound.
performed between 9 - 13 weeks of gestation; not diagnostic
The major risk factor for shoulder dystocia is fetal […].
The major risk factor for shoulder dystocia is fetal macrosomia.
i.e. fetal weight > 4.5 kg (9.9 lb); conditions that predispose to macrosomia include post-term pregnancy, maternal obesity, gestational diabetes, and excessive weight gain during pregnancy
The optimal fetal positioning is occiput […].
The optimal fetal positioning is occiput anterior.
deviations from this position may cause arrest of the second stage of labor
The presence of amniotic fluid may be detected with the […] and/or […] test.
The presence of amniotic fluid may be detected with the nitrazine and/or fern test
a positive nitrazine test turns the test strip blue.
Theca lutein cysts arise due to ovarian hyperstimulation secondary to markedly elevated […] levels.
Theca lutein cysts arise due to ovarian hyperstimulation secondary to markedly elevated beta-hCG levels.
e.g. complete hydatidiform mole, multifetal gestation
Treatment for eclampsia includes blood pressure control, […] for seizure prevention, and expedient delivery.
Treatment for eclampsia includes blood pressure control, magnesium sulfate for seizure prevention, and expedient delivery.
if magnesium sulfate does not control seizures, diazepam or phenytoin are second-line options
Universal screening for group B Streptococcus colonization is typically done by vaginal and rectal culture at […] - […] weeks gestation.
Universal screening for group B Streptococcus colonization is typically done by vaginal and rectal culture at 35 - 37 weeks gestation
the result is most accurate within 5 weeks of the anticipated delivery.
Uterine rupture classically occurs in a woman with prior […].
Uterine rupture classically occurs in a woman with prior uterine surgery.
e.g. prior cesarean delivery or myomectomy; inelastic scar may not be able to withstand labor contractions
What acid-base disturbance is physiological during normal pregnancy?
Chronic respiratory alkalosis
due to increased minute ventilation
What are the current recommendations for influenza vaccination during pregnancy?
All pregnant women should receive the inactivated (injectable) influenza vaccine
the intranasal (live) influenza vaccine is contraindicated
What are the first-line agents (3) for maternal hypertensive crisis?
nifedipine, hydralazine, or labetalol
What are the most common causes (2) of hyperandrogenism in pregnancy?
luteomas and theca luteum cysts
may manifest as new-onset hirsutism and/or acne
What are the most common causes of acute cervicitis?
Chlamydia trachomatis and Neisseria gonorrhoeae infection
What are the target 1-hour and 2-hour postprandial blood glucose levels in patients with gestational diabetes mellitus?
What changes detected by maternal quadruple screen are indicative of trisomy 18 (Edward syndrome)?
AFP: […]
Estriol: […]
beta-hCG: […]
Inhibin A: […]
AFP: decreased
Estriol: decreased
beta-hCG: decreased
Inhibin A: normal
decreased hCG and normal inhibin A help differentiate trisomy 18 from trisomy 21 (increased hCG and inhibin A)
What changes detected by maternal quadruple screen are indicative of trisomy 21 (Down syndrome)?
AFP: […]
Estriol: […]
beta-hCG: […]
Inhibin A: […]
AFP: decreased
Estriol: decreased
beta-hCG: increased
Inhibin A: increased
elevated hCG and inhibin A help differentiate trisomy 21 from trisomy 18 (decreased hCG, normal inhibin A)