Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/GYN > Prenatal Care and Disorders > Flashcards

Prenatal Care and Disorders Flashcards

1
Q

Definition of Pre-conception Care

A

a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Purpose of Pre-conception Care

(4)

A

goals for advancing pre-conceptional care

  • improve knowledge, attitudes, and behaviors of men and women related to pre-conceptual health
  • assure all women of childbearing age receive pre-conceptual care services to enterpregnancy at OPTIMAL health:
  • evidence-based risk screening
  • health promotion
  • interventions
  • interconceptual interventions to prevent or minimize risks from previous adverse pregnancy
  • reduce disparities in adverse pregnancy outcomes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Elements of Pre-conception Care

A
  • reproductive life plan (more children)
  • past reproductive history
  • PMH - conditions that could affect preg.
  • meds (teratogens?)
  • infections/immunizations
  • genetic screening/family hx
  • nutritional assessment (BMI, eating d/o, anemia)
  • substance abuse
  • environmental toxins/teratogens
  • psychosocial (depression, violence)
  • PE - oral, thyroid, heart, breasts, pelvic
  • labs - prenatal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contraindications to Exercise in Pregnancy

A
  • preeclampsia or pregnancy induced HTN
  • severe anemia
  • restrictive lung disease
  • hemodynamically significant heart disease
  • premature rupture of membranes
  • premature labor during prior or current preg.
  • incomptent cervix or cerclage
  • persistent 2nd or 3rd trimester bleeding
  • placenta previa after 26 weeks
  • intrauterine growth restriction (IUGR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 Main Components of Prenatal Care

(ideally before pregnancy)

A
  1. early and continuing risk assessment
  2. health promotion
  3. medical and psychological interventions and follow-up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Trimester Weeks

A
  • First: weeks 1 - 13
  • Second: weeks 14-27
  • Third: weeks 28-40
  • Post dates/term beyond week 40 (42)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

First Prenatal Visit - History

A
  • medical/surgical
  • reproductive
    • menstrual
    • OB/GYN
    • sexual
    • contraceptive
  • meds
  • allergies
  • family/genetic
  • nutritional
  • psychological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

First Prenatal Visit - Labs

A
  • CBC
  • blood type / Ab
  • rubella, syphilis, Hep B, HIV
  • gonorrhea, chlamydia
  • early diabetes screening if indicated
  • TB if indicated
  • UA (proteinuria, WBC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

First Prenatal Visit - PE

A
  • pap smear
  • pregnancy and dating confirmation
  • education about what to expect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Confirmation of Implantation/Viability - Tests

A
  • 30-40% implantation bleeding
  • hCG (human chorionic gonadotropin) hormone detected in urine or blood
    • used to eval. abortion, ectopic, molar (slower rise)
  • transvaginal US to predict viability early
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

reproductive age women w/ abnormal bleeding

what should be done

A

pregnancy test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when do serum hCG levels double

A

every 2.2 days for 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when do serum hCG levels peak

A

10-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when can hCG levels be detected

A
  • urine
    • >25 IU/L
  • blood
    • Beta subunit from syncytiotropoblast 8 days after fertilization and detected 8-11d after conception/21-22d after LMP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when do hCG levels return to normal

A

normal (<5 mIU/mL) 21-24 days after delivery/loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Confirmation of Pregnancy/Viability - Physical**

A
  • amenorhhea - abrupt cessation of menstruation when otherwise normal
  • lower tract changes
    • Chadwick sign
    • cervical softening
  • uterine changes
    • anteroposterior growth
    • doughy/elastic to bimanual exam
    • Hegar sign
  • ​breast and skin changes
    • increased pigmentation
    • abdominal striae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

bluish-red vaginal mucosa and cervix

A

Chadwick sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

firm cervix w/ softened fundus and isthmus

A

Hegar sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Confirmation of Pregnancy/Viability - Transvaginal Sonagraphy Findings

A

accurately est. gestational age and confirm preg.

  • gestational sac
    • small anechoic fluid collection w/in endometrial cavity
    • implants eccentrically
    • 1st sonographic evidence of preg.
    • seen w/ TVUS by weeks 4-5
  • double decidual sign
    • decidua parietalis (outer ring)
    • decidua capsularis (inner ring)
  • pseudogestational sac / pseudosac
    • fluid collection in endometrial cavity
    • implants midline
    • sign of ectopic pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Indications for 1st Trimester US

A
  • confirmation of intrauterine pregnancy
  • evaluation of suspected ectopic pregnancy
  • define cause of vaginal bleeding
  • evaluate pelvic pain
  • estimate gestational age
  • confirm cardiac activity
  • assist w/ chrionic villus sampling, etc.
  • assess fetal anomalies like encephaly
  • evaluate maternal pelvic masses/uterine abno.
  • measure nuchal translucency
  • evaluate suspected gestational trophoblasic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indications for 2nd/3rd Trimester US

(maternal)

A
  • vaginal bleeding
  • abdominal/pelvic pain
  • pelvic mass
  • suspected uterine abnormality
  • suspected ectopic pregnancy
  • suspected molar pregnancy
  • suspected placenta previa and surveillance
  • suspected pleacental abruption
  • premature membrane rupture/labor
  • cervical insufficiency
  • adjunct to cervical cerclage, amniocentesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Indications for 2nd/3rd Trimester US

(fetal)

A
  • gestational age estimation
  • evaluate fetal growth
  • significant fetal size/clinical date discrepancy
  • suspected multifetal gestation
  • fetal anatomical evaluation
  • fetal anomaly screening
  • abnormal biochemical markers
  • fetal presentation determination
  • suspected hydramnios/oligohydramnios
  • fetal well-being evaluation
  • suspected fetal death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Calculating Due Date

(alternate term)

A

estimated date of confinement (EDC)

based on 40 weeks

  • Naegele’s rule: 1st day LMP + 7d - 3m + 12m
  • 6-11w: crown-rump length
    • GA within 7d
  • 12-20w: biparietal diam., femur len., ab and head circumference
    • GA within 10d
  • third trimester
    • GA withing +/-3w
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

anatomy/growth US performed

A

~20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

glucose tolerance, CBC, syphilis, Coombs performed

A

24-28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tdap vaccine recommended

A

27-36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

GBBS (Group B strep), GC/chlamydia if indicated

A

35-37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

education and risk factor screenings performed

A

each visit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

checked at each visit

(5)

A
  • BP
  • weight
  • urine dip: protein, glucose, ketones
  • uterine size (fundal height)
    • monitor growth and amniotic fluid volume
    • weeks 20-34 height in cm approximates age in weeks
  • fetal heart sounds/rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

normal fetal HR and when heard

A

110-160 bpm

heard with Doppler at about 10 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

assessed at each visit

(5)

A
  • fetal movement
  • bleeding
  • contractions
  • suspected loss of amniotic fluid
  • low back pain/pelvic pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

when fetal movement expected

A
  • primiparous: 18-20 weeks
  • multigravida: 14-18 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when uterus is palpable above pubic symphesis

A

8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

when uterus becomes and abdominal organ

A

12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

when uterus is midway between

pubic symphesis and umbilicus

A

16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

when utererus is palpable at umbilicus

A

20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

when uterine size (fundal height) in cm from pubic symphesis correlates with gestational age

A

18-34 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

education topics at visits

A
  • preterm labor symptoms <37 weeks
  • symptoms of labor >37 weeks
  • symptoms of preeclampsia
  • fetal movement counts
  • lifestyle, breastfeeding, contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

when depression screenings done

A
  • initial OB visit
  • 3rd trimester
  • postpartum

relationship between Vit D and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

manual assessment of fetal size and position

A

Leopold maneuvers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

when Leopold maneuvers indicated

A

after 26 weeks

(checking for abnormal lie late in pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

appearance of cervix in nulliparous woman

A

closed external cervical os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

appearance of cervix in multiparous woman

A

greater opening/dilation of external cervical os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what to check in women with previous spontaneous preterm birth

A

transvaginal US to check

  • cervical dilation
  • cervical shortening (< 3-4 cm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Steps in Leopold Maneuver

A

maneuvers

  • first - palpate superior fundus
    • shape, consistency, mobility
  • second - palpate both sides
    • determine direction back is facing
  • third - palpate inferior fundus
    • determine part of fetus at inlet and its mobility
  • fourth
    • determine fetal attitude and degree of extension into the pelvis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Follow-up Visit Labs

when are fetal aneuploidy screenings done

A

11-14 weeks and/or 15-20 weeks

(check for abnormal number of chromosomes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Follow-up Visit Labs

when screenings for neural-tube defects offered

A

15-20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Follow-up Visit Labs

when hematocrit/hemoglobin and syphilis repeated

A

28 and 32 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Follow-up Visit Labs

when HIV tested if increased risk

A

third trimester - before 36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Follow-up Visit Labs

when tested if high risk HBV

A

at time of hospitalization for delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Follow-up Visit Labs

when Rh testing done for Rh- mother

A

weeks 28-29

administer anti-D Ig if mother remains unsensitized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Frequency of OB Visits

(3 time periods)

A
  • up to 28 weeks: every 4 weeks
  • 28-35 weeks: every 2 weeks
  • 36+ weeks: weekly until delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Warning Signs in First Trimester

A
  • vaginal bleeding
  • persistent NAV
  • fever, chills
  • dysuria, hematuria, inability to void
54
Q

Warning Signs in Second/Third Trimester

A
  • leaking fluid, change in vaginal discharge
  • sudden abdominal pain/cramping
  • vaginal bleeding
  • pelvic pressure, persistent backache
  • persistent HA unrelieved by OTC treatments
  • generalized edema
  • visual changes
  • decreased fetal movement
  • fever, chills
  • dysurea, hematuria
  • protrusion of umbilical cord from vagina
55
Q

Education Topics at Visits

A
  • work accomodations (restrictions, FMLA, etc)
  • exercise
  • travel risks
  • sexual activity
  • breastfeeding
  • postpartum contraception
  • social needs
  • parenting classes
  • vaccines
56
Q

how is fetal well-being assessed

A
  • HR
  • breathing
  • fetal movement
  • fetal tone
  • amniotic fluid volume
57
Q

Measuring Fetal Kick Count

A
  • patient counts movements starting at 9am until 10 movements perceived
  • count done daily
  • alerts physician if:
    • <10 movements w/in 12h on 2 consec. d
    • no movements in 12h in a single d
58
Q

Non-stress Testing (NST)

Reactive vs. Non-reactive

A

reactive

  • acceleration of 15 bpm above baseline for 15 seconds 2x in 20 min with movement
59
Q

excessive vs. inadequate amniotic fluid

A
  • polyhydramnios (AFI > 23cm) - excessive
  • oligohydramnios (AFI < 5cm) - inadequate
60
Q

normal fetal breathing

A

_>_1 episode of rhythmic breathing

lasting _>_30 sec within 30 min

61
Q

normal fetal movement

A

_>_3 discrete body or limb movements

withing 30 min

62
Q

normal fetal tone

A

_>_1 episode of extremety extension

and subsequent return to flexion

63
Q

scores of the fetal activities and actions

(biophysical profile)

A

amniotic fluid volume (AFV) - 2x2cm pocket norm.

  • 8/10 w/ normal AFV - normal, repeat testing
  • 8/10 w/ decreased AFV - deliver
  • 6 - possible asphyxia
    • abnormal AFV- deliver
    • normal AFV, >36w, favorable cervix- deliv.
    • repeat test < 6- deliver
    • repeat test > 6- observer, repeat per prot.
  • 4 - probable asphyxia- repeat same day, _<_6 del.
  • 0-2 - almost certain asphyxia- deliver
64
Q

nutritional requirement of pregnancy

(kcal/day, weight gain)

A
  • increase 300 kcal/day
  • recommended weight gain per BMI
    • <19 28-40lbs
    • 19-24.9 25-35lbs
    • 25-29.9 15-25lbs
    • _>_30 11-20lbs
65
Q

percent of spontaneous abortion

A

10-15%

66
Q

hCG present in blood 7-10 days after ovulation but menses begins as expected

increases rate of loss up to 50% with most occurring 14 days following ovulation

A

biochemical pregnancy

67
Q

pregnancy bleeding prior to 20 weeks

A

threatening abortion

68
Q

vaginal bleeding, cramping, partially dilated cervix

A

inevitable abortion

69
Q

only passage of some products of conception

A

incomplete abortion

70
Q

passage of all POC, cramps and bleeding stop, cervix closes, uterus normal size, preg. test normal

A

complete abortion

71
Q

fetus has died but remains in uterus > 6 weeks

A

missed abortion

72
Q

3 spontaneous abortions

A

recurrent abortion

73
Q

causes of recurrent abortions

(general)

A
  • infections- mycoplsma, listeria, toxoplasma
  • smoking & alcohol
  • psychosocial stress
  • medical
    • diabetes
    • hypothyroidism
    • lupus (affects 40% of preg.)
  • age
74
Q

causes of recurrent abortions

(local maternal factors)

A

uterine abnormalities

  • cervial incompetence
  • congenital abnormal uterus
  • fibroids
  • intrauterine adhesions
75
Q

scar tissue that develops following procedures

(like D&C)

A

Asherman syndrome**

76
Q

recurrent abortions

(MCC)

A

genetic abnormality of the fetus**

77
Q

recurrent abortions

(placental factors)

A
  • conversion of cortisol to inactive corticosterone by 11Beta-hydroxylase between 22-24 weeks
    • protective factor
    • genetic polymorphisms can reduce enzyme production
  • leptin resistance if obsese
    • increases risk of fetal IUGR
78
Q

management of threatened abortion

A

US, reassurance

79
Q

management of incomplete abortion

A
  • heavy bleeding: IV access, type and cross
  • POC removal and sent to pathology
  • tx delays can lead to sepsis
80
Q

management of missed abortion

A

confirm by US, manage pain

81
Q

management of recurrent abortion

A
  • parental testing
  • hysteroscopy to eval. uterine cavity
  • pelvic US
  • Vit D considerations
  • future cerclage
82
Q

indications for genetic counseling

(must have informed consent)

A
  • A previous child with or family history of birth defect, chromosomal abnormality or known genetic disorder
  • A previous child with undiagnosed mental retardation
  • A previous baby who died in the neonatal period
  • Multiple fetal losses
  • Abnormal serum marker screening results
  • Consanguinity
  • Maternal conditions predisposing the fetus to congenital abnormalities
  • A current pregnancy history of teratogen exposure
  • A fetus with suspected abnormal ultrasound findings
  • A parent that is a known carrier of a genetic disorder
83
Q

Genetic Screening for Autosomal Recessive D/O

A

cystic fibrosis screening should be offered to all according to current recommendations

  • CF (whites)
  • sickle cell (AA)
  • tay-sachs (Jews, French, Canadians)
  • thalassemia (mediterranean, southeast asians)
84
Q

prevention of spina bifida

A

4mg folic acid prior to conception

85
Q

first trimester screening

A

nuchal translucency

86
Q

second trimester screening

A

weeks 15-20

  • serum triple screen
    • alpha-fetoprotein (low = Downs)
    • hCG
    • unconjugated estriol (UE3)
  • US if increased risk
  • quad screen
    • triple + inhibin A for Downs
  • amniocentesis and AChE (neural tube defect)
87
Q

triple screen indications**

AFP__hCG__uE3

high

all low

high n/a n/a

A

Down Syndrome

Trisomy 18 (Edwards)

NTDs (ex. spina bifida)

88
Q

combined 1st and 2nd trimester screening

(integrated screening)

A

elevated hCG -or- AFP

+

low pregnancy plasma protein A -or- estriol

=

preterm birth, IUGR, preeclampsia

89
Q

drug classifications

A
  • A - no evidence of fetal risk
  • B - animal studies no risk or minor risk
  • C - animal shows risk, use w/ caution only if benefits outweigh risk
  • D - positive fetal risk, use only in life-threatening emergency
  • X - do not use in pregnancy
90
Q

common teratogenic drugs

A

methotrexate, coumadin, dilantin, valproic acid

91
Q

good seizure med, safer alternative for Coumadin

A

Keppra, heparin

92
Q

leading cause of maternal mortality in U.S.**

A

pre-eclampsia

93
Q

triad of preeclampsia**

A
  • hypertension (140/90)
  • proteinuria (> 3g / 24h after 20 weeks)
  • generalized edema

highest risk in 1st pregnancy

cure is delivery, anti-hypertensives to tx HTN

94
Q

signs of severe pre-eclampsia

A
  • severe HTN (>160/110)
  • renal insufficiency
  • cerebral/visual disturbances
  • pulmonary edema
  • epigastric or right upper quadrant pain
  • elevated liver enzymes (AST/ALT 2x+ norm)
  • thrombocytopenia (<100K platelets)
95
Q

HELLP Syndrome

A
  • hemolysis
  • elevated liver enzymes
  • low platelets
96
Q

what is HELLP syndrome

A

varient of severe preeclampsia

  • multiparous
  • age > 25
  • < 36 weeks gestation
  • HTN presence varies
    • 20% no change
    • 30% mild elevation
    • 50% severe elevations
97
Q

pre-eclampsia with new onset grand mal seizures

A

eclampsia

98
Q

when to consider other underlying causes of seizures

A

atypical presentation

  • underlying seizures
  • hypertensive encephalopathy
  • hypoglycemia
  • hyponatremia
  • CNS hemorrhage
  • thrombosis
  • tumor
  • infection
99
Q

know HTN before preg. or dev. before 20 weeks

A

chronic hypertension

(most are essential,

secondary gets collaboratoin w/ high risk physician)

100
Q

when to treat chronic HTN

A

BP > 160/105

(many improve in 2nd trimester)

101
Q

drug of choice for chronic hypertension

&

what NOT to use

A
  • DOC:
    • Aldomet (Methyldopa)
    • hydralazine, labetalol, nifedipine 2nd line
  • NO ACE-inhibitors (teratogenic)
102
Q

chronic hypertension w/ superimposed preeclampsia

symptoms

A

chronic HTN w/ new proteinura after 20 weeks

-OR-

preexisting HTN and proteinuria that dev. suddenly

(significant increase in BP or proteinuria)

103
Q

HTN w/out proteinuria after 20 weeks or within

48-72 hours after delivery and resolves by 12 weeks

A

gestational hypertension

(baby does well but mom fails)

104
Q

leading cause of obstetric hemorrhage

in 2nd and 3rd trimester

A

placental abruption -

premature separation of placenta from uterine wall

105
Q

symptoms of placental abruption

A

back discomfort

abdominal cramping

vaginal bleeding

severe abdominal pain

106
Q

when prophylactic given for Rh incompatibility

A

rhogam/rhophylac

  • bleeding in pregnancy
  • at 28 weeks
  • after birth with Rh positive newborn (2nd preg.)
107
Q

pregnancy implanted outside endometrial cavity

A

ectopic pregnancy

108
Q

S/s of ectopic pregnancy

A
  • missed period, then intermittent light bleeding
  • cramping/pelvic pain
  • adnexal enlargement/tenderness on pelvic exam
  • +pregnancy test
  • US confirmation of implantation location
109
Q

Tx of ectopic pregnancy

A

methotrexate to preserve fallopian tube

surgery if emergent

110
Q

when to surgically intervene w/ ectopic pregnancy

A
  • rigid abdomen
  • severe tenderness
  • involuntary guarding
  • evidence of hypovolemic shock
    • tachycardia, orthostatic BP changes
111
Q

inability of cervix to retain pregnancy in 2nd trimester

A

incompetent cervix

(> 30mm considered normal)

112
Q

symptoms of incompetent cervix

A
  • vaginal bleeding
  • pelvic pressure
  • back pain
  • abdominal cramping
113
Q

Tx of incompetent cervix

A

Cerclage

17-hyroxyprogesterone

114
Q

placenta implants over cervical os

(sudden painless bleeding common sx)

A

placenta previa

(low-lying placenta safe for labor and vaginal birth)

115
Q

benign neoplasm w/ potential to become malignant

A

gestational trophoblastic disease

(hydatidiform mole)

116
Q

rare condition preceeded by hydatididform mole

A

choriocarcinoma

117
Q

S/s of molar pregnancy

A
  • large for dates uterus
  • uterine bleeding evident by 12th week
  • SOB
  • enlarged tender ovaries
  • no fetal heart tones
  • no fetal activity
  • PIH, preeclampsia, eclampsia before 24w
118
Q

risk of gestational diabetes

A
  • hyperglycemia in 1st trimester teratogenic
  • macrosomia and fetal demise later in preg.
119
Q

when gestational diabetes treated

A

serum glucose > 200 mg/dL

120
Q

max blood glucose levels in OGTT

A
  • fasting: 95
  • 1 hour: 180
  • 2 hour: 155
  • 3 hour: 140
121
Q

risk factors of GDM

A
  • age > 35
  • previous baby > 9lbs
  • obesity
  • AA
  • hispanic
  • GDM in prev. preg.
  • recurrent infections
122
Q

Tx of choice for GDM

A

insulin

123
Q

GDM follow-up

A

75gram OGTT at 6-12 weeks postpartum to ensure glucose levels return to normal

124
Q

hyperthyroid disease

contraindications and drugs used**

A
  • contraindication
    • radioactive iodine treatment
  • drugs
    • Propylthiouracil (PTU) 1st trimester
    • Methlmazole 2nd and 3rd trimesters
125
Q

complications of untreated hypothyroid

A
  • mom: fatigue, cold intolerance, weight gain
  • increased spontaneous abortion
  • preeclampsia
  • abruption
  • low birth weight
  • stillborn
  • lower cognitive function
126
Q

mitral stenosis MC condition

higher risk CHF

MS worsens as pregnancy advances

higher risk a-fib

A

rheumatic heart disease

127
Q

highest risk for pts. with primary pulmonary HTN or cyanotic heart disease

A

congenital heart disease

128
Q

significant pulmonary HTN w/ contraindication to pregnancy

A

Elsnemenger’s syndrome

129
Q

palpitations common in pregnancy

A

cardia arrhythmias

130
Q

ischemic heart disease avoidances

A

ACE-I or lipid lowering agents

131
Q
  1. Development of cardiac failure in the last month of pregnancy or within 5 months after delivery
  2. Absence of an identifiable cause for the cardiac failure
  3. Absence of recognizable heart disease prior to the last month of pregnancy (monitor after pregnancy)
  4. Left ventricular systolic dysfunction demonstrated by classic echocardiographic criteria, such as depressed ejection fraction or fractional shortening along with a dilated left ventricle
A

peripartum cardiomyopathy

(cardomegaly w/ LVEF < 45%)

132
Q

spread via mosquito or sex and causes microcephaly

A

zika

OB/GYN (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions