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Repro 2 Final AH > SAB, Rh - Moulton > Flashcards

SAB, Rh - Moulton Flashcards

1
Q

Painless dilation and delivery usually seen w/2nd trimester loss is what?

A

Cervical incompetence

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3
Q

What anembryonic gestation or a gestational sac too large to not have embryo (> 25mm)?

A

Blighted ovum

Empty gestational sac aka no embryo

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4
Q

Classic triad for ectopic pregnancy?

A

Missed menses
Vaginal bleeding
Lower abdominal pain

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5
Q

What ethnicity has highest incidence of Rh D (-)?

A

Caucasians - 15%

Sickle cellers - 8%

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7
Q

How long is the 2nd trimester?

A

14-27 weeks + 6 days

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10
Q

What fetal MCA peak systolic velocity is predictive of mod-severe fetal anemia?

Need to do what next?

A

> 1.5

Percutaneous umbilical blood sampling
Maybe intrauterine transfusion

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11
Q

What surgery method is preferred for ectopic pts who are hemodynamically unstable?

Stable pts?

A

Laparotomy

Laparoscopy

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12
Q

What should every pregnant woman get at her 1st prenatal appointment?

A

ABO
Rh D
Antibody screen

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13
Q

What is the most common single chromosomal abnormality of spontaneous abortion?

Most common class?

A

45 XO

Trisomy 16

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15
Q

Any women presents with vaginal bleeding, what is the 1st step?

A

Pregnancy test

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17
Q

What is preterm delivery?

Full term?

A

20-36 weeks + 6 days

37-42 weeks

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18
Q

Rh-Ab Titers less than 1:8 indicate what?

> 1:16?

A

Fetus ok, recheck q4wk

Need doppler of MCA

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20
Q

Where does ART increase ectopic pregnancy?

A

Ampulla - 93%
Cornual - 7.3%
Ovarian/abdominal - 4.6%

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21
Q

80% of what ectopics will not rupture and resolve spontaneously?

A

hCG < 1000

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22
Q

Fever, uterine, cervical motion tenderness, purulent discharge, hemorrhage, and rarely renal failure is what?

Tx?

A

Septic abortion

IV Abs - Ampicillin, Gentamycin

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23
Q

What surgical management of ectopic results in better long-term tubal fx?

Incision is sutured closed?

A

Salpingostomy

Salpingotomy

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26
Q

What hCG levels confirm ectopic pregnancy/abnormal IUP?

A

If hCG rises less than 53% in 2 days

27
Q

what is the problem in rhesus isoimmunization?

A

Rh (-) mom, Rh (+) fetus

D antigen

28
Q

How to tx ectopic pregnancy?

A

Methotrexate (folic acid antagonist) 50 mg

Check hCG levels and if decrease by 15%, follow weekly until negative. If they plateau/fall slowly give another dose

If pt symptomatic or hCG INC, do surgery

33
Q

Vaginal bleeding and a closed cervix means what?

A

Threatened abortion

25-50% result in abortion

34
Q

Absolute contraindications to methotrexate?

A 
Breast feeding
Immunodeficiency
Alcoholism
Blood dyscrasia
Active pulmonary disease
PUD
Renal/hepatic dysfx
35
Q

Probable ectopic pregnancy find what on PE?

A

Abdominal or adnexal tenderness

Cervical motion tenderness

36
Q

What medical disorder most commonly causes recurrent abortions?

What else is common?

A

Antiphospholipid Ab syndrome

Advanced maternal AGE

37
Q

How long is the 3rd trimester?

A

28-42 weeks

38
Q

What dosage for RhoGAM?

When?

A

Single dose 300 mci

28 weeks and w/in 72 hours after delivery or Rh (+) baby

39
Q

What is severe fetal anemia due to Rh?

Management?

A

Hct < 30%, or 2 SDs below

Intrauterine transfusions peformed bw 18-35 weeks

using group O, Rh (-) rbc’s for < 20 weeks

41
Q

Differential dx of falling hCG?

A

Blighted ovum
Spontaneous resolving ectopic
Abnormal pregnancy

42
Q

What test identifies fetal rbcs in maternal blood?

A

Kleinhauer-Betke test

45
Q

Acutely ruptured ectopic has what symptoms?

A

Severe abdominal pain and dizziness (secondary to intraperitoneal hemorrhage)

46
Q

Symptoms of missed abortion?

Management?

A

None

Check fibrinogen weekly until SAB occurs or do DandC

47
Q

What hCG level is negative for pregnancy?

A

Titer < 5 IU/L

50
Q

What may indicate an ectopic on US?

A

Thickened endometrial stripe (Arias-Stella reaction)

51
Q

What defines recurrent abortions?

A

3 in a row excluding ectopic and moles

52
Q

Vaginal bleed, cramping lower abdominal pain with dilated cervix means what?

A

Incomplete abortion

55
Q

How to treat Antiphospholipid Ab syndrome?

A

Propyylactic dose of heparin and low dose ASA

60
Q

Vaginal bleed and cervix partially dilated means what?

A

Inevitable abortion

62
Q

What infections linked to recurrent abortions?

A

Mycoplasma
Chlamydia
Listeria
Toxo

65
Q

How long is the 1st trimester?

A

13 weeks, 6 days

67
Q

Abortion is classified as what?

A

< 20 weeks or < 500 gms

69
Q

When can the gestational sac been seen on US?

A

1500-2000 hCG

Repro 2 Final AH (9 decks)

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