SAB's, Ectopic, and Rh Isoimmunization Flashcards

1
Q

1st trimester =

A

FDLMP –> 13+6 wks

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2
Q

2nd trimester =

A

14 wks –> 27+6 wks

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3
Q

3rd trimester =

A

28 wks –> 42 wks

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4
Q

Estimated Date of Confinement (EDC) =

A

FDLMP + 40 wks

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5
Q

Preterm delivery =

A

20 wks –> 36+6 wks

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6
Q

Full term delivery =

A

37 wks –> 42 wks

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7
Q

Postdates =

A

> 42 wks

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8
Q

When is hCG first detected in urine

A

6-8 days after ovulation

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9
Q

At what hCG level is pregnancy detected in the urine

A

25

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10
Q

What is the rate at which hCG rises and when does it peak

A

Doubles every 2 days

Peak at 10 wks (100,00)

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11
Q

At what hCG level can a gestational sac be seen

A

1500-2000

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12
Q

At what hCG level can a fetal pole be seen

A

5200 (5 wks)

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13
Q

Which abnormalities are the most common causes of SAB’s in the 1st trimester

A

Chromosomal

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14
Q

What is the most common chromosomal abnormality causing SAB

A

Turner syndrome

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15
Q

What is the most common class to cause an SAB and which member of the class is most common

A

Trisomy’s

Trisomy 16

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16
Q

Def = vaginal bleeding and a closed cervix with 50% chance of loss

A

Threatened abortion

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17
Q

Def = vaginal bleeding and partially dilated cervix with definite loss

A

Inevitable abortion

18
Q

Def = vaginal bleeding, dilated cervix, lower ab cramping with some passage of conception products

A

Incomplete abortion

19
Q

Def = passage of all conception products with resolution of Sx’s

A

Complete abortion

20
Q

Def = expired fetus with remains staying in uterus and no Sx’s

A

Missed abortion

21
Q

Def = retained, infected conception products causing fever, hemorrhage, purulent discharge, and cervical tenderness

A

Septic abortion

22
Q

Gestational sac but no fetus

A

Blighted ovum

“Anembryonic gestation”

23
Q

What is the definition of recurrent abortions

A

3 successive SAB’s (not including ectopic and molar)

24
Q

What is the classic triad of Sx’s for an ectopic pregnancy

A

Missed menses
Vaginal bleeding
Lower ab pain

25
Q

Sx’s = ab pain, vaginal spotting/bleeding, normal uterus, and no adnexal mass

A

Possible ectopic

26
Q

Sx’s = ab/pelvic pain, vaginal spotting/bleeding, cervical tenderness, and adnexal tenderness

A

Probably ectopic

27
Q

Sx’s = severe ab pain and dizziness with distended/tender ab, cervical tenderness, and hemodynamic instability

A

Acutely ruptured ectopic

28
Q

What are the signs you’d see on US for the 3 types of ectopic pregnancies

A
Possible = thickened endometrial stripe
Probable = fluid in cul de sac
Ruptured = empty uterus with lots of free fluid
29
Q

What is the protocol for Methotrexate Tx of ectopic pregnancy

A

Check hCG levels at 4 and 7 days

30
Q

What vitamin should pts avoid when they are on Methotrexate

A

Folate

31
Q

What is the preferred surgical ectopic Tx for hemodynamically unstable pts

A

Laparotomy

32
Q

What is the preferred surgical ectopic Tx for stable pts

A

Laparoscopy

33
Q

What is the term for complete removal of the tubes

A

Salpingectomy

34
Q

Which surgical ectopic Tx results in better long-term tubal function and allows healing by 2˚ intention

A

Salpingostomy

35
Q

What is the term for the surgical ectopic Tx where the tubes are closed with sutures

A

Salpingotomy

36
Q

When is RhoGAM given

A

28 wks

W/in 72 hours of delivery of Rh+ baby

37
Q

What is the Kleinhauser-Betke test

A

Determines if more RhoGAM is needed by sensing fetal RBCs in maternal blood

38
Q

Sx’s = ascites, pleural effusion, scalp edema, polyhydramnios

A

Fetal hydrops

39
Q

What is the most useful tool for detecting fetal anemia

A

Doppler of the MCA

40
Q

At what Hct level is severe fetal anemia determined

A

Hct < 30%