UW OB 2 Flashcards
28yo Prego. NV, RUQ Pain, BP 160/94, 98.9 F, Hg 8.5, Platelets 96K, +3 protein, AST/ALT elevated. dx? tx?
HELLP Syndrome = systemic inflammation + platelet consumption.tx: DELIVERY, MgSO4, Hydralazine
Whats the major benifit with transdermal estrogen?
no increased risk of DVT!
FHR monitoring: Nadir + contraction mirroring each otherWhat could this mean?
normal or fetal head compression
FHR monitoring: Nadir occurs slowly after contraction. as contraction subsides nadir is being reached.(late deceleration)What could this mean?
uteroplacental insufficiency
FHR monitoring: Nadir is sharp and not related to contractionsWhat could this mean?
cord compression, oligohydraminose, cord prolapse
How do you manage cord compression? what would you see on FHR monitoring?
move mother onto left side to avoid compressing IVC, Amnioinfusion if ruptured membranes.On FHR monitoring would see sharp decelerations not related to contractions.
describe the histology seen on bx of fat necrosis of the breast?
foamy macrophages w/fat.*may see in women how had previous breast surgery
HTN meds safe in prego
methyldopa, labetalol, hydralazine, nifedipine2nd line: clonidine, Thz
HELLP or Eclampsia…which do you deliver?
both! tx is immediate delivery!
Tx of chorioamnionitis?
- Abx(amp + genta +/- clinda if c-section)2. delivery
Placenta previa vs Placeta abrution on presentation?
Previa = PAINLESSAbrution = PAINFUL
Gestational diabetes goals. Tx hierarchy?
Fasting <95, 1hr pp <140, 2h pp <120tx: diet > insulin > metformin > glyburide
What labs do you need @ initial vists for prego?
1.RhD type + ab2.Hg/Hct, MCV(CBC)3.HIV, VDRL/RPR, HBsAg4.Rubella + varcella immunity5.pap test6. chlamydia PCR7. urine cult + protein
What labs do you need for prego @ 24-28 wks?
1.Hg/Hct, MCV(CBC)2.RhD type + ab3. 1hr Glucose tests
What labs do you need from prego @35-37 wks?
GBS Culture!
Genitourinary Syndrome of Menopausesx? pe?
sx: dryness, itching, dysparuria, urinary incon,recurrent UTI, Pelvic pressure, VAGINAL BLEEDINGpe: narrow introitus, pale mucosa, dec elasticity, dec rugae, PETECHIA, FISSURES, loss of labial volume