UW OB3 Flashcards
Endometrial Bx Criteria
A. >45: AUB or postmeno bleeding
B. <45: AUB w/unopposed estrogen(obesity, anov), failed men management, lynch syndrome.
C. >35: Atypical GLANDULAR cells on pap
young girl w/pharyngitis, fever, lower ab pain. dx?
Gonococcal pharyngitis, test for w/NAAT
Sx of Oxytocin tox? tx?
3: Hyponatremia, Hypotension & TACHYSYSTOLE
tx: 3% hypertonic saline
* Oxytocin is simular to ADH
Sx of Mg tox? tx?
NV, flushing, HA, hyporeflexia, hypocal, respiratory paralysis, cardiac arrest
tx: stop Mg, IV Ca-gluconate bolus
* sx will be worse with RENAL INSUFF!
do OCP cause weight gain?
nope
in addition to paps what must you do for owmen <25
pap + gon/chal test
tx of postpartum endometritis
clindamycin + genta
tx of Bactauria in prego
Cephelaxin, amox-clau, nitrofurantoin, fosfomycin
how do you measure cervical length?
trans vag U/S
baby born w/thin, loose skin + small, thin umbilical cord + wide anterior fontanel. cause?
FGR! = do placental hystopath
elevated AFP indicates…
abdominal wall defect
*low is trisomy 18 or 21
define inadequate contractions?
<3 in 10 min w/ab soft to palp
Protracted labor in the active stage of labor.
<1.2cm/h for nullipar
<1.5cm/h for multipar
*tx w/augmentation of labor
Arrested labor in the acitve stage of labor.
no change in 4h w/good contrac
or no change in 6h w/o good contrac
*tx w/augmentation of labor
Protracted labor in the second stage of labor.
longer than 2h in nullipar (3w/epi)
longer than 1h in multipar(2 w/epi)
*tx w/operative vag del or c-section
Arrested labor in the second stage of labor.
no pro after 3h in nulli par(4 w/epi)
no pro after 2h in nulli par(3 w/epi)
*tx w/operative vag del or c-section
What is secondary arrest of labor? how do you tx it?
cessation of labor that was initially doing fine for 2h…tx w/membrane rupture manually or just watch
APGAR score…explain..
Activity, Pulse, Grimance(irritability), Appearance, Respiration(cry?)
0-2 normal is 7-10
how long do postpartum blues lasts? when is it postpartum depression?
blues = less than 2wks
depression = with in 6months
what organism causes mastitis? tx?
streptococcus!
Penicillin or cephalosporin
Description of Candidiasis of the nipple. tx?
sore nipple, painful nipple, peeling at periphery.
tx: mom w/topical clotrimazole or miconazole; baby w/oral nystatin
Signs babies is getting enough breastmilk
- 3-4 stools in 24hrs
- 6 wet diapers in 24hrs
- Weight gain
- Sounds of swallowing
women is breastfeeding but experienceing great pain. her breasts are full and tender. what can you recommend to help?
frequent nuring, warm shower + hot compress, massaging breast + expressing milk to soften, good support bra, analgesic 20 min beofre breastfeeding.
- 6 wk prego B-hCG initially 1500, 48hrs later its 3100. She has 3 days of spotting and uterine cramping. What would you see on U/S?
Viable IUP = spotting common in 1st trimester & since BhCG dbled its prob a viable prego
RF for spontaneous abortion
DM, chronic RF, SLE, smoking, alcohol, radiation, infections, advaced age, advanced parity
*preeclampsia is not a RF! neither is previous abortion!
T1 DM risks to baby…
spontaneous abortion, congenital malformations, IUFGR, Fetal Macrosomia, polyhydramnios, preterm birth, HTN Complication
Tx of HA in prego
Amitriptyline
how do you manage asthma inprego?
Inhaled BB, then inhaled corticosteroids or cromolyn sodium then subQ terbutaline+steroids for acute cases
how do you treat MVP in prego?
BB
Obesity risks to baby…
chronic HTN, Gestational diabetes, preeclampsia, fetal macrosomia, higher C-section rates, postpartum complications
SSRI that is not sage in prego…
paroxetine! other SSRIs are safe
target HTN in prego…
diastolic 90-100
risk factors for preeclampsia
previous hx, chronic HTN, multifetal prego, molar prego, diabetes, chronic renal dz, APLS, vascular dz, tripolidy, extremes of age
moms bleeding, baby shows tachy w/decreased variability and sinusoidal pattern…
placenta abruptio! =sinusoidal pattern shows placental insufficiency
U/S finding of RH dz…
- increase systol flow on MCA doppler.
2. Fetal Hydrops(ascites, pericardial effusions + other effusions, scalp edema)
dafuq are lewis antibodies?
- Lewis Antibodies are IgM and do not cross the placenta = not associated w/isosensitization or hemolytic disease of the fetus = no F/U needed.
best indicator of severity of Rh hemolytic dz
bilirubin from amniotic fluid
risk w/twins…
5x death rate, cerebral palsy, higher incidence of IUGR, increased prematurity, increased congenital abnormalities
Twin-twin transfusion syn risks to the babies…
Donor: anemic, hypovol, growth retardation
surviving twin: neurological morbidity risk, cerebral palsy, cardiomegaly, tricuspid regurge, ventricular hypertrophy, hydrops fetalis
Stages of Loss:
o Denial o Anger o Bargaining o Depression o Acceptance
Cytotec(Misoprostol)
o Given prior to Pitocin
Given for women with unfavorable cervix/closed increases cervical ripening!
MC breech presentations
- Incomplete Breech = 3-4% *one leg down
- Complete Breech = 5-12% *baby curled into ball with legs crossed
- Frank Breech = 48-73% *babys legs straight up into the air
RF for breech presentation
o Prematurity o Multiple gestation o Genetic disorders o Polyhydramnios o Hydrocephaly o Anencephaly o Placenta previa o Uterine anomalies o Uterine fibroids
Risks for baby/mom associated w/tobacco/smoking
o Placental abruption o Placental previa o IUGR o Preeclampsia o Infection
