Westra's pregnancy; 4.15

Question 1

How is gestational diabetes screened for?

Answer 1

50g 1hr glucose test…>130mg/dL is a positive screen

Question 2

How is gestational diabetes diagnosed?

Answer 2

100g 3hr tolerance test…Fasting >90; 1hr >165; 2hr >145; 3h >125

(2+ abnormal is diagnostic)

Question 3

How is gestational diabetes treated?

Answer 3

Diet
Glyburide
Glucophage (Metformin)
Intensive Insulin Therapy

Question 4

What is the goal of gestational diabetes treatment?

Answer 4

Glucose levels ~130mg/dL 1hr postprandially

Question 5

What is done first when a pregnant woman comes in with uterine bleeding?

Answer 5

Do an ultrasound…if no ultrasound then do a speculum

Do NOT do a bimanual

Question 6

What are two potential causes of bleeding while pregnant?

Answer 6

Placenta previa

Abruption

Question 7

How long after delivery is the placenta delivered?

Answer 7

20-30 minutes

Question 8

A patient with chronic HTN becomes pregnant. What drug is the patient likely on that she will have to be taken off of?

Answer 8

ACE inhibitor

Question 9

What is seen with pre-eclampsia?

Answer 9

HTN (>140/90 at 20 weeks)

Proteinuria (300+mg in 24hr urine)

Question 10

What is a definitive treatment method for pre-eclampsia?

Answer 10

Delivery…sometimes cannot be done d/t gestational age

Question 11

If a pre-eclampsia patient cannot deliver, what meds can be given?

Answer 11

Hydralazine/labetolol (HTN)
Magnesium sulfate (seizures)

Question 12

What are the symptoms of HELLP syndrome?

Answer 12

Hemolysis
Elevated Liver enzymes
Low Platelet count

Question 13

What are the five criteria considered in Bishop’s score for induction?

Answer 13

Position
Consistency
Effacement
Dilation
Fetal station

Question 14

What Bishop’s score would bode well for induction?

Answer 14

8