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Blueprints OBGYN Shelf-OB
Terms in this set (66)
What are some cardiovascular changes in pregnancy?
decrease in systemic vascular resistance, blood pressure
increase in CO
If you cannot date a pregnancy based on LMP, by which way should you assess the GA of the fetus?
Which trimester is going to pick up genetic and congenital abnormalities?
What are common things that are assessed at each prenatal care visit?
Blood pressure, weight gain, fundal height, fetal <3 rate
What are the tests part of the triple screen?
What are the tests part of the quad screen?
Fetal status can be assessed antepartum by which methods?
BPP (Biophysical profile),
NST (Non-stress test) for heart,
OCT (Oxytocin challenge)
What percentage of pregnancies are ectopic?
How often in a normal pregnancy does the B-HcG change?
It doubles approximately every 48 hours.
What is the medical management for a stable patient with an ectopic pregnancy?
What is the most common cause of first trimester abortions?
Define incomplete abortion.
partial expulsion of some but not all parts of a conception.
Define threatened abortion.
any vaginal bleeding before 20 weeks without dilation of the cervix.
Define inevitable abortion.
no expulsion of products but rather a dilation of cervix and vagina up to point that a viable pregnancy is unlikely.
What is the most common cause of second trimester abortions?
uterine or cervical abnormalities,
What do we use to manage SABs that need assistance to completion?
Dilation and expulsion
Painless dilation of the cervix that can cause preterm labor is defined as _______________.
What is the therapy for incompetant cervix and during which weeks should it be offered?
12 to 14 weeks, patients should be offered a cerclage (closes the cervix).
How many pregnancies does it take to be called "recurrent pregnancy loss"?
What are the two most common causes of recurrent pregnancy loss?
Luteal phase defects (no progesterone to maintain pregnancy)
What percentage of patients after 3 consecutive spontaneous abortions will have a normal pregnancy afterwards?
2/3 of the time patients will have normal pregnancy.
What are two common indications for a primary C-section?
Failure to progress in labor
What percent of antepartum hemorrhage can be attributed to placenta previa?
What are risk factors of previa?
1. Prior previa
2. Uterine Scars
3. Multiple gestations
What is the classical presentation of previa?
Painless vaginal bleeding in third trimester.
How is previa commonly diagnosed?
What percent of third trimester hemorrhages is attributed to placental abruption?
What are risk factors for placental abruptions?
1. chronic hypertension
4. history of abruption
What is the presentation of abruption?
Painful vaginal bleeding, painful contractions, and a firm tender uterus.
Describe management in a patient that has abruption and is hemodynamically stable?
Describe management in a patient that has abruption and is hemodynamically unstable?
What is a primary risk factor for uterine rupture?
What is the management of uterine rupture?
Immediate laporatomy and delivery
What is fetal vessel rupture associated with?
Velamentous cord insertion
What is the heart rate monitor show in a fetal vessel rupture?
Sinusoidal pattern indicating anemia
What is the risk of a baby getting an AR disease if both parents are carriers?
Describe he founder effect?
A small ancestry group is actually a high carrier for a mutant gene.
What is an example of the founder effect?
Tay Sachs and Ashkenazi Jews
What is an example of heterozygote advantage?
Abnormal number of chromosomes usually results in ____________________.
What is the most common aneuploides:
a. sex chromosomes
b. autosomal aneuploids
a. sex chromosomes, these individuals are less affected than autosomal aneuploides
What are NTD associated with?
How do you make fetal diagnosis in the first trimester?
Chorionic Villus Sampling. This obtains trophoblastic cells.
How do you make fetal diagnosis in the second trimester?
Amniocentesis. This obtains fetal cells.
Prenatal imaging studies is done by which imaging study?
What does the physical exam of a pregnant woman in labor include?
1. Leopold maneuver
2. Sterile speculum exam
3. Cervical exam
What is included in the cervical examination?
dilation, effacement (how shortened the cervix has become), station, consistency, position.
What are the three stages of labor?
1. complete cervical dilation.
What are the two divisions of stage one of labor?
Latent phase: Onset of labor to 3-4 cm.
Active phase: Until greater than 9 cm.
The most common indication for C-section is ______________________.
prior cesarean delivery.
Spinals are to _____________ whereas epidurals are used for ______________ delivery.
C section- spinals
Vaginal delivery- vaginal
What stage of labor do epidurals prolong?
What is preterm defined as?
before 37 weeks.
What are low birth weight infants?
less than 2500 gm.
Tocolytic that is used in USA _______.
When is fetal lung maturity and what is prescribed for it?
34 wks. and Betamethazone.
How does B-mimetics cause decreased contractions?
ATP converts to cAMP and the more cAMP the more Ca is sequestered thus decreasing contractions.
How long does terbutaline or ritodrine prolong gestation?
How does Mg act as tocolytic?
What does nifedipine help do?
Decrease uterine contractions by inhibiting Ca2+ flow.
When is indomethacin used?
It is used 32 wks gestation for only 78 hours to effectively decrease contractions.
A patient before 37 wks has preterm rupture of membranes. What tests can we do to confirm labor?
Tampon test. Amniocentesis into uterus and see if it leaks into vag.
Or speculum exam for pooling.
What is the most common indication for C -section?
FTP in labor caused by cephalopelvic disproportion.
Describe the obstetric conjugate?
Distance between sacral promntory and midpoint of symphysis pubis.
What is the point where the sutures meet?
Anterior and posterior fontinelle.
Compound presentation has which associated complication?
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