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OB
Test 3
213
Medical
Graduate
05/18/2011

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Cards

Term
Hypertension diagnosed before the 20th week of pregnancy?
Definition
Chronic HTN
Term
HTN diagnosed after the 20th week of pregnancy with no proteinuria?
Definition
Pregnancy-associated HTN
Term
HTN with proteinuria after 20 wks.
Definition
Preeclampsia
Term
HTN during pregnancy with seizures.
Definition
Eclampsia
Term
What does HELLP stand for?
Definition
Hemolysis, Elevated Liver enzymes, Low Platelet count
Term
What is considered HTN in prego?
Definition
140/90
Term
When can a baseline BP be taken?
Definition
Before prego or in 1st trimester
Term
How long apart do BP readings need to be to be able to dx HTN?
Definition
at least 6 hrs
Term
What is the Tx for mild preeclampsia?
Definition
Rest and monitoring
Term
What is the Tx for severe preeclampsia? (4)
Definition
Admittance
Mag sulfate
AntiHTN meds
Monitoring
Term
What is the most common cause of Preeclampsia?
Definition
Maternal Vasospasm
Term
Above what age is a risk factor for Preeclampsia?
Definition
>35
Term
What 3 things increase risk for preeclampsia?
Definition
1. extremes of age
2. multifetal gestation
3. preexisting vascular dz/DM
Term
Sx: HA, blurry vision, RUQ pain, non-dependent edema, hyperreflexia.
Definition
Preeclampsia
Term
What are the two diagnostic factors for Preeclampsia?
Definition
1. increased BP
2. Proteinuria
Term
If this lab is elevated, it is predictive for a preeclamptic event.
Definition
Uric Acid
Term
What is the cure for preeclampsia?
Definition
Delivery
Term
Giving antiHTN medications in preeclampsia is to protect the baby or the mother?
Definition
Mother
Term
What is the goal BP in preeclamptics?
Definition
140/90
Term
What med do you give for seizure prophylaxis in preeclamptic pts?
Definition
Mag sulfate
Term
At what gest. age would you deliver a preeclamptic pt?
Definition
37 wks
Term
What is the tx for a preeclamptic pt at 30 weeks gest. age?
Definition
Bedrest
Term
What is the treatment for HELLP?
Definition
Delivery
Term
Do pregnant pts bodies compromise for blood loss/hemorrhage?
Definition
Yes, by the time they show sx, blood volume is severely compromised
Term
What are the 2 most common causes of bleeding in pregos?
Definition
Placenta abruption and abnormal placentation
Term
What is the term for the placenta over the cervical os?
Definition
Placenta Previa
Term
What is the best diagnostic method of placenta previa?
Definition
TVUS
Term
Sx: painless bleeding in the 3rd trimester.
Definition
Placenta Previa
Term
What type of placenta previa is just over the edge of the cervical os?
Definition
marginal placenta
Term
What type of placental implantation lies low but not over the cervical os?
Definition
Low-lying placenta
Term
What is passage of fetal blood vessels over the cervical os or below the presenting part?
Definition
Vasa previa
Term
When the placenta villi go into the superficial layer of the myometrium?
Definition
Placenta accreta
Term
When the placenta villi go into the myometrium?
Definition
Placenta increta
Term
When the placenta villi goes thru the serosa of the uterus?
Definition
Placenta percreta
Term
How do you diagnose Placenta abruption?
Definition
Clinical dx
Term
Sx: bleeding with severe contractions, dark thin blood in vagina, pain.
Definition
Placenta abruption
Term
What will you see on the FHR monitor with placenta abruption?
Definition
Decelerations
Term
What is the tx for placental abruption?
Definition
Delivery
Term
What is the most common part of the uterus to rupture?
Definition
posterior portion
Term
What is the most common type of c section cut to cause uterine rupture?
Definition
Classic cut
Term
What is the least common type of C section cut that will cause uterine rupture?
Definition
Low transverse
Term
what type of C section cut can a pt undergo a trial of vaginal labor for their next birth?
Definition
Low transverse
Term
You see a presenting part in the cervical os, you feel it and it is pulsating. Dx?
Definition
Cord prolapse
Term
What is the tx for cord prolapse? (2)
Definition
1. Elevate fetal head
2. C section
Term
What is the normal blood loss during SVD?
Definition
500cc
Term
What is the nl blood loss for a C section?
Definition
1000cc
Term
How much of a decrease must a Hct have to do a transfusion in postpartum hemorrhage?
Definition
10% decrease
Term
What is the most common cause of postpartum hemorrhage?
Definition
Uterine atony
Term
What is the first line tx for postpartum hemorrhage?
Definition
Check the uterus - Massage
Term
If the uterus is boggy and massage isn't working, then what do you do?
Definition
Oxytocin
Term
Term for abnormal labor.
Definition
Dystocia
Term
What type of maneuver is for shoulder dystocia that presses on the suprapubic area?
Definition
McRoberts
Term
What is the type of move that you push the head back in the vaginal canal to relieve shoulder dystocia?
Definition
Zavanelli
Term
Which type of presentation is where a foot presents first?
Definition
Footling Breech
Term
If the baby is sitting indian style in the canal, what presentation is this?
Definition
Complete breech
Term
What presenting position is where the baby's legs are straight up towards the face?
Definition
Frank Breech
Term
What manuevers determine the position of the baby?
Definition
Leopold Maneuvers
Term
What maneuvers use pressure to move the baby around?
Definition
External Cephalic Version
Term
What presentation is where the baby is lying diagonal?
Definition
Oblique
Term
Fraternal twins are dizygotic or monozygotic?
Definition
Dizygotic
Term
Maternal twins are dizygotic or monozygotic?
Definition
monozygotic
Term
What type of twins occur when two seperate ova are fertilized by 2 seperate sperm?
Definition
Dizygotic
Term
What type of twins represent division of the fertilized ovum at various times after conception?
Definition
Monozygotic
Term
Is increasing age and parity a risk factor for mono or dizygotic twinning?
Definition
dizygotic
Term
Does twinning occur on the maternal or paternal lineage?
Definition
Maternal
Term
What is the avg expected duration of a twin pregnancy?
Definition
37 wks
Term
What is the avg expected duration of a triplet pregnancy?
Definition
33 wks
Term
In Monozygotic twins, if division occurs at 3 days after fertilization, what type is it?
Definition
Diamniotic, dichorionic
Term
In Monozygotic twins, if division occurs btwn 4-8 days after fertilization, what type is it?
Definition
Diamniotic, monochorionic
Term
In Monozygotic twins, if division occurs btwn 9-12 days after fertilization, what type is it?
Definition
Monoamniotic, monochorionic
Term
In Monozygotic twins, if division occurs beyond 12 days after fertilization, what will occur?
Definition
Conjoined twins
Term
What is the term for twins with 2 placentas, 2 sacs and 2 cords?
Definition
Diamniotic, dichorionic
Term
What is the term for 1 placenta, 2 sacs and 2 cords in twins?
Definition
diamniotic, dichorionic
Term
What is the term for 1 placenta, 2 sacs and 1 cord in twins?
Definition
Monochorionic, diamniotic
Term
What is the term for 1 placenta, 1 sac and 1 cord in twins?
Definition
Monoamniotic, monochorionic
Term
What is the term for vascular anastomoses btwn the fetuses?
Definition
Twin-twin transfusion syndrome
Term
If you have twins, one has impaired growth, anemia and hypovolemia, what should be suspected?
Definition
Twin-twin transfusion syndrome
Term
If there is an absence of an umbilical artery what is the baby at risk for?
Definition
congenital anomalies - esp renal agenesis
Term
What should you suspsect an abnormality in if there is vanishing twin syndrome?
Definition
vascular abnormalities
Term
What is it called when there is death of a twin really early in the 1st trimester?
Definition
vanishing twin syndrome
Term
What are the the major causes of perinatal morbidity of the baby?
Definition
Preterm labor and delivery
Intrauterine growth restriction
Term
At what gest. age should twinning mothers be advised to begin increasing rest?
Definition
24-26 wks
Term
At what gest. age should you instruct a twinning mother to start counting kicks?
Definition
30-32 wks
Term
At what gest. age should periodic US be started for twinning mothers?
Definition
16-18 wks - q4wks
Term
What is considered discordant growth in twins?
Definition
20% difference in weight
Term
What does the delivery mode depend on in twins?
Definition
the presentation of baby A
Term
If twin A is in the non-vertex presentation, what type of delivery must be done?
Definition
C section
Term
What is the formation of maternal antibodies?
Definition
Isoimmunization
Term
Development of a significant titer to specific antibody as a result of antigenis stimulation w/ material contained on or in the RBCs of another individual.
Definition
Isoimmunization
Term
What is the long term consequence of isoimmunization of a mother?
Definition
Hemolytic disease of the fetus
Term
What is the most common antigen in pregnancies?
Definition
Rh-D
Term
Isoimmunization occurs with an Rh ________ woman with an Rh _________ fetus.
Definition
Negative woman
Positive fetus
Term
Less than ____mL of blood is sufficient to cause isoimmunization.
Definition
0.1 mL
Term
What is the Ab to the D Ag of the Rh system?
Definition
Rhogam
Term
What is the standard dose of Rhogam?
Definition
300 mcg
Term
If a woman is RH- and father is Rh+, should she get Rhogam?
Definition
Yes
Term
If the woman is Rh- and the father is Rh- should she get Rhogam?
Definition
No
Term
At what gest age should you give Prophylactic Rhogam?
Definition
28 wks
Term
If you are giving Rhogam postpartum for a Rh- mother who just gave birth to a Rh+ baby, up to how many hours can it be given?
Definition
up to 72 hrs
Term
Which immunoglobulin does not cross the placenta and can cause an Ab-mediated immune response?
Definition
IgM
Term
Which immunoglobulin crosses the placenta and can cause hemolysis of fetal cells, bilirubin release, anemia and hydrops fetalis?
Definition
IgG
Term
Is ABO incompatability an emergent disease?
Definition
No, does not cause a severe dz
Term
Which pregnancy is usually affected by isoimmunization?
Definition
the second one
Term
A titer of what would show sensitization of an immunoglobulin and could cause fetal jeopardy?
Definition
1:16
Term
If a mother is susptected to be sensitized to immunoglobulins what should be done to test for it?
Definition
Aniotic fluid analysis
Term
What test can show hemolysis in the fetus?
Definition
US
Term
PPROM is before what gest. age?
Definition
<37 wks
Term
Amniotic fluid is more acidic or more alkaline than vaginal secretions?
Definition
more alkaline
pH >7.1
Vaginal secretions - 4.5
Term
How many hours after delivery is considered prolonged ROM?
Definition
>18 hrs
Term
What is the risk for Prolonged ROM?
Definition
chorioamionitis - infection
Term
What tx should be done for Prolonged ROM?
Definition
Abx
Term
A positive Nitrazine test will show up what color?
Definition
Dark Blue
Term
Which test is more indicative of amniotic fluid, Nitrazine or Fern?
Definition
Fern
Term
What should you test the amniotic fluid for in PPROM?
Definition
FLM - fetal lung maturity
Term
What test can be done for PPROM that includes injecting indigo carmine into the amniotic fluid and seeing if it leaks out?
Definition
Tampon Test
Term
What can be given to hasten fetal lung maturity?
Definition
Steroids - betamethasone
Term
Which drugs stop contractions long enough to give steroids for fetal lung maturity?
Definition
tocolytics
Term
With PPROM, most pts will go into labor in how long?
Definition
1-2 wks
Term
What should be given for PPROM to prevent complications?
Definition
Abx - ampicillin and azithromycin
Term
After what gest age would you deliver the baby if the pt has PPROM?
Definition
after 34 weeks just deliver - too big of risk for infxn
Term
What and how much steroid do you give for FLM?
Definition
betamethasone - 12 mg q24H apart
Term
Contractions resulting in cervical dilation and effacement.
Definition
True labor
Term
% of thinnes and shortening of the cervix.
Definition
Effacement
Term
What happens to the upper uterus during labor?
Definition
it thickens
Term
What happens to the lower uterus during labor?
Definition
it thins
Term
How is cervical dilation evaluated?
Definition
sterile vaginal exams
Term
What type of contractions are associated with lower abdominal pain and resolve with ambulation, hydration or analgesia?
Definition
Braxton Hicks - false labor
Term
What type of contractions are associated with pain over the fundus that radiates to the lower back.
Definition
True labor
Term
Which leopold maneuver assesses for what occupies the fundus?
Definition
#1
Term
Which leopold maneuver assesses for small parts?
Definition
#2
Term
Which leopold maneuver assesses for the presenting part?
Definition
#3
Term
Which leopold maneuver assesses for cephalic prominence?
Definition
#4
Term
What is the most common pelvis shape that is best for birthing?
Definition
Gynecoid
Term
What shape of pelvis is wedge-shaped and more common in AA?
Definition
Android
Term
What stage of labor is the onset of labor to 10 cm dilation?
Definition
1st stage
Term
What stage of labor is from complete dilation to delivery of infant?
Definition
2nd Stage
Term
What stage of labor is after delivery to placental delivery?
Definition
3rd Stage
Term
What stage of labor is 2 hrs immediate pospartum?
Definition
4th Stage
Term
Which phase of the first stage of labor is from cervical effacement to 4 cm dilation?
Definition
Latent Phase
Term
Which phase of the first stage of labor is from 4-10 cm dilated and is rapid?
Definition
Active phase
Term
What station is at the ischial spines?
Definition
0 station
Term
What is the most common cause of overstimulation of amount of descent?
Definition
Molding, and capput succ
Term
where do lacs usually occur from labor?
Definition
3 Oclock and 9ocock
Term
Which degree of lac is through the vaginal mucosa and NOT the underlying tissue?
Definition
1st degree
Term
What lac involves the underlyign subQ tissue but not the rectal sphincter?
Definition
2nd Degree
Term
Which lac from labor goes thru the rectal sphincter but NOT into rectal mucosa?
Definition
3rd Degree
Term
What lac from labor goes into the rectal mucosa?
Definition
4th Degree
Term
What are the 3 P's of labor?
Definition
Power, passenger, Passage
Term
Abnormal labor in nulliparous women in the latent phase would be > how many hrs?
Definition
20
Term
Abnormal labor in multiparous women in the latent phase would be > how many hrs?
Definition
14
Term
Abnormal labor in nulliparous women in the fist phase of labor would be what cervical dilation rate?
Definition
<1cm/hr
Term
Abnormal labor in multiparous women in the fist phase of labor would be what cervical dilation rate?
Definition
<1.2 to 1.5 cm/hr
Term
Arrest disorder is considered no cervical dilation for more than how many hrs in both multi and nulliparous women?
Definition
>2 hrs
Term
Arrest disorder in multi and nulliparous women in the second phase of labor would be no descent after how many hours?
Definition
1 hr of pushing
Term
Labor that is slow to progress is called what?
Definition
Protraction
Term
Labor that ceases to progress is called what?
Definition
Arrest
Term
Augmentation or labor induction is done when cxns are < what?
Definition
<3 in 10min or <25 mm Hg above baseline
Term
What type of labor device can cause shoulder dystocia?
Definition
Forceps
Term
What is considered bradycardia in an infant?
Definition
<110 bpm
Term
What is tachycardia in an infant?
Definition
>160 bpm
Term
What is the most common cause of tachycardia in a fetus?
Definition
chorioamnionitis
Term
How long do you need a strip to be to figure out baseline FHR?
Definition
at least 20 min
Term
What type of variability shows beat to beat changes?
Definition
Short term variability
Term
What type of variability shows overall undulating pattern?
Definition
Long term variability
Term
Is moderate variability good or bad?
Definition
good - reassuring
Term
Decreased variability is caused by what?
Definition
hypoxia
Term
Accelerations should peak in < how many secs?
Definition
<30 secs
Term
How long of a strip do you need to check for reactivity?
Definition
at least 20 min
Term
To be a positive reactive strip how many accelerations must be present?
Definition
at least 2 w/in 20 min
Term
How high and long much accelerations be?
Definition
15 secs and 15 over baseline
Term
How long are fetal sleep cycles usually?
Definition
20 min
Term
If you have a reactive non-stress test the baby can be thought to stay alive for the next how many hrs?
Definition
48-72hrs
Term
What are the units contractions are measured in?
Definition
Montevideo units
Term
What type of decelerations are bad?
Definition
Late decelerations
Term
What type of decelerations have the nadir after the apex of the contraction and are slow to return to baseline?
Definition
Late decelerations
Term
Can late decelerations be reactive?
Definition
No
Term
What is the first thing to do if late decels are seen?
Definition
put mom on her side
Term
What is the most common FHR pattern?
Definition
Variable decelerations
Term
What type of decelerations are nl in a fetus?
Definition
Variable decels
Term
If these type of decelerations are repetitive and deep they are bad.
Definition
Variable decels
Term
What do variable decels usually mean?
Definition
Cord compression or oligohydramnios
Term
This FHR pattern rapidly goes down and comes back up and last about 10 secs.
Definition
Variable decels
Term
What type of decelerations are early decels?
Definition
Variable
Term
What type of FHR abnormalities are seen with the baby moving down the canal?
Definition
Early decels
Term
Early decelerarions - quick or slow to return to baseline?
Definition
quick - recover as cxns recover
Term
What type of FHR abnormalities are an indicator that the baby is in the complete station?
Definition
Early decels
Term
At what times are APGAR scores taken?
Definition
1 and 5 min

10 min again if there is a problem
Term
How often do you take the newborns vital signs after birth?
Definition
Q30 min until stable for 2 hrs
Term
What 2 medications are given to the newborn right after birth?
Definition
1. Vit K - IM
2. Erythromycin ointment on eyes - for gonococcal infxn
Term
What assessment sheet can be used to test the neuromuscular maturity of a newborn?
Definition
Ballard Scale
Term
If a narcotic addicted mother has a baby should you give them naloxone?
Definition
No, the baby will go thru w/drawls - only give for ODs
Term
What is the normal arterial blood pH from an umbilical cord?
Definition
7.25-7.30
Term
At what HR do you start neonatal resuscitation?
Definition
<100 bpm
Term
Immediately after birth where should you feel the uterus?
Definition
under the umbilicus
Term
At 6 wks postpartum, what size should the uterus be?
Definition
normal size
Term
What is the vagina bleeding after birth called?
Definition
lochia
Term
What is the shape of a muliparous woman's cervical os?
Definition
Transverse os
Term
When should Kegel's be started?
Definition
6 wks after birth
Term
When does ovulation return to a postpoartum woman who is NOT breastfeeding?
Definition
4-5 wks
Term
When does ovulation tend to occur in a breastfeeding postpartum woman?
Definition
6 wks
Term
How long does a woman usually stay in the hospital for a NSVD?
Definition
24-48 Hrs
Term
What type of Birth control should a woman have postpartum?
Definition
Progestin only for 2-3 wks
Term
When can a pt switch from progestin only birth control to combination?
Definition
6 wks postpartum if breast feeding
Term
Can a pregnant woman get the Rubella vaccine?
Definition
No, give post partum
Term
Can a pregnant woman get a tetanus shot?
Definition
No, give postpartum
Term
How long do women usually stay in the hospital for a C section delivery?
Definition
3-4 days
Term
At what age should iron supplementation be started in baby?
Definition
6 mos
Term
Can a infant with galactosemia be breastfed?
Definition
No
Term
What cream can be given for nipple care?
Definition
Lanolin
Term
Sx: reddened, hardened area on one breast with fever, chills, malaise.
Definition
Mastitis
Term
WHat is the tx for mastitis?
Definition
Dicloxacillin 500mg
Term
What is the most common organism of Mastitis?
Definition
Staph Aureus
Term
Postpartum depression last longer than how long?
Definition
>2 wks
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