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OBGYN: Pregnancy CIL
Pregnancy CIL: OBGYN
16
Anatomy
Graduate
09/10/2011

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Cards

Term
Presumptive signs of pregnancy:
Definition
Amenorrhea
N/V (2-12 weeks)
Breast changes
Quickening (16-20 weeks)
Urinary tract
Basal body temperature
Skin changes
Term
Probable Manifestations of Pregnancy:
Definition
Pelvic organs
Chadwick’s sign (pelvic congestion)
Leukorrhea
Hegar’s sign (isthmus
Pelvic bones and ligaments
Abdominal enlargement
Contractions
Braxton Hicks (28 weeks and on)
Term
Positive Manifestations of Pregnancy:
Definition
Fetal Heart Tones
Palpation (22 weeks)
Ultrasound (5-6 weeks)
Pregnancy tests
Urine
Serum
Qualitative
Quantitative
Term
What levels of hcg would you expect to see with a molar pregnancy?
Definition
very high, greater than 100,000

with a normal pregnancy they dont go above 40,000
Term
Beta-hCG
Thought to be produced by placenta as well as all types of trophoblastic tissue
Doubles every 1-2 days
Half life of 1.5 days
Is produced days after fertilization
Is detected in maternal serum 8-11 days after conception
Peak at 10-12 weeks
Decrease in 2nd and 3rd trimesters
Low in missed or threatened abortion
High in twins and trophoblastic disease
Definition
Term
At 10-12 weeks, there should be a __ __ and beta hCG should __.
Definition
- heart beat
- peak
Term
hCG:
Abnormally low in
ectopic pregnancy
threatened or missed abortion
embryo resorption
Unexpectedly high
Twins and multifetal pregnancy
Gestational trophoblastic neoplasia
(molar pregnancy,invasive mole,choriocarcinoma)
Definition
Term
If someone has had 2 ectopic pregnancies> be thinking PID. b/c PID increases risk of ectopic pregnancies.
Definition
Term
A 29-year-old presents for a New OB visit. She and her husband have been trying to get pregnant for three months. She had a UPT+ three weeks ago. Her LMP is 11/14/2007.
She was pregnant in 2004, but miscarried. In 2003, she delivered twins via cesarean section. And she has a two-year-old at home as well.
What is her EDC using Naegele's Rule?
Definition
Term
. The only blood type that actually matters though is moms. Give Rogan at 28 weeks and at delivery.
What if Rh- negative mom comes in with threatened abortion and she is 12 weeks and bleeding, this is her first pregnancy, what do you do? Rogan shot. Rh- mom has to Rogan shot every times shes pregnant. A rogan shot is good for 12 weeks. So would have to give this again at 28 weeks and then delivery. And then every time shes pregnant after that.

Give the rogan shot with first pregnancy even though wouldn’t be an issue until second pregnancy b/c want to prevent antibodies from forming in the first place.
Definition
Term
. The only blood type that actually matters though is moms. Give Rogan at 28 weeks and at delivery.
What if Rh- negative mom comes in with threatened abortion and she is 12 weeks and bleeding, this is her first pregnancy, what do you do? Rogan shot. Rh- mom has to Rogan shot every times shes pregnant. A rogan shot is good for 12 weeks. So would have to give this again at 28 weeks and then delivery. And then every time shes pregnant after that.

Give the rogan shot with first pregnancy even though wouldn’t be an issue until second pregnancy b/c want to prevent antibodies from forming in the first place.
Definition
Mom that is Rh- and baby that is Rh+
Term
. The only blood type that actually matters though is moms. Give Rogan at 28 weeks and at delivery.
What if Rh- negative mom comes in with threatened abortion and she is 12 weeks and bleeding, this is her first pregnancy, what do you do? Rogan shot. Rh- mom has to Rogan shot every times shes pregnant. A rogan shot is good for 12 weeks. So would have to give this again at 28 weeks and then delivery. And then every time shes pregnant after that.

Give the rogan shot with first pregnancy even though wouldn’t be an issue until second pregnancy b/c want to prevent antibodies from forming in the first place.
Definition
Term
On exam if you feel the uterus about 4 cm below the umbilicus, the mother is __ weeks.
Definition
16
Term
On exam if you feel the uterus at the umbilicus, the mother is __ weeks.
Definition
20
Term
Initial pregnancy visit labs:
Definition
Blood
H&H, WBC/diff
Blood group & Rh
VDRL or RPR, rubella titer, hep B, HIV
Glucose initially if hx of prior diabetes or Hx of prior stillbirth
Genetic testing
>35 y/o, hx of prior or current fetal abnormalities
Pap Smear, STIs
Urine c&s
Urine dipstick at each visit
proteinurea,glucosuria, ketones,nitrites, blood
Group B Streptococcus culture
35 weeks
10 - 30% +
+/- Tuberculin skin test if hx of exposure
Term
The same patient’s quad screen reveals low estradiol levels. What might this indicate?
Definition
Trisomy 21 or Trisomy 18
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