Term
| What is the most common etiology for Premature ovarian Failure? |
|
Definition
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|
Term
| What are the 3 common causes of Delayed sexual maturation? |
|
Definition
Premature Ovarian Failure
Hypothalamic Dysfunction
Genital Tract Anomalies |
|
|
Term
| What are the 3 elements that play a role in the timing of secondary sexual maturation? |
|
Definition
1. Adequate body fat
2. Adequate sleep
3. Vision - optic exposure to sunlight |
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Term
|
Definition
| the sequence of breast development |
|
|
Term
|
Definition
| the sequence of pubic hair growth |
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|
Term
| When physical signs of secondary sexual development occur before 6-8 yoa its called: |
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Definition
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|
Term
| During menses, endometrium is sloughed off in response to _______________. |
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Definition
|
|
Term
|
Definition
| a twinge of pain experienced at the time of ovulation |
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|
Term
| Progesterone has a negative feedback on ______ and ______ |
|
Definition
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|
Term
| 3 main causes of a couple's failure to conceive |
|
Definition
1. anovulation (~30%)
2. anatomic defects of the female genital tract (~30%)
3. Abnl spermatogenesis (~40%) |
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|
Term
| What is the first chemical evidence of ovarian failure? |
|
Definition
|
|
Term
| What is the first physical manifestation of ovarian failure? |
|
Definition
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|
Term
| Hot flashes are a result of : |
|
Definition
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|
Term
| What does the umbilical vein do? |
|
Definition
| it carries oxygenated blood to the baby through the placenta and into the portal system of the fetus |
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|
Term
| What do the umbilical arteries do? |
|
Definition
| they carry deoxygenated blood to the placenta |
|
|
Term
| what is the primary substrate for placental metabolism? |
|
Definition
|
|
Term
| Chadwick's sign (Dx of preg) |
|
Definition
| bluish discoloration of the cervix |
|
|
Term
| Hegar's sign (Dx of preg) |
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Definition
|
|
Term
| Progesterone levels of pregnancy |
|
Definition
<5ng/ml - not consistant with viable preg
>25ng/ml - consistent with a viable IUP
~95% of levels fall btwn these 2 numbers |
|
|
Term
|
Definition
| LMP + 7 days - 3 months + 1 year |
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|
Term
|
Definition
| FHT incs by >15 bpm for 15 sec following FM. 2 such accelerations = nl |
|
|
Term
| Biophysical profile components |
|
Definition
Reactive NST
Adequate amniotic fluid
Fetal breathing mvts
fetal limb mvts
fetal tone |
|
|
Term
| Which organ system is the last to mature intrauterinely? |
|
Definition
|
|
Term
| When does production of surfactant start to increases in utero? |
|
Definition
|
|
Term
|
Definition
| change in shape of abd (flatter upper abd), sensation that the baby is less heavy, easier breathing time |
|
|
Term
|
Definition
1. Engagement
2. Flexion
3. Descent
4. Internal Rotation
5. Extension
6. External Rotation |
|
|
Term
| What is the most common delivery position in the US? |
|
Definition
|
|
Term
| Why is the midline episiotomy the most common? |
|
Definition
| causes less pain, easier to repair and less blood loss |
|
|
Term
| Excess traction on the umbilical cord causes... |
|
Definition
| uterine inversion - an OB emergency |
|
|
Term
| What is the VBAC success rate? |
|
Definition
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|
Term
| The likelihood of postpartum complications are greatest in the first ____ after delivery |
|
Definition
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|
Term
| Postpartum hemorrhage occurs in ___ % of patients |
|
Definition
|
|
Term
| What are the likely causes of postpartum hemorrhage? |
|
Definition
rapid labor/delivery
protracted labor
uterine enlargement |
|
|
Term
| Conditions associated with breech positioning |
|
Definition
prematurity
multiple pregs
anencephaly
uterine anomalies
hydrocephaly
polyhydramnios
uterine tumor |
|
|
Term
| At what fetal weight is CSection indicated? |
|
Definition
|
|
Term
|
Definition
| 6-8 wk period after birth during which the reproductive tract returns to its normal non-pregnant state |
|
|
Term
|
Definition
blood clots expelled from the uterus postpartum as the myometrium contracts
usually done by pp wk 3 |
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|
Term
|
Definition
produced the first five days postpartum and is slowly replaced by maternal milk
contains more minerals and protein, less fat and sugar
contains immunoglobulin A |
|
|
Term
| Operative delivery indications |
|
Definition
previous classical Csection
macrosomia
non-reassuring fetal/maternal status
active STD infection
placenta previa
preeclampsia/eclampsia
breech presentation
cord prolapse |
|
|
Term
| When is amniocentesis best performed? |
|
Definition
|
|
Term
| Why would you use amnio in more advanced gestational ages? |
|
Definition
| to assess fetal lung maturity |
|
|
Term
| Risk factors for postpartum depression |
|
Definition
previous postpartum mental disease
h/o psych disease
woman who does not cope well with stress
traumatic stimuli
conflicts in roles (mom/wife)
women with young children
poverty
abuse
professional careers |
|
|
Term
| 3 categories of postpartum mood disorders |
|
Definition
1. maternity blues
2. postpartum depression
3. postpartum psychosis |
|
|
Term
| Periodic antepartum visit intervals |
|
Definition
q4wks until 32 wks
q2wks from 32-36 wks
qwk thereafter |
|
|
Term
| What are the only routine lab tests done at every prenatal visit? |
|
Definition
| glucosuria and proteinuria |
|
|
Term
| At term, ____% of fetuses are in the cephalic presentation |
|
Definition
|
|
Term
| Patients are told to go to the hospital for any of the following reasons: |
|
Definition
contractions q5min for at least 1 hr
sudden gush of fluid or constant leakage
significant vaginal bleeding
significant decrease in fetal mvt |
|
|
Term
|
Definition
| identify the relative level of the foremost part of the fetal presenting part relative to the level of the ischial spines |
|
|
Term
| What is the single most reliable electronic fetal monitoring indicator of fetal status? |
|
Definition
|
|
Term
| Increasing _________ causes changes in insulin during pregnancy |
|
Definition
|
|
Term
| Diabetic mothers have ______ the incidence of UTI |
|
Definition
|
|
Term
| Diabetic mothers have a 2 fold increase of ____, _________ and ____ |
|
Definition
|
|
Term
| Infants have a _____ increased risk of congenital abnormalities if their mom is diabetic |
|
Definition
|
|
Term
| Most common anomalies caused by diabetic mothers |
|
Definition
| cardiac and limb deformities |
|
|
Term
| When do you get a 1 hr gtt in a pregnant woman? |
|
Definition
|
|
Term
| If the 1 hr gtt is > ____, a 3 hr gtt is required |
|
Definition
|
|
Term
|
Definition
1 hr - 105
2 hr - 165
3 hr - 145 or less |
|
|
Term
| BGlucose goals in pregnant women |
|
Definition
|
|
Term
| Fetal assessment in Diabetic pregnancy |
|
Definition
| 30-32 wks -- daily kick counts, serial NST or BPP weekly or biweekly, serial US |
|
|
Term
| If HTN occurs before 28 wks what do you need to look for? |
|
Definition
renal artery stenosis
coarctation of the aorta
Cushing Syndrome
SLE
pheochromocytoma |
|
|
Term
| Which drugs are indicated for HTN in preg? |
|
Definition
1st line: methyldopa
2nd line: alpha and beta blockers
NO diuretics |
|
|
Term
| Pregnancy Induced HTN may lead to: |
|
Definition
IUGR
oligohydramnios
dysmaturity |
|
|
Term
|
Definition
| the development of HTN with proteinuria and/or edema induced by pregnancy, generally in the 2nd half of gestation (associated with seizures in eclampsia) |
|
|
Term
|
Definition
Hemolysis
Elevated liver enzymes
Low platelets |
|
|
Term
| HELLP syndrome occurs in ____% of pts with severe preeclampsia or eclampsia |
|
Definition
|
|
Term
|
Definition
multiparous
Advanced maternal age
somewhat less HTN than many preeclamptic women |
|
|
Term
| Anemia in pregnancy levels |
|
Definition
|
|
Term
|
Definition
| fraternal twins; 2 separate ova fertilized by 2 separate sperm |
|
|
Term
|
Definition
|
|
Term
| Division of embryo after 12 days results in... |
|
Definition
|
|
Term
| If there is a twin-twin transfusion syndrome the "donor" twin can develop... |
|
Definition
|
|
Term
| If there is a twin-twin transfusion syndrome, the "recipient" twin can develop... |
|
Definition
hypervolemia
HTN
polycythemia
CHF
This twin will also produce excess amniotic fluid |
|
|
Term
| DDX of multiple gestations |
|
Definition
hydramnios
hyaditiform mole
uterine fibroids
incorrect dates |
|
|
Term
|
Definition
| premature separation of the normally implanted placenta from the uterine wall |
|
|
Term
| Features of abruptio placenta |
|
Definition
vaginal bleeding
abdominal discomfort
painful uterine contractions
frequent decelerations
|
|
|
Term
| Abruptio Placenta is associated with... |
|
Definition
| cocaine use, abdominal trauma, maternal HTN, multiple gestations, hydramnios |
|
|
Term
| What is the most common cause of consumptive coagulopathy in pregnancy? |
|
Definition
|
|
Term
|
Definition
| abnormal location of the placenta over, or in close proximity to the internal cervical os |
|
|
Term
| Suspect _______ in a woman with painless vaginal bleeding in the 3rd trimester |
|
Definition
|
|
Term
|
Definition
amniotic fluid volume increased >2000ml
uterine size also increased |
|
|
Term
| There is an increased risk of what in a woman with polyhydramnios? |
|
Definition
abruption of the placenta
risk of preterm labor |
|
|
Term
| What does IUGR stand for? |
|
Definition
| Intrauterine growth restriction |
|
|
Term
| IUGR puts you at a greater risk for... |
|
Definition
Intrauterine fetal death
neonatal death
asphyxia
fetal distress before or during labor
meconium aspiration
hypoglycemia (once delivered)
respiratory distress (once delivered) |
|
|
Term
| Early onset IUGR lead to an... |
|
Definition
| irreversible decrease in organ size/function |
|
|
Term
| Infants that had IUGR are at greater risk for: |
|
Definition
respiratory distress
Hyperviscosity syndrome
hypoglycemia
hypothermia |
|
|
Term
|
Definition
| >4000 - 4500 g (>90th % for given gestational age) |
|
|
Term
| Macrosomia is associated with... |
|
Definition
maternal DM
maternal obesity
excessive wt gain during pregnancy |
|
|
Term
| If labor occurs before wk ___ its considered preterm. |
|
Definition
|
|
Term
| 75% of neonatal deaths that are not due to congenital malformations are due to ___________ |
|
Definition
|
|
Term
| Complications of preterm labor |
|
Definition
perinatal death
RDS
intravascular hemorrhage
necrotizing enterocolitis
sepsis
neurological impairment
seizures
long-term morbidity |
|
|
Term
| Which drugs are tocolytics? |
|
Definition
MgSO4
Nifedipine
Terbutaline
indomethacin |
|
|
Term
| Contraindications to tocolytics |
|
Definition
advanced labor
mature fetus
intrauterine infection
significant vaginal bleeding
conditions where AE may be marked
obstetric complications |
|
|
Term
|
Definition
| premature rupture of membranes |
|
|
Term
| What are the functions of amniotic fluid? |
|
Definition
protection against infection
protection from trauma
protection from umbilical cord compression |
|
|
Term
| PROM occurs in what percentage of pregnancies? |
|
Definition
|
|
Term
|
Definition
smoking
prior PROM
short cervical length
prior preterm delivery
hydramnios
multiple gestation
bleeding early in preg |
|
|
Term
|
Definition
Nitrazine test
Fern test
US |
|
|
Term
| 1/4 of all Csections are done bc of _______ |
|
Definition
|
|
Term
|
Definition
prolonged latent phase
protraction disorder (prolonged active phase)
Arrest disorder (dilation or descent) |
|
|
Term
| Causes of prolonged latent phase |
|
Definition
abnormal fetal position
unripe cervix
CP
excessive anesthsia
ineffective contractions |
|
|
Term
| Causes of prolonged active phase |
|
Definition
fetal malposition
CPD
ROM before onset of active labor
excessive sedation
inadequate contractions |
|
|
Term
| Causes of secondary arrest of dilation |
|
Definition
insufficent contractions
fetal lie, position, attitude, small pelvis |
|
|
Term
| Arrest of descent is caused by... |
|
Definition
CPD
Ineffective contractions |
|
|
Term
| Risk factors for spontaneous abortion |
|
Definition
increasing parity
increasing maternal age
increasing paternal age
conception within 3 months of live birth |
|
|
Term
|
Definition
| vaginal bleeding without cervical dilation |
|
|
Term
|
Definition
| ROM or dilation during 1st half of pregnancy |
|
|
Term
|
Definition
| documented pregnancy that passes all products of conception |
|
|
Term
|
Definition
| partial expulsion of pregnancy tissue has occurred |
|
|
Term
|
Definition
| retention of failure IUP for an extended period (> 2 menstrual cycles) |
|
|
Term
|
Definition
| >2 consecutive (or a total of 3) spontaneous abortions |
|
|
Term
| Recurrent abortion can be the result of... |
|
Definition
uterine anomalies
incompetent cervix
intrauterine synechiae |
|
|
Term
| 1st trimester bleeding occurs in what percentage of pregnancies? |
|
Definition
|
|
Term
| What is the most common cause of bleeding in the 1st trimester? |
|
Definition
|
|
Term
| With a threatened abortion, if you can visualize an embryo with a heart beat the chance of continuing the pregnancy is ... |
|
Definition
|
|
Term
| Risk factors for threatened abortion |
|
Definition
coffee intake >6c/d
Infection
Poor nutrition
EtOH
Smoking
Severe Trauma |
|
|
Term
|
Definition
| a sac with a mean diameter of 20mm that has no yolk sac |
|
|
Term
| You should see a heart beat by transvaginal US when crown rump length is > ____ |
|
Definition
|
|
Term
| Risk factors for ectopic pregnancy |
|
Definition
Biggest - h/o salpingitis
prior h/o ectopic
Age 35-44
fallopian tube damage
Gonorrhea/Chlamydia and PID
Women who get pregnany after tubal or IUD |
|
|
Term
| If hCG levels do not inc by 66% in 48 hrs... |
|
Definition
|
|
Term
| Which types of HPV are considered high risk? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| "Money spots" are associated with what? |
|
Definition
|
|
