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78 Cards in this Set
- Front
- Back
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ectopic pregnancy is |
often ampulla, outisde uterus
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rf ectopic
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pid, std, surgery, smoking
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sx ectopic
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pain, nausea, bleeding, mass, amenorrhea; sever epain and unstable if rupture
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labs ectopic
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elevated bhcg but doesn't double
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early bleeding in pregnancy
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ectopic, abortion, physiologic, uterine/cervical
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radio ectopic
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ultrasound once 1500, transvaginal, free fluid if rupture
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ectopic treatment
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methotrexate to abort, surgical excision
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ectopic complications
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fetal death, material hemorrhage, rh sensitization, maternal death
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spotaneous abortion is
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less than 20w, often trisomies
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later miscarriages due to
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cervical incompetence, uterine, hypercoag, drug use
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miscarriage rf
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old, multip, prior miscarriage, uterine, smoking, alchol, nsaids, cocaine, caffeine, etc
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types of miscarriages
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threatened, missed, inevitable, incomplete, complete
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what to do for missed-inevitable-incomplete
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misoprostol and d&c to evacuate the uterus
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threatned abortion?
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bed rest, closed os, nothing expelled, u/s shows viable fetus
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IUFD is
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after 20w but no labor
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iufd causes
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placental/cord fail, infection, congenital abn
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iufd sx
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no activities, small, no movement, no heart
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iufd dx
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ultrasound shows no heart activity
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iufd rx
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oxytocin, misoprostol, prostaglandin, d&e, surgery
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iufd complilcations
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DIC
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IUGR is
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less than 10th percenitle
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iugr types
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symm/asymm
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symetric iugr is
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20%, early, TORCH, chromosomes, drugs
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asymmetric is
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80%, later, poor health, placental insuff, multip
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iugr sx
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fundal height less than 3cm expected
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iugr imaging
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measure head, abd, femur; abd goes first, then femur and head
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iugr treat
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follow with u/s, nutritional, o2, bedrest, delivery if distress with betmethasone
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oligohydramnios
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AFI less than 5cm
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oligo timing
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1st aborts, 2nd renal abnorm, 3rd prom
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oligo related sx
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iugr, stress, renal, poor health
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oligo sx
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small fundus
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oligo imaging
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no fluid pockets more than 2cm, overall afi less than 5
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oligo srx
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induce delivery, hydration, bed rest
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oligo comp
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abortion, death, abnormalities in limbs and face from compression
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polyhydram
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afi more than 25
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poly cs
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esoph atresia, multi gest, anemia, chromo, maternal diabetes increased urination
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poly sx
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big fundal height
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poly img
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us showing pockets greater than 8 cm
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poly treat
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can do amnioreduction and indomethacin
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poly comp
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preterm labor, prom, fetal malpres, maternal resp comp
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PROM
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spontaneous amniotic rpture before labor
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PROM rf
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vag/cerv infection, cerv incomp, poor health, prior prom
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prom sx
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loss of fluids, pooling in vagina
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prom labs
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microscopic with ferning, nitrazine blue, can fulture fluid to check for infection
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prom radio
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u/s to asses fluid volume
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prom means what is ci
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internal manual exam before introduces infection
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prom rx
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less than 32w, give prophy steroids and abx, if 34w, check lung maturity, delivery if mature, more than 34, antibodies and delivery
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how to check fetal lung mat
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lecithin to sphingomyelin ratio more than 2, presence of phosphatidyl glycerol
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preterm labor is
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earlier than 37w
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preterm rf
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multip, prom, infection, abruption, smoking, incomp, stress, poor
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preterm sx
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low back pain, cramping, labor - ctx and cervical change
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preterm labs
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urine, vag, cerv cultures for infection
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preterm img
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u/s for afi, age, presentation
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preterm treat
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less than 34w - expectant hospitalize, tocolytic with mag, terbutaline, nifedipine, betamethasone, amp; more than 34, can expectant and deliver
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preterm comp
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neonatal complications, respiratory distress
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placenta previa is
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placenta near os, low/partial/complete
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previa rf
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multip, old, prior, prior c/s, fibroids, abortion, smoking
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CI in previa!
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examination@ you'll cause hemorrhage!
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common causes of vag bleeding after 20w
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previa and abruption
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bleeding painful?
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painful in abruption, painless in previa although baby freaks out
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previs sx
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painless third trim vag bleeding like 30w
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previa img
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u/s to find location
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previa rx
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if minor, bed rest and rhogam, if bad tocolytics until lung maturity, then caesarian
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previa comp
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bleeding, iugr, mal pres, prom, previa, death
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abruption is
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premature separation of placenta from wall; maternal bleeds out
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abruption rf
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htn, prior, trauma, smoking, cocaine, prom, multip
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abruption sx
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painful vag bleeding, back, abd, pelvic, pain, increased uterine tone, hypotensive
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abruption img
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u/s is inconsisnte, can sometimes show separation
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abruption rx
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bed rest, delivery by caesarian, transfuse
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abruption comp
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DIC, hemorrhage, death, future risk
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multip
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more than 1 fetus, common with infertility treatments
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monozycotic is
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identical, may/not have amnion too
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dizygotic
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two eggs fertilized, fraternal, separate amnions
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multip comp
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htn, dm, pree, preterm, malpres, previoua, iugr, trauma, transfusion
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multip sx
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big fundus, multiple tones
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multip img
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ultrasound sees two duhh
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multip treat
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really close following, activity restriction, weekly nst at 36, tocolytics for preterm
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can deliver what
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only vertex-vertex, otherwise need caesarean |
