Ob Test 2 Vocab And Mc

Front 1

MC finding with uterine rupture?

Back 1

Fetal HR abnormality

Front 2

Definition of Gestational DM?

Back 2

Glucose intolerance that begins or is first recognized during pregnancy.

Front 3

MC medical complication of pregnancy?

Back 3

Gestational DM

Front 4

Biophysical profile

Back 4

NST,
Fetal breathing,
Fetal tone,
Fetal motion,
Quantity of amniotic fluid

Front 5

Diabetic Rule of 15

Back 5

15% OB pts: abnormal gluc load test (GLT).
15% pts w/ abnorm GLT have abnorm OGTT.
15% pts w/ abnorm OGTT need insulin.
15% pts w/ GDM have infants >4000g.
Capillary levels are 15% higher than plasma levels after meals.

Front 6

Essential Chronic Hypertension

Back 6

HTN that predates pregnancy or identified before 20 weeks.

Does not resolve w/in 12 weeks postpartum.

Front 7

Gestational Hypertension

Back 7

HTN after 20 weeks gestation but NO proteinuria.

Previously called "pregnancy induced hypertension"

Resolves w/in 12 weeks of delivery

Front 8

Chronic Hypertension with Superimposed Preeclampsia

Back 8

Chronic hypertension w/ increasing blood pressures and proteinuria

Front 9

Preeclampsia

Back 9

Gestational hypertension in presence of proteinuria (>300 mg/24 hrs or >30mg in 2 random samples).
Edema.
Usually occurs after 20 weeks.
Mild: rise in BP after 20th wk to >140/90

Formerly called 'toxemia of pregnancy"

Front 10

Eclampsia

Back 10

Occurrence of convulsions in a woman who meets criteria for preeclampsia

Front 11

Soluble fms-like tyrosine kinase1 (sFlt 1)

Back 11

New protein identified as major factor in preeclampsia.
Inhibits blood vessel growth.

Front 12

H.E.L.L.P. Syndrome

Back 12

Complication of preeclampsia.

H-Hemolysis
E.L.- Elevated Liver enzymes.
L.P.-Low Platelet count

These lead to DIC

Front 13

New York Heart Association Classification of Heart Disease.

Class I

Back 13

Uncompromised.
No limitation on phys activity.
No SOB, fatigue or palpitations w/ ordinary phys activity.

Front 14

New York Heart Association Classification of Heart Disease.

Class II

Back 14

Slightly compromised.
Slight limitation of phys activity.
SOB, fatigue or palps w/ ordinary phys activity, but comfortable at rest.

Front 15

New York Heart Association Classification of Heart Disease.

Class III

Back 15

Markedly compromised.
Marked limitation of activity.
SOB, fatigue, palps w/ LESS THAN ordinary phys activity.
Still comfortable at rest.

Front 16

New York Heart Association Classification of Heart Disease.

Class IV

Back 16

Inability to perform any phys activity w/out discomfort.
Severe to complete limitation of activity.
SOB, fatigue or palps w/ ANY phys exertion.
Sx at rest.

Front 17

Fowler position

Back 17

Head and knees raised

Front 18

MCC acute pyelonephritis in pregnancy?

Others?

Back 18

E. coli

Proteus, Kleb, GBS, Staph

Front 19

MCCs of anemia in pregnancy?

Back 19

Iron deficiency

Acute blood loss

Front 20

Sheehan's syndrome

Back 20

Postpartum pituitary ischemia and necrosis.
Associated w/ OB blood loss --> hypopituitarism.

Do not lactate postpartum d/t low prolactin.

Front 21

Intraheptaic Cholestasis of Pregnancy (ICP)

Back 21

Cholestasis in pregnancy --> jaundice.
Etiology not well defined but thought to be related to genetic predisposition.
Usually self-limited. Benign.

Front 22

2nd most common cause of jaundice in pregnancy

Back 22

ICP

Front 23

Postpartum Psychosis

Back 23

Severe psychiatric illness.

Begins w/in days of delivery.

Assoc w/ child neglect, abuse and infanticide.

Front 24

Postpartum Thyroiditis

Back 24

Transient postpartum hypothyroidism or thyrotoxicosis assoc w/ autoimmune thyroiditis.

Common.

Front 25

TORCH

Back 25

Toxoplasmosis,
Other,
Rubella,
CMV,
HSV

Front 26

Intrapartum

Back 26

During delivery

Front 27

Leading cause of perinatal infectious morbidity/ mortality

Back 27

GBS - 15% mortality

Front 28

Leading cause of neonatal sepsis (w/in 7 days of life)

Back 28

GBS

Front 29

Erythroblastosis fetalis

Back 29

hemolytic disease of newborn
Can be mild or severe

BM eventually can't keep up --> extramedullary hematopoiesis (liver, spleen, adrenal gland, kidneys, placenta, intestinal mucosa)

Front 30

Hydrops Fetalis

Back 30

Total body Edema with +/- heart failure in the fetus.
Can be caused by immune causes (Rh incompat) or non-immune (other anemias, etc)

Hgb falls >7 g/dL below normal level (12-18)

Front 31

Grandmother Theory

Back 31

Rh isoimmunization that occurs at birth where the baby is Rh neg and is exposed to mom's Rh pos blood. Develops anti-D which then can affect her own pregnancies later in life.

Front 32

Direct Coombs Test

Back 32

Antibodies are attached to red cells in vivo. Anti-IgG added - form complex = positive direct coombs.

Front 33

Indirect Coombs Test

Back 33

Antibodies are in serum but not attached to RBCs. Donor RBCs w/ antigen added to serum. Additional anti-IgGs added. - form complex = positive indirect coombs.

Front 34

Anasarca

Back 34

Total body edema

Front 35

Spell test used for assessing amount of fetal maternal hemorrhage

Back 35

K L E I H A U E R - B E T K E

Front 36

MCC infectious vulvar ulcers in united states?

Back 36

HSV

Front 37

Definition of Preterm Birth

Back 37

< 37 weeks gestation.

Manifested by low birth wt (500-2500 g), physical signs of immaturity, multisystem disorders

Front 38

Definition or Preterm Labor

Back 38

Regular contractions (2-4 per 10 min) with progressive cervical dilation and effacement at less than 37 weeks.

Front 39

MCC morbidity and mortality in newborns worldwide

Back 39

Preterm birth

Front 40

Tocolytic

Back 40

Med that can inhibit labor, slow down or halt contractions of uterus.

Used widely to treat premature labor.

Front 41

Most popular Tocolytic

Back 41

Beta-2 Adrenergic Agents

Of these, most commonly used: Terbutaline* and Ritdorine

Front 42

Definition of PROM

Back 42

Rupture of chorioamniotic membrane before onset of labor.

10-15% of all pregs.

Front 43

Amniotic Band Syndrome

Back 43

Series of findings assoc w/ entanglement of fetal parts w/ amniotic membranes that collapse around fetus after ROM.

Can --> deformities or amputation of digits.

Front 44

Ectopic Pregnancy

Back 44

Any implantation outside the uterine cavity

Front 45

MC site of ectopic

Back 45

Fallopian tube (95%) - 55% in Ampulla (section of fallopian tube closest to ovary).

*Other sites: ovary, cervix, abdominal caivity.

Front 46

Leading cause of first-trimester pregnancy related deaths

Back 46

Ectopic

Front 47

MC sx of ectopic pregnancy

Back 47

Pain: Abd (90-99%).

Unilat pelvic knife-like or dull pain not well defined.

Front 48

Culdocentesis

Back 48

Good for pts presenting w/ acute pelvic pain, abnorm bleeding, syncope or shock.

Determines presence of free blood in peritoneal cavity.
Needle inserted behind uterus into cul-de-sac. Presence of non-clotting or previously clotted blood dx of free blood in peritoneal cavity --> ectopic.
Rarely used bc of improved US and HcG.

Front 49

Salpingo- oophorectomy

Back 49

Surgical removal of ovary/ tube (ex in ectopic)

Front 50

MC treatment for ectopic

Back 50

Salpingectomy: removal of fallopian tube.

Best tx in ruptured ectopic bc of bleeding.

Front 51

Salpingostomy

Back 51

Opening of fallopian tube to remove ectopic pregnancy. Can be done for ectopics at midpoint of tube.

Not usually closed afterward.

Front 52

Spontaneous abortion

Back 52

Natural, without apparent cause.

Before 20th week.

Expulsion of any or all placenta or membranes and immature, nonviable fetus

Front 53

Early abortion

Back 53

Before 12 weeks

Front 54

Late abortion

Back 54

Between 12 and 20 weeks

Front 55

Complete abortion

Back 55

Total products of conception expelled and identified.

Uterine contractions, bleeding and dilation of cervix.

Front 56

Incomplete abortion

Back 56

Bleeding, cramp-like pain and cervical dilation.

Expulsion of some, but not all of products of conception before 20th wk.

Front 57

Threatened abortion

Back 57

Appearance of signs/ sx of possible loss of fetus.

Vaginal bleeding (usually less than inevitable) w/ or w/out intermittent pain before 20th wk.
Cervix closed.
If fetus is alive and attachment to uterus not interrupted, preg may continue.
Absolute bed rest, sedation, avoid coitus, douches, stress, cathartics (agent for purging bowels)

Front 58

Inevitable abortion

Back 58

Can't be halted.
Profuse intrauterine bleeding before 20th week w/ cramp-like lower abd pain.
Cervix dilated contributing to inevitability

Front 59

Missed abortion

Back 59

Preg/ products of conception retained in uterus after death of fetus for at least 8 weeks.

Front 60

Recurrent/ Habitual abortion

Back 60

3 or more successive spontaneous abortions, at about same level of development.
Before 20 wks, fetus less than 500g.

Front 61

Infected abortion

Back 61

Accompanied by infection of genital tract from retained material w/ resultant febrile reaction

Front 62

Septic abortion

Back 62

Assoc w/ serious infection of uterus and endometrial lining of uterus from retained products of conception leading to generallized infection.

Front 63

Partial birth abortion

Back 63

Lay term for 2nd or 3rd trimester abortion.

Sometimes referred to as "dilation and extraction"

Cranial contents of fetus evacuated prior to removal of fetus from uterus.

Front 64

Recidive Abortion

Back 64

2 consec spontaneous abortions before 20 wks w/ fetus wt less than 500 g

Front 65

Antiphospholipid Antibody Syndrome (APS)

Back 65

Acquired, multi-system, prothrombotic disorder.

Presence of circ auto-abs against phospholipid compounds.
MC acquired blood protein defect assoc w/ venous and/or arterial thrombosis.
Dx: lupus anticoag or titer IgG anticardiolipin abs.

Front 66

Gestational Trophoblastic Disease (GTD)

Back 66

Rare, but curable, even if advanced.

Abnormal growth of placental trophoblastic tissue.
Most - benign and remits spontaneously.
Cause unk, more freq in Asians.
Possible result from defective fertilization.

Front 67

Persistent Gestational Trophoblastic Neoplasia (GTN)

Back 67

Histology - molar tissue or choriocarcinoma.

Usually non-metastatic but locally invasive.
Presents w/ uterine bleeding and high hCG.
Treatment: chemo, hysterectomy.

Front 68

Antepartum bleeding

Back 68

Bleeding in second half of preg, from 20th week to term.

In 2 to 5 pregs; cause of 1/3 maternal deaths.

Front 69

Placenta Previa

Back 69

Placenta implanted in lower pole, usually over or very near internal os.
Total: completely over internal os.
Partial: partially covers internal os.
Marginal: Edge of placenta palpable at margin. does NOT cover. - may resolve by term.
Low-lying: near os, can palpate near edge.

Front 70

Postpartum Pituitary Necrosis

Back 70

Sheehan's syndrome. From hemorrhage.

Sx: chronic fatigue, failure to lactate, oligomenorrhea, cold intolerance, coarse skin/ hair, inability to concentrate, hypoglycemia, wt loss.

Front 71

Placenta accreta

Back 71

Placenta tissue A-ttaches to the myometrium w/out intervening decidual layer.

Can occur in placenta previa bc endometrium in lower uterine seg is thinner.
Prior c-section common risk: absence of deciduas basalis and incomplete development of fibrinoid layer.

Front 72

Placenta Increta

Back 72

Placenta I-nvades into myometrium

Front 73

Placenta Percreta

Back 73

Placenta P-enetrates THROUGH myometrium.

Front 74

Abruptio Placentae

Back 74

Normally implanted placenta prematurely separates from uterus before delivery.

Involves hemorrhage.

Front 75

MCC DIC in pregnancy

Back 75

Abruption

Front 76

Couvelaire Uterus

Back 76

From extravasation of blood into uterine muscle --> myometrial hematomas.

Uterine musculature disrputed and infiltrated w/ blood.

Responds well to IV oxytocin. Purplish/ bluish color from blood.

Front 77

Complete uterine rupture

Back 77

Entire thickness of uterus.
Usually occurs during labor.

Trauma: MVA, improper oxytocin use, breech.

Spontaneous: Prev uterine scar or hx of uterine damage.

Front 78

MCC uterine rupture

Back 78

C-section scar.

3% of classical scars - usually during labor.

Front 79

Incomplete uterine rupture

Back 79

"occult" - dishiscence of uterine incision from previous surgery.

Front 80

3rd MC form of injury in pregnant females

Back 80

Domestic abuse

Front 81

Leading cause of maternal death worldwide and leading cause of maternal morbidity in developed nations

Back 81

Postpartum hemorrhage

Front 82

MCC of postpartum hemorrhage

Back 82

Uterine atony.

Also, retained products of conception

Front 83

Definition of Immediate Postpartum Hemorrhage

Back 83

Blood loss >500 mL during first 24 hrs after vaginal delivery.

Blood loss >1000 mL during first 24 hrs after C-section

Front 84

Definition of Delayed Postpartum Hemorrhage

Back 84

Blood loss btwn 24 hrs and 6 weeks after delivery.

D/t sub-involution of placental bed or retained products of conception.

Front 85

Subinvolution

Back 85

A condition in which blood vessels at the implantation site of the placenta fail to completely remove following delivery, which will cause persistent postpartum bleeding and vaginal discharge.

Decidua basalis and adjacent endometrium don't regenerate to cover placental implantation site.

Front 86

MCC delayed postpartum hemorrhage (24 hrs to 6 wks)

Back 86

Retained placental tissue

Front 87

Uterine inversion

Back 87

Prolapse of fundus to or through cervix so that uterus is turned inside out.

Most cases - after delivery made worse by excess traction on cord before separation of placenta.

Front 88

3 MCCs trauma in pregnancy

Back 88

MVA,

Domestic violence,

Falls

Front 89

MC result of physical injury in pregnancy

Back 89

Contractions

Front 90

MC fetal injury in pregnancy

Back 90

Skull fracture

Front 91

Puerperium

Back 91

The state of a woman during childbirth or immediately thereafter.

Front 92

MCC anterior pituitary insufficiency

Back 92

Postpartum Pituitary necrosis/ Sheehan's.

Front 93

MCC for C-sections

Back 93

Previous C-section

Failure to progress during labor

Front 94

Paramedian incision

Back 94

Located near the midplane, most commonly parallel and close to the linea alba.

Front 95

Pfannestiel incision

Back 95

Horizontal (slightly curved) line just above the pubic symphysis. This incision is commonly called the "bikini line incision"

Provides most desired cosmetic effect, but takes more time to perform.

Front 96

Coaptation

Back 96

The drawing together of the separated tissue in a wound or fracture.

Front 97

Median Episiotomy

Back 97

MC in US.
Less blood loss, easier repair, more comfortable healing.
May cut anal sphincter and rectum.

Front 98

Mediolateral Episiotomy

Back 98

Gives more room.
More difficult to repair, more blood loss and more difficult to heal.

Front 99

Outlet Forceps

Back 99

Fetal head is at perineum and scalp is visible at introitus between uterine contractions.

NEVER apply forceps to breech. Only to aftercoming head.

Front 100

Low forceps

Back 100

Fetal vertex at +2 station

Front 101

Midforceps

Back 101

Forceps applied when head is engaged.

Fetal head is above a +2 station

Front 102

Simpson forceps

Back 102

Used for occiput anterior

Front 103

Tucker-McLean Forceps

Back 103

To rotate from occiput posterior to occiput anterior and deliver

Front 104

Kielland and Barton Forceps

Back 104

To rotate occiput transverse to occiput anterior

Front 105

Piper Forceps

Back 105

To deliver the aftercoming head of breech

Front 106

Cervical incompetence

Back 106

Premature, painless dilation of cervix without being in labor.
2nd trimester - usually results in preg loss.
Recurrence: 20-30%.
Secondary to insufficiency of internal os.

Congen or acquired (prev rapid delivery, use of forceps, trauma, breech)

Front 107

Cervical cerclage

Back 107

Suturing incompetent cervix.

Done between 13-16 wk. Remove suture 38th wk or earlier.
Success: 85-95%.

Front 108

The Shirodkar

Back 108

Most complicated cervical cerclage.
Vaginal mucosa dissected away from cervix before placing suture.
Permanent - can be left in place.

Front 109

The McDonald

Back 109

Simplest form of cervical cerclage.
Less trauma to cervix, less blood loss.
Simple purse string. No mucosal dissection.

Temporary. Remove before labor begins.

Front 110

MC conidition associated with stillbirth

Back 110

Fetal growth restriction!

43%

Front 111

Induced Abortion

Back 111

Termination of preg medically or operatively before viability (before capable of surviving)

Definition of viability varies from state to state.
Types: Therapeutic, elective

Front 112

Therapeutic Abortion

Back 112

Interruption for purpose of safeguarding health of mother and in cases of genetic disease and anomalies of fetus. Laws state to state vary.

*became legal 1973.
1st and 2nd trimester.
Can be induced up to 20-24 wks.

Front 113

Laminaria

Back 113

Type of seaweek. Used to dilate cervix slowly and gently.

Front 114

Abortifacient

Back 114

Substance used to induce abortion (can be extrauterine or intrauterine).

Intravaginal Prostaglanding E2 w/ urea.
Methotrexate.
Mifepristone.

Front 115

Mifepristone/ Mifeprex

Back 115

*19 norsteroid analogue.
Progesterone antagonist (RU 486).
95% effective.

Blocks progesterone receptor sites in deciduas --> bleeding.
Increases prostaglandin levels --> uterine contractions.

Front 116

Asherman's syndrome

Back 116

Adhesions and/or fibrosis within the uterine cavity due to polyps.

Front 117

Definition of "Use" regarding illegal/ legal substances

Back 117

Taking low, infrequent doses of illicit substances for experimentation or social reasons

Front 118

Definition of Substance Abuse

Back 118

Persistent or repeated use of a psychoactive substance for more than 1 month, despite persistence or recurrence of adverse social, occupational, psychological or physical effects.

Front 119

Teratology

Back 119

Science - production, development, anatomy and classification of malformed fetuses

Front 120

Teratogenicity

Back 120

Related to genetic predisposition (maternal and fetal),
developmental stage of fetus when exposed,
Route and length of administration of teratogen.

Front 121

Thalidomide

Back 121

Teratogen.
Used as anti-anxiolytic and anti-nausea in first trimester in the 50s.
Caused limb reduction in 1/3 exposed.
"Classic" teratogen: effects between 31 and 71 days from LMP (5th-10th wk gestation).

Front 122

Diethylstillbesterol (DES)

Back 122

Teratogen
Estrogenic hormone to prevent variety of reproductive probs (miscarriage to premature delivery) used in1940s-70s.
Exposed offspring - risk of adenocarcinoma of cervix and vagina and male reproductive anomalies.
Example of long period that can exist btwn fetal exposure and drug effect.

Front 123

Developmental Stage at Time of Exposure: Resistant Period

Back 123

Day 0 to 11 gestation.
All or none phenomenon.
Fetus will be killed or survive unaffected.

Front 124

Developmental Stage at Time of Exposure: Maximum Susceptibility (Embryonic Period)

Back 124

Day 11 to 57 of gestation.

Fetus most susceptible to adverse effects of teratogens.

Front 125

Developmental Stage at Time of Exposure: Lowered Susceptibility (Fetal period)

Back 125

After 57 days (8 weeks) gestation.
Organs formed and increasingin size.
Teratogen - retardation in cell size and #.

Front 126

Malformation

Back 126

MORPHOLOGIC DEFECT of an organ or other body part from an INTRINSIC abnormality in process of development, usually in first trimester.
Example: VSD
Primary structural defect from a localized error of morphogenesis.

Front 127

Deformation

Back 127

STRUCTURAL DEFECT - abnormal forms, shapes or positions of a previously normal body part caused by a non-disruptive mechanical force, i.e. constraint w/in uterus usually in 2nd or 3rd trimester.
Example: club feet from oligohydramnios.
Usually occurs after organogenesis and involves to MS system.

Front 128

Disruptions

Back 128

MORPHOLOGIC DEFECT from EXTRINSIC interference w/ normally developing organ system, usually later in gestation - 2nd or 3rd trimester.
Example: amniotic band syndrome.

Front 129

Category A Teratogen

Back 129

Controlled studies don't show risk to fetus.
Possibility of fetal harm seems remote.

Example: Prenatal vitamin

Front 130

Category B Teratogen

Back 130

No evidence of risk to humans.
Animal studies have not shown fetal risk but no controlled studies in pregnant women OR animal studies have shown adverse effect that was NOT confirmed in controlled studies in women in first trimester and no evidence of risk in later trimester.

Examples: PCN, dig, epi, terbutaline

Front 131

Category C Teratogen

Back 131

Risk can't be ruled out.
Animal studies have either shown teratogenic or embyocidal effects OR approp animal data is not available.

Give only when benefits outweigh potential harm.

Examples: Furosemide, Quinidine, Verapamil, Beta blockers

Front 132

Category D Teratogen

Back 132

Positive evidence of risk in humans.
Benefit may outweigh fetal risk in certain circumstances.

Use if drug is needed in life-threatening situation or for a serious dz for which safter drugs can't be used.

Example: Phenytoin

Front 133

Category X Teratogen

Back 133

Contraindicated.
Studies show fetal abnormalities OR evidence of fetal risk.

Risk of using drugs in this category clearly outweigh any benefit.
Contraindicated in preg or anyone who may become preg.

Example: Isotretinoin

Front 134

MC teratogenic cause of mental retardation, MC abused substance

Back 134

ETOH

Front 135

Fetal Hydantoin Syndrome

Back 135

Birth defects due to fetal exposure to Phenytoin or Carbamazepine.

Growth/ MR, microcephaly, eyelid ptosis, depressed nasal bridge, craniofacial abnorm, digital anomalies.