Obgyn Pt. 1: Care Of The Woman With Complex Alterations During Antepartum And Intrapartum

Front 1

Define abortion

Back 1

Expulsion of the fetus before viability, which is 20 weeks gestation or weight of less than 500g.

Types of abortions: 1. spontaneous/miscarriage (natural) or 2. induced

Front 2

What is the major cause of bleeding and abortion during the first and second trimesters of pregnancy?

Back 2

Abortion

Front 3

First trimester period?

Back 3

0 - 12 weeks (0 - 3 and a half months)

Front 4

Second trimester period?

Back 4

12 - 28 weeks (3 1/2 months to 6 months)

Front 5

What is an ectopic pregnancy?

Back 5

An ectopic pregnancy, or eccysis, is a complication of pregnancy in which the embryo implants outside the uterine cavity.

Front 6

What are signs of an ectopic pregnancy and when does it occur?

Back 6

Lower abdominal pain in the first trimester (0-12 wks)

Front 7

4 maternal risks of HIV in pregnancy?

Back 7

1. HSV (Herpes Simplex Virus)
2. Wasting Syndrome
3. Candida/Thrush
4. Cervical Pathologies (Cell Irregularities)

Front 8

When do weekly non-stress testing screens begin in pregnancy?

Back 8

Non-stress testing begins at 32 weeks of pregnancy

Front 9

What is used to check for fetal growth issues?

Back 9

Ultrasound

Front 10

Which drug is used to prevent HIV transmission from mother to child during the period of pregnancy, labor (IV prior to birth), and delivery?

Back 10

Azidothymidine (AZT)/Zidovudine
Trade name: Retrovir
Pharmacologic: Nucleoside/nucleoide reverse transcriptase inhibitor AZT (ZDV)
Dose: 200 mg TID or 300 mg BID

Front 11

When is azidothymidine (AZT) started in the pregnancy of a women with HIV?

Back 11

Azidothymidine (AZT) should be started within the 2nd trimester of pregnancy (12-28 wks)

Front 12

HIV transmission from mother to fetus can occur due to...

Back 12

1. Breastfeeding
2. Amniocentesis
3. Mixing blood in utero

Front 13

How many hours should a woman wait after consuming alcohol to breastfeed her baby?

Back 13

2 hours

Front 14

Complications from illicit drug use while the fetus is in utero:

Back 14

1. Intrauterine asphyxia (hypoxemia - low oxygen in blood, hypercapnia - excess carbon dioxide in blood, and respiratory/metabolic acidosis)
2. Intrauterine infection (STD, HIV, Hepatitis)
3. Lower APGAR scores
4. Alterations is birth weight (small gestational age)

Front 15

What drug counteracts respiratory depression caused from opioids?

Back 15

Naloxone/Narcan

Front 16

Complications of illicit drug abuse during pregnancy:

Back 16

1. Respiratory distress
2. Jaundice
3. Methamphetamine users increase occurance of cleft lip/palate, cardiac abnormalities, microcephaly, and low birth weight
4. Congenital anomalies and growth restriction
5. Behavior issues (disorganization, decreased interactive behavior and engagement in auditory/visual stimuli)

Front 17

Cocaine use during pregnancy can cause what complications in the fetus?

Back 17

1. Microcephaly
2. IUGR (intrauterine growth restriction - small baby)
3. Cardiac and genitourinary defects
4. High risk of SIDS (sudden unexpected infant death)

Front 18

What does azidothymidine/zidovudine do?

Back 18

1. Decreases viral load
2. Increases CD4 T-cell counts
3. Delays onset of disease symptoms
4. Reduction of symptom severity

Front 19

Side affects of azidothymidine/zidovudine?

Back 19

1. Anemia
2. Neutropenia (lack of white blood cells - neutorphils)
3. Lactic acidosis (low pH in body tissues/blood)
4. Hepatotoxicity (liver toxicity)

Front 20

Gestational diabetes mellitus occurs in typically what trimester?

Back 20

2nd trimester

Front 21

Diabetes mellitus definition

Back 21

Endocrine disorder of carbohydrate metabolism resulting from inadequate production or use or insulin.

Front 22

Where is insulin produced?

Back 22

Insulin is produced by beta-cells of the islets of Langerhans in the pancreas

Front 23

Purpose of insulin

Back 23

Lowers blood glucose to move from the blood into muscle and adipose tissue cells

Front 24

What happens during the first trimester in a pregnant woman with diabetes?

Back 24

The need for insulin frequently decreases

Front 25

When does insulin requirements begin to rise during pregnancy?

Back 25

2nd trimester

Front 26

What may diabetes in pregnancy cause without careful monitoring?

Back 26

1. high risk of birth defects
2. hypertension
3. eclampsia
4. oversized fetus
5. risk of ketoacidosis (fetal death may result)
6. nephropathy
7. retinopathy

Front 27

When is diagnostic testing done for gestational diabetes?

Back 27

24-28 weeks

Front 28

What type of test is down for gestational diabetes at 24-28 weeks?

Back 28

OGTT (oral glucose tolerance test)

Front 29

What does the OGTT consist of?

Back 29

75 g oral glucose solution taken after fasting. Plasma blood of these levels determine GDM (gestational diabetes):

Fasting: 95 mg/dL
1 hr: 180 mg/dL
2 hr: 155 mg/dL
3 hr: 140 mg/dL

Front 30

What A1C level determines gestational diabetes?

Back 30

6.5% or higher A1C

Front 31

What are two analog insulin brands a pregnant woman with diabetes can take?

Back 31

1. Aspart
2. Lispro
NOT PO!