Obs

Front 1

Amount of blood that mom can afford to lose during pregnancy?

Back 1

1000 cc

Front 2

Uterine blood flow at term?

Back 2

750 cc/min (12% of CO)

Front 3

D dimers & fibrinogen level during pregnancy?

Back 3

D-dimers=> Inc=> never use during pregnancy

Fibrinogen => inc => if “normal “ it’s pathological

Front 4

Resp system changes in pregnancy?

Back 4

Dec FRC=> Inc TV => inc minute ventilation

Front 5

Resp system changes in pregnancy?

Back 5

Dec FRC=> Inc TV => inc minute ventilation

Front 6

Cr changes in pregnancy? Normal value during pregnancy?

Back 6

Dec due to Inc blood flow to kidney => inc GFR

0.4- 0.8 mg/dl

Front 7

Obstructive uropathy In pregnancy?

Back 7

Enlarged uterus compresses on ureters at pelvic brim esp on R side

Front 8

Weight gain according to BMI in pregnancy?

Back 8

<18.5 => 1Ib/wk

18.5-24.9 => 0.75 Ib/wk

25-29.9 => 0.5 Ib/wk

>30 => 0.25 Ib/wk

Front 9

Weight gain according to BMI in pregnancy?

Back 9

<18.5 => 1Ib/wk

18.5-24.9 => 0.75 Ib/wk

25-29.9 => 0.5 Ib/wk

>30 => 0.25 Ib/wk

Front 10

1st trimester screening?

Back 10

Done between wk 10-0/7 & 13-6/7

PUB

US=> nuchal translucency (normal is <3mm)

b-HCG=> inc in downs

PAPP-A=> dec in all

Front 11

2nd trimester screening?

Back 11

Best time=> between 16-18 weeks

IBEA

Inhibin A ,B-hCG=> inc in downs

Estriol, AFP => inc in neural tube defects

Front 12

2nd trimester screening?

Back 12

Best time=> between 16-18 weeks

IBEA

Inhibin A ,B-hCG=> inc in downs

Estriol

AFP=> inc in neural tube defects

Front 13

Goals for 1st trimester US?

Back 13

Dates+ no of gestations + aneuploidy

Front 14

W/U of gestational DM?

Back 14

1 hr glucose tolerance test (screening test) => 3 hr glucose tolerance test (confirmatory test)

Front 15

1 hr glucose tolerance test procedure?

Back 15

50 gm of glucose => glucose level after 1 hr

If <140 => stop screening

If >140=> 3 hr glucose tolerance test

Front 16

W/U of gestational DM?

Back 16

1 hr glucose tolerance test (screening test) => 3 hr glucose tolerance test (confirmatory test)

Front 17

1 hr glucose tolerance test procedure?

Back 17

50 gm of glucose => glucose level after 1 hr

If <140 => stop screening

If >140=> 3 hr glucose tolerance test

Front 18

W/U of gestational DM?

Back 18

1 hr glucose tolerance test (screening test) => 3 hr glucose tolerance test (confirmatory test)

Front 19

1 hr glucose tolerance test procedure?

Back 19

50 gm of glucose => glucose level after 1 hr

If <140 => stop screening

If >140=> 3 hr glucose tolerance test

Front 20

Protocols of 3 hr glucose tolerance test?

Back 20

Fasting level=> 100 gm of glucose => glucose levels hourly for 3 hours

Front 21

W/U of gestational DM?

Back 21

1 hr glucose tolerance test (screening test) => 3 hr glucose tolerance test (confirmatory test)

Front 22

1 hr glucose tolerance test procedure?

Back 22

50 gm of glucose => glucose level after 1 hr

If <140 => stop screening

If >140=> 3 hr glucose tolerance test

Front 23

Protocols of 3 hr glucose tolerance test?

Back 23

Fasting level=> 100 gm of glucose => glucose levels hourly for 3 hours

Front 24

Positive 3 hr glucose tolerance test criteria?

Back 24

Any 2 of following 4:

Fasting=> _>95

1 hour=> _> 180

2 hour=> _>155

3 hour=> _> 140

Front 25

Condition associated with hypothyroidism ?

Back 25

Infertility due to anovulation

Front 26

Condition associated with hypothyroidism ?

Back 26

Infertility due to anovulation

Front 27

Rx of hypothyroidism in pregnancy?

Back 27

1- frequent TSH monitoring every 4-6 wks

2- adjust dose of levothyroxine based on TSH levels

Front 28

Rx of hyperthyroidism?

Back 28

1- surgery in 2nd trimester

2- PTU in pregnancy

Front 29

Rx of epilepsy in pregnancy?

Back 29

Levetiracetam

Lamotrigine

Folic acid supplement

Front 30

Rx of HTN in pregnancy?

Back 30

H LMN

Hydralazine

Labetalol

Methyl dopa (DOC)

Nifedipine

Front 31

Umbilical A doppler use?

Back 31

To monitor growth restriction

Normal => inc End Diastolic volume

If absence/reversed flow=> inc risk of mortality

Inc Systolic/Diastolic ratio is abnormal

Front 32

MCA doppler?

Back 32

Inc blood flow in fetal anemia

Front 33

Amniocentesis vs CVS?

Back 33

Both => genetic testing

CVS=> done at 10-13 wks

Amniocentesis => done at 15-20 wks

Front 34

Amniocentesis vs CVS?

Back 34

Both => genetic testing

CVS=> done at 10-13 wks

Amniocentesis => done at 15-20 wks

Front 35

PUBS AKA? Done during which time?

Back 35

Cordocentesis

20-32 wks=> if >32 , just deliver

Front 36

Stages of labour?

Back 36

Stage 1:

Latent=> upto 6cm dilation, 20 hrs in nullipar, 14 hr in multipar

Active+> upto 10cm dilation

Stage 2: delivery of baby,3 hr for N & 2 hr for M

Stage 3=> delivery of placenta, usually w/i 30 min of delivery

Front 37

Amniocentesis vs CVS?

Back 37

Both => genetic testing

CVS=> done at 10-13 wks

Amniocentesis => done at 15-20 wks

Front 38

PUBS AKA? Done during which time?

Back 38

Cordocentesis

20-32 wks=> if >32 , just deliver

Front 39

Stages of labour?

Back 39

Stage 1:

Latent=> upto 6cm dilation, 20 hrs in nullipar, 14 hr in multipar

Active+> upto 10cm dilation

Stage 2: delivery of baby,3 hr for N & 2 hr for M

Stage 3=> delivery of placenta, usually w/i 30 min of delivery

Front 40

Cervical change for labour?

Back 40

AKA cervical ripening => due to breakage of S-S bonds b/w collagen & infusion of water => effacement of cervix

Front 41

Amniocentesis vs CVS?

Back 41

Both => genetic testing

CVS=> done at 10-13 wks

Amniocentesis => done at 15-20 wks

Front 42

PUBS AKA? Done during which time?

Back 42

Cordocentesis

20-32 wks=> if >32 , just deliver

Front 43

Stages of labour?

Back 43

Stage 1:

Latent=> upto 6cm dilation, 20 hrs in nullipar, 14 hr in multipar

Active+> upto 10cm dilation

Stage 2: delivery of baby,3 hr for N & 2 hr for M

Stage 3=> delivery of placenta, usually w/i 30 min of delivery

Front 44

Cervical change for labour?

Back 44

AKA cervical ripening => due to breakage of S-S bonds b/w collagen & infusion of water => effacement of cervix

Front 45

Breech types?

Back 45

1- Frank=> hip flexed, knee extended

2- Complete=> hip flexed,knee flexed

3- Footling=> hip EXTENDED , knee any

Front 46

Pelvic inlet?

Back 46

From pubic symphysis to sacral prominence

Front 47

Adequate contraction?

Back 47

1- 3 in 10 minutes (averaged over 30 minutes)

2- Montevideo units >200 in 10 min (averaged over 30 min)

Front 48

How to Augment labour?

Back 48

1- balloon to stimulate engagement

2- misoprostol, dinoprostone

3- Oxytocin

4- amniotomy

Front 49

Cervical change during active phase of labor?

Back 49

1- 1.2 cm/hr in nulliparous

2- 1.5 cm/hr in multiparous

Front 50

How to Augment labour?

Back 50

1- balloon to stimulate engagement

2- misoprostol, dinoprostone

3- Oxytocin

4- amniotomy

Front 51

Cervical change during active phase of labor?

Back 51

1- 1.2 cm/hr in nulliparous

2- 1.5 cm/hr in multiparous

Front 52

Criteria for arrest of active phase?

Back 52

No cervical change:

1- after 4 hrs of adequate contractions

2- after 6 hrs of inadequate contractions

Front 53

Causes of arrest of active phase?

Back 53

1- Passenger=> baby too big(C/S)

2- Pelvis => mom’s anatomy (C/S)

3- Power=> dec strength of contractions => augment with oxytocin & amniotomy

Front 54

Px of ROM? P/E? Dx?

Back 54

1- rush of fluid

2- speculum exam=> pooling in posterior vagina

3- nitrazine test=> paper/swab turns blue

Ferning on slide

U/S=> oligohydramnios

Front 55

Preterm? Premature?

Back 55

1- before 37 weeks

2- no contractions

Front 56

P PROM?

Rx?

Back 56

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 57

P PROM?

Rx?

Back 57

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 58

Prolonged ROM?

Association?

Back 58

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 59

P PROM?

Rx?

Back 59

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 60

Prolonged ROM?

Association?

Back 60

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 61

Chorioamnionitis vs endometritis?

Px?

Back 61

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 62

P PROM?

Rx?

Back 62

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 63

Prolonged ROM?

Association?

Back 63

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 64

Chorioamnionitis vs endometritis?

Px?

Back 64

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 65

Chorioamnionitis & endometritis rx?

Back 65

IV Clindamycin + amp + gent

Front 66

P PROM?

Rx?

Back 66

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 67

Prolonged ROM?

Association?

Back 67

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 68

Chorioamnionitis vs endometritis?

Px?

Back 68

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 69

Chorioamnionitis & endometritis rx?

Back 69

IV Clindamycin + amp + gent

Front 70

Preterm labour? Rx?

Back 70

1- contractions + cervical change before 37 wks

2- >34 => deliver

<20 => abortion

20-34 => steroids + tocolytics

Front 71

P PROM?

Rx?

Back 71

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 72

Prolonged ROM?

Association?

Back 72

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 73

Chorioamnionitis vs endometritis?

Px?

Back 73

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 74

Chorioamnionitis & endometritis rx?

Back 74

IV Clindamycin + amp + gent

Front 75

Preterm labour? Rx?

Back 75

1- contractions + cervical change before 37 wks

Front 76

Tocolytics?

Back 76

BC PM

1- Beta agonist => rarely used

2- CCB=> nifedipine

3- PGE-i => indomethacin (avoid in >32 wks )

4- magnesium => <32 weeks for neuroprotection

Front 77

Post dates?

Back 77

>40 wks by conception OR

>42 wks by LMP

Front 78

Pre eclampsia def?

Rx?

Back 78

_>140/ _>90 + _>300 mg/dl proteinuria after 20 wks

Continue preg until 37 wks then deliver

Front 79

P PROM?

Rx?

Back 79

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 80

Magnesium used in? Schedule?

Back 80

1-Pre eclampsia with severe features & eclampsia

2- during labour & 24 hrs after delivery

Front 81

Prolonged ROM?

Association?

Back 81

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 82

Chorioamnionitis vs endometritis?

Px?

Back 82

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 83

Chorioamnionitis & endometritis rx?

Back 83

IV Clindamycin + amp + gent

Front 84

Preterm labour? Rx?

Back 84

1- contractions + cervical change before 37 wks

2- >34 => deliver

<20 => abortion

20-34 => steroids + tocolytics

Front 85

Tocolytics?

Back 85

BC PM

1- Beta agonist => rarely used

2- CCB=> nifedipine

3- PGE-i => indomethacin (avoid in >32 wks )

4- magnesium => <32 weeks for neuroprotection

Front 86

Post dates?

Back 86

>40 wks by conception OR

>42 wks by LMP

Front 87

Pre eclampsia def?

Rx?

Back 87

_>140/ _>90 + _>300 mg/dl proteinuria after 20 wks

Continue preg until 37 wks then deliver

Front 88

Pre eclampsia with severe features?

Back 88

1- _>160/_>110

2- Cr _>1.1 or 2* baseline

3- platelets <100000

4- AST/ALT 2* ULN

5- pul edema

6- RUQ or epigastric pain

7- headache or visual disturbance

Front 89

Rx of Pre eclampsia with severe features?

Back 89

Magnesium & urgent delivery

Front 90

P PROM?

Rx?

Back 90

1- ROM without contractions before 37 wks

2- <24 wks=> abortion

24-34 => steroids for lung maturity

>34=> deliver

Front 91

Magnesium used in? Schedule?

Back 91

1-Pre eclampsia with severe features & eclampsia & HELLP

2- during labour & 24 hrs after delivery

Front 92

Earliest sign of Mg toxicity?

Antidote?

Preventive measures?

Back 92

1- dec resp rate + loss of DTRs

2- Ca

3- Mg checks

Front 93

Alarm sx that eclampsia is around the corner?

Back 93

1- capsular stretch

2- inc LFTs

3- dec platelets

Front 94

Added risk for di-zygotic twins?

Back 94

1- Breech

2- CS

3- PPH

4- preterm

Front 95

Prolonged ROM?

Association?

Back 95

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 96

Chorioamnionitis vs endometritis?

Px?

Back 96

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 97

Chorioamnionitis & endometritis rx?

Back 97

IV Clindamycin + amp + gent

Front 98

Preterm labour? Rx?

Back 98

1- contractions + cervical change before 37 wks

2- >34 => deliver

<20 => abortion

20-34 => steroids + tocolytics

Front 99

Tocolytics?

Back 99

BC PM

1- Beta agonist => rarely used

2- CCB=> nifedipine

3- PGE-i => indomethacin (avoid in >32 wks )

4- magnesium => <32 weeks for neuroprotection

Front 100

Post dates?

Back 100

>40 wks by conception OR

>42 wks by LMP

Front 101

Pre eclampsia def?

Rx?

Back 101

_>140/ _>90 + _>300 mg/dl proteinuria after 20 wks

Continue preg until 37 wks then deliver

Front 102

Pre eclampsia with severe features?

Back 102

1- _>160/_>110

2- Cr _>1.1 or 2* baseline

3- platelets <100000

4- AST/ALT 2* ULN

5- pul edema

6- RUQ or epigastric pain

7- headache or visual disturbance

Front 103

Rx of Pre eclampsia with severe features?

Back 103

Magnesium & urgent delivery

Front 104

P PROM?

Rx?

Back 104

1- ROM without contractions before 37 wks

Front 105

Magnesium used in? Schedule?

Back 105

1-Pre eclampsia with severe features & eclampsia & HELLP

2- during labour & 24 hrs after delivery

Front 106

Earliest sign of Mg toxicity?

Antidote?

Preventive measures?

Back 106

1- dec resp rate + loss of DTRs

2- Ca

3- Mg checks

Front 107

Alarm sx that eclampsia is around the corner?

Back 107

1- capsular stretch

2- inc LFTs

3- dec platelets

Front 108

Added risk for di-zygotic twins?

Back 108

1- Breech

2- CS

3- PPH

4- preterm

Front 109

Timing of separation of embryos & type of twins?

Back 109

1- day 0-3=> tubal phase, di-ch di-amn

2- day 4-8=> blastocyst stage , mono ch & di amn

3- day 9-12=> non-conjoint with mono ch & mono amn

4- >12 days=> conjoint with mono ch & mono amn

Front 110

All multiple gestations at risk of?

Back 110

BC PPP

1- breech birth

2- pre term delivery (due date 4 wks less per fetus)

3- placenta previa

4- PPH

5- CS

Front 111

Prolonged ROM?

Association?

Back 111

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 112

Chorioamnionitis vs endometritis?

Px?

Back 112

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 113

Chorioamnionitis & endometritis rx?

Back 113

IV Clindamycin + amp + gent

Front 114

Preterm labour? Rx?

Back 114

1- contractions + cervical change before 37 wks

Front 115

Tocolytics?

Back 115

BC PM

1- Beta agonist => rarely used

2- CCB=> nifedipine

3- PGE-i => indomethacin (avoid in >32 wks )

4- magnesium => <32 weeks for neuroprotection

Front 116

Post dates?

Back 116

>40 wks by conception OR

>42 wks by LMP

Front 117

Pre eclampsia def?

Rx?

Back 117

_>140/ _>90 + _>300 mg/dl proteinuria after 20 wks

Continue preg until 37 wks then deliver

Front 118

Pre eclampsia with severe features?

Back 118

1- _>160/_>110

2- Cr _>1.1 or 2* baseline

3- platelets <100000

4- AST/ALT 2* ULN

5- pul edema

6- RUQ or epigastric pain

7- headache or visual disturbance

Front 119

Rx of Pre eclampsia with severe features?

Back 119

Magnesium & urgent delivery

Front 120

P PROM?

Rx?

Back 120

1- ROM without contractions before 37 wks

Front 121

Magnesium used in? Schedule?

Back 121

1-Pre eclampsia with severe features & eclampsia & HELLP

2- during labour & 24 hrs after delivery

Front 122

Earliest sign of Mg toxicity?

Antidote?

Preventive measures?

Back 122

1- dec resp rate + loss of DTRs

2- Ca

3- Mg checks

Front 123

Alarm sx that eclampsia is around the corner?

Back 123

1- capsular stretch

2- inc LFTs

3- dec platelets

Front 124

Added risk for di-zygotic twins?

Back 124

1- Breech

2- CS

3- PPH

4- preterm

Front 125

Timing of separation of embryos & type of twins?

Back 125

1- day 0-3=> tubal phase, di-ch di-amn

2- day 4-8=> blastocyst stage , mono ch & di amn

3- day 9-12=> non-conjoint with mono ch & mono amn

4- >12 days=> conjoint with mono ch & mono amn

Front 126

All multiple gestations at risk of?

Back 126

BC PPP

1- breech birth

2- pre term delivery (due date 4 wks less per fetus)

3- placenta previa

4- PPH

5- CS

Front 127

Delivery decision in multiple gestations?

Back 127

1- cephalic-cephalic=> vaginal

2- cephalic-breech=> clinical decision

3- breech-breech => CS

Front 128

PPH def?

Back 128

1000 cc for c section

500 cc for vaginal delivery

Front 129

Uterine atony px?

Rx?

Back 129

1- boggy uterus

2- MUTS

uterus massage=> uterotonics => mechanical tamponade with Bakri balloon/packing => surgery

Front 130

Prolonged ROM?

Association?

Back 130

1->18 hrs between ROM & delivery of placenta

2- inc risk of Gp B strep infections => chorioamnio, endometritis

Front 131

Chorioamnionitis vs endometritis?

Px?

Back 131

1-baby out=> endomet

baby in=> chorioamnio

2- maternal fever, tachy ,fundal (uterine)tenderness, purulent amniotic fluid

Front 132

Chorioamnionitis & endometritis rx?

Back 132

IV Clindamycin + amp + gent

Front 133

Preterm labour? Rx?

Back 133

1- contractions + cervical change before 37 wks

Front 134

Tocolytics?

Back 134

BC PM

1- Beta agonist => rarely used

2- CCB=> nifedipine

3- PGE-i => indomethacin (avoid in >32 wks )

4- magnesium => <32 weeks for neuroprotection

Front 135

Post dates?

Back 135

>40 wks by conception OR

>42 wks by LMP

Front 136

Pre eclampsia def?

Rx?

Back 136

_>140/ _>90 + _>300 mg/dl proteinuria after 20 wks

Continue preg until 37 wks then deliver

Front 137

Pre eclampsia with severe features?

Back 137

1- _>160/_>110

2- Cr _>1.1 or 2* baseline

3- platelets <100000

4- AST/ALT 2* ULN

5- pul edema

6- RUQ or epigastric pain

7- headache or visual disturbance

Front 138

Rx of Pre eclampsia with severe features?

Back 138

Magnesium & urgent delivery

Front 139

R/f for percreta/increta/acreta?

Rx?

Back 139

1- inc risk with increasing pregnancies

2- D&C then hysterectomy

Front 140

Normal fetal HR?

Back 140

110-160

Front 141

R/f for percreta/increta/acreta?

Rx?

Back 141

1- inc risk with increasing pregnancies

2- D&C then hysterectomy

Front 142

Normal fetal HR?

Back 142

110-160

Front 143

Non stress test evaluates?

Back 143

Accelerations & variability

Front 144

Non stress test evaluates?

Back 144

Accelerations & variability

Front 145

Adequate accelerations?

Back 145

>32 wks=> 15*15, 2 in 20

<32 wks=> 10*10, 2 in 20

Front 146

Non stress test evaluates?

Back 146

Accelerations & variability

Front 147

Adequate accelerations?

Back 147

>32 wks=> 15*15, 2 in 20

<32 wks=> 10*10, 2 in 20

Front 148

15*15, 2 in 20 interpretation?

Back 148

15 bpm rise in HR sustained for 15 seconds occurring twice in 20 minutes

Front 149

NST employed when?

Back 149

Dec fetal movements felt by mom

Front 150

NST employed when?

Back 150

Dec fetal movements felt by mom

Front 151

Biophysical profile determinants?

Back 151

NAB MT

1- NST

2- Amniotic fluid index

3- Breathing

4- movement

5- tone

Each given 2 points

Front 152

Amniotic fluid index ?

Interpretation?

Back 152

Sum of max depths of amiotic fluid pockets in each 4 quadrants

Oligo<5

Normal >5

Reassuring 8-25

Polyhydramnios >25

Front 153

NBSIM according to BPP?

Back 153

0-2 => fetal demise imminent

8-10=> reassuring

4-6=>

>36 wks=> deliver oxytocin,CS

<36 wks=> contraction stress test

Front 154

Contraction stress test interpretation?

Back 154

EH LU VC

Early deceleration => head compression

Variable deceleration => cord compression

Late deceleration => uteroplacental insufficiency

Front 155

Variability stratification?

Back 155

Absent => no variation-smooth line

Minimal=> <5 bpm variation

Moderate=> 6-25 bpm variation

Marked=> >25 bpm variation

Front 156

Findings suggestive of placenta previa remaining until end of pregnancy?

Back 156

1- lack of resolution by 3rd trimester

2- extension over Os by more than 25 mm

Front 157

Findings suggestive of placenta previa remaining until end of pregnancy?

Back 157

1- lack of resolution by 3rd trimester

2- extension over Os by more than 25 mm

Front 158

Vasa previa triad?

Back 158

ROM

Bleeding

Fetal bradycardia

Front 159

Uterine rupture px?

Back 159

Contractions + sudden fetal distress => loss of contractions + loss of fetal station

Front 160

Fetal R/F for erythroblastosis fetalis ?

Back 160

1- Mom Rh neg

2- Father Rh positive/unknown

3- Mom Rh antibody positive

4- Antibodies cause anemia ie Kell,D, Duffy antibodies

5- Antibody titers >1:8 to 1:32

Front 161

Fetal R/F for erythroblastosis fetalis ?

Back 161

1- Mom Rh neg

2- Father Rh positive/unknown

3- Mom Rh antibody positive

4- Antibodies cause anemia ie Kell,D, Duffy antibodies

5- Antibody titers >1:8 to 1:32

Front 162

NBSIM in erythroblastosis fetalis if paternity in question?

Back 162

Amniotic fluid PCR to determine genotype of baby

Front 163

Ppx of alloimmunization?

Back 163

Rhogam-D IMIG at 28 wks & w/i 72 hrs of delivery

Front 164

Intrapartum abx choice in Gp B strep?

Back 164

1- Ampicillin => DOC

2- Cefazolin=> PCN allergic but not anaphylactic

3- clindamycin => PCN allergic and anaphylactic , if sensitive to both clinda & erythro

4- vancomycin => PCN allergic and anaphylactic , resistant to either clinda OR erythro

Front 165

Intrapartum abx choice in Gp B strep?

Back 165

1- Ampicillin => DOC

2- Cefazolin=> PCN allergic but not anaphylactic

3- clindamycin => PCN allergic and anaphylactic , if sensitive to both clinda & erythro

4- vancomycin => PCN allergic and anaphylactic , resistant to either clinda OR erythro

Front 166

Baby born to a hep B positive mom. NBSIM?

Back 166

CS=> IVIG hep B & Hep B vaccine on the day of delivery

Breastfeeding is Ok

Front 167

Route of delivery in HIV mom?

Back 167

If viral load <1000 copies/ml=> ARVT + vaginally

>1000 copies/ml or not on HAART=> AZT+ ARVT +C/S

Front 168

Intrapartum abx choice in Gp B strep?

Back 168

1- Ampicillin => DOC

2- Cefazolin=> PCN allergic but not anaphylactic

3- clindamycin => PCN allergic and anaphylactic , if sensitive to both clinda & erythro

4- vancomycin => PCN allergic and anaphylactic , resistant to either clinda OR erythro

Front 169

Baby born to a hep B positive mom. NBSIM?

Back 169

CS=> IVIG hep B & Hep B vaccine on the day of delivery

Breastfeeding is Ok

Front 170

Route of delivery in HIV mom?

Back 170

If viral load <1000 copies/ml=> ARVT + vaginally

>1000 copies/ml or not on HAART=> AZT+ ARVT +C/S

Front 171

HIV status positive at time of delivery. NBSIM?

Back 171

Zidovudine

Front 172

Intrapartum abx choice in Gp B strep?

Back 172

1- Ampicillin => DOC

2- Cefazolin=> PCN allergic but not anaphylactic

3- clindamycin => PCN allergic and anaphylactic , if sensitive to both clinda & erythro

4- vancomycin => PCN allergic and anaphylactic , resistant to either clinda OR erythro

Front 173

Baby born to a hep B positive mom. NBSIM?

Back 173

CS=> IVIG hep B & Hep B vaccine on the day of delivery

Breastfeeding is Ok

Front 174

Route of delivery in HIV mom?

Back 174

If viral load <1000 copies/ml=> vaginally

>1000 copies/ml or not on HAART=> CS

Front 175

HIV status positive at time of delivery. NBSIM?

Back 175

Zidovudine

Front 176

Breastfeeding in HIV?

Back 176

Not recommended

Front 177

Factors for successful VBAC?

Back 177

<_2 CS

Low transverse cut

Front 178

Conditions under which vacuum & forceps are applied?

Back 178

Mom fully dilated & effaced

Fetal station 2+

Front 179

Grades of episiotomy?

Back 179

1=> involves vagina

2 => involves perineum

3 => involves anal sphincter

4 => involves anal mucosa

Front 180

Pain of stage 1 & 2 spinal levels?

Back 180

Stage 1=> T10-T12 (visceral pain)

Stage 2=> S2-S4 (somatic pain)

Front 181

Narcotics analgesia toxicity?

Rx?

Back 181

1- resp depression

2- naloxone

Front 182

Narcotics analgesia toxicity?

Rx?

Back 182

1- resp depression

2- naloxone

Front 183

Labour stage respective nerve blocks?

Toxicity?

Back 183

Stage 1=> para cervical block with local lidocaine, fetal bradycardia

Stage 2=> by palpating ischial tuberosity & injecting towards pudendal N near sacrospinous ligament

Front 184

Anesthesia of choice in labour?

Toxicity?

Back 184

1-Epidural

2- if introduced in subdural space=> vasodilation & hypotension

If too high=> paralysis of diaphragm

Front 185

Signs of placental separation?

Back 185

1- gush of blood

2- lengthening of cord

3- globular ,firm shape of uterus

4- uterus rises up to ant abd wall

Front 186

Low fetal birth wt?

Back 186

<2.5 kg OR

<5.5 Ib

Front 187

Polyhydramnios def? Associations?

Back 187

1- AFI _>24 or single deepest pocket _>8cm

2- cong fetal malformation + maternal DM

Front 188

Fetal alcohol syndrome px?

Back 188

Microcephaly

Mid face hypoplasia (small palpebral fissure, smooth philtrum, thin vermillon border)

Front 189

Def of infertility?

Back 189

Inability to conceive after

1- >6 mon of unprotected sex in >35 yr

2- >12 mon of unprotected sex in <35 yr

Front 190

Umbilical cord prolapse px?

FHR tracing ?

Back 190

UC delivers ahead of fetal part , fetus is unengaged

FHR tracings => persistent variable decelerations or severe bradycardia

Front 191

Uterine inversion vs vaginal/cervical inversion?

Back 191

Uterine=> shaggy appearance

Cervix/vagina=> smooth

Front 192

Prolonged 3rd stage?

Rx?

Back 192

>30 min

Manual extraction of placenta

Front 193

Condition associated with uterine inversion?

Back 193

Hemorrhage

Front 194

Best initial therapy for non reducible uterus ie cervix tightly contracted in uterine atony?

Back 194

Uterine relaxing agent=> halothane, terbutaline, Mgso4

Front 195

Steps to take with fetal bradycardia?

Back 195

1- confirm fetal HR

2- vaginal exam to assess for cord prolapse

3- positional changes

4- o2

5- IVF +/- pressors

6- discontinue oxytocin

Front 196

Mc finding in uterine rupture?

Back 196

Fetal HR abnormality

Front 197

Uterine hyper stimulation def?

Association?

Back 197

>5 contractions in 10 min

Misoprostol

Front 198

Type of Px associated with cord prolapse?

Back 198

Footling breech

Transverse lie

Front 199

Polyhydramnios def?

Back 199

Single deepest pocket _> 8cm

AFI => _>24

Front 200

Sources of progesterone?

Back 200

Before 7 weeks=> corpus luteum

Between 7& 9=> both

After 9 wks=> placenta

Front 201

Functions of progesterone?

Back 201

Early=> endometrial changes for blastocyst implantation

Late=> immune tolerance & prevent myometrial contraction

Front 202

Striae gravidarum AKA?

Back 202

Stretch marks

Front 203

Chadwick sign?

Back 203

Bluish discoloration of vagina & cervix as a result of increased vascularity

Front 204

Cloasma?

Back 204

Blotchy pigmentation of nose & face

Front 205

Criteria for MTX use in ectopic pregnancy?

Back 205

1- no fetal heart sounds

2- hcg<6000

3- pregnancy mass diameter <3.5

4- no hx of folic acid supplementation

Front 206

Different methods for abortion?

Back 206

Front 207

Different types of abortion?

Back 207

Front 208

Wu of fetal demise?

Back 208

S DEA G

Front 209

Management of fetal demise?

Back 209

Front 210

Most common location if ectopic pregnancy?

Back 210

Ampulla of fallopian tube

Front 211

Wu of ectopic pregnancy?

Back 211

Spec B V

Front 212

Dd of ectopic pregnancy?

Further Wu with?

Back 212

A-TIME

1- Threatened abortion

2- incomplete abortion

3- molar preg

4- ectopic pregnancy

B- US

Front 213

Prenatal diagnostic tests?

Back 213

Front 214

Obs US?

and when they are done?

What can they assess?

Back 214

Front 215

Nuchal translucency dd?

Back 215

1- aneuploidy

2- congenital heart dz

Front 216

Tasks for 1st prenatal visit?

Back 216

Front 217

Clinical landmars of gestation with their associated gestational age?

Back 217

Front 218

Fundal height in pregnancy?

Back 218

Front 219

Fetal biometric parameters & when they are measured?

Back 219

Front 220

Common findings with preg by trimester?

1- sx

2- signs

3- wt gain

4- complications

Back 220

Front 221

Routine prenatal tests by trimester?

Back 221

Front 222

Tasks of first prenatal visit?

Back 222

Front 223

Signs of pregnancy?

Back 223

Front 224

Establishing due date?

Back 224

1- conception dating=> 266 days or 38 wks

2- menstrual dating=> 280 days or 40 wks

3- Naegele's rule=> +7days/-3mon/+1year

Front 225

STDs screened during initial prenatal visit?

Back 225

Front 226

Causes of Inc AFP?

NBSIM?

Back 226

2- abd US

Front 227

Initial approach to late trimester bleeding?

Back 227

Front 228

MCC of:

1- late preg bleeding

2- late preg painful bleeding

3- Obstetric DIC

Back 228

All=> apruptio placenta

Front 229

Perinatal infections?

Rx?

Mode of delivery?

Back 229

Front 230

Perinatal infections with characteristic findings?

Back 230

Front 231

Perinatal infections that cause IUGR?

Back 231

CTR

Rubella

Toxo

CMV

Front 232

Perinatal infections that are transferred via placenta?

Back 232

CTR VS

CMV

Toxo

Rubella

Varicella

Syphilis

Front 233

Perinatal infections that are transferred via vaginal fluids?

Back 233

HSV

HBV

HIV

Front 234

Px of GBS sepsis in neonates?

Rx?

Back 234

1- bilat diffuse PNA & sepsis w/I hrs of birth

2- Pen G

Alt=> clindamycin, erythromycin

Front 235

Toxo infection

1- lethal during

2- most occur during

3- prevention

Back 235

1- 1st trimester

2- 3rd trimester

3- avoid contact with cat feces

Front 236

Varicella mode of transmission?

Residual effects of 1 infection?

Risk of fetal infection highest?

Back 236

1- resp droplets

2- lifelong latency

3- 5 day AP to 2nd day PP

Front 237

MCC of congenital deafness?

Back 237

CMV

Front 238

Mc congenital viral infection?

Back 238

CMV

Front 239

Ppx of HIV?

Back 239

Triple therapy starting at 14 wks regardless of viral load

Front 240

Px of congenital syphilis?

Delivery mode?

Back 240

Front 241

Residual status of perinatal infections?

Back 241

Front 242

Mode of transmission of perinatal infections to mother?

Back 242

1-Resp droplets=> Rubella + varicella

2-Mucous membranes=> herpes+ syphilis

3-Cat feces=>toxo

4-Body fluids=>CMV+ HIV+ HBV

Front 243

Cervical insufficiency triad?

Back 243

Front 244

Wu of alloimmunization?

Back 244

RAIG

Front 245

Alloimmunization ppx?

Back 245

Front 246

Preterm labor dx criteria?

Management?

Screening?

Back 246

CT 32 34 G

Front 247

CI to tocolytics?

Back 247

Front 248

SE of tocolytics?

Back 248

Front 249

Reasons not to prolong preg in PROM?

Back 249

1- labor

2- distress

3- chorioamnionitis

Front 250

Management of post term pregnancy?

Back 250

DCS

Front 251

Cf suggesting superimposed preeclampsia on chronic HTN?

Back 251

Front 252

Anti hypertensives never used in preg?

Back 252

1- ACE/ARBs

2- diuretics

Front 253

Cervical cerclage is considered in cervical insufficiency if?

Back 253

1- cervical length <25mm before 24 wks by vag US &

2- Prior preterm birth at <34 wks

Front 254

Management of cervical insufficiency?

Back 254

1- elective cerclage placement at 13-14 wks

2- emergency cerclage placement, but first ro labor, chorioamnionitis

3- cerclage removal at 36-37 wks to allow vag delivery if McDonald procedure performed

4- C/S if shirodkar

Front 255

Post conception embryos' separation day & associated type of twin?

Back 255

Front 256

CI to mgso4?

Back 256

1-Renal insufficiency

2-Myasthenia gravis

Front 257

Prerequisite for fetal fibronectin test?

Back 257

1- gestation 22-35 wks

2- cervical dilation <3 cm

3- membranes intact

Front 258

Two different syndromes of post term pregnancy?

Back 258

Front 259

Management of meconium aspiration?

Back 259

1- amnioinfusion

2- laryngoscopic visualization=> only if fetus is depressed

Front 260

Preg with Multiple gestations px with preterm labor. NBSIM?

Back 260

Observation

Front 261

Rx of rheumatic MS?

Back 261

1- activity limitation

2- avoid anemia

3- balloon valvuloplasty

Front 262

Rx of eisenmenger syn?

Back 262

Avoid hypotension

Front 263

Do we need Abx ppx with congenital heart defects during delivery?

Back 263

No as s viridans aren't associated with genital tract

Front 264

NYHA classification?

And associated delivery place?

Back 264

1 & 2=> deliver in L&D, No invasive monitoring

3 & 4=> deliver in ICU, invasive monitoring

Front 265

Rx of hyperthyroidism?

Back 265

1st trimester=> PTU

2nd/3rd=> methimazole

Front 266

Fetal demise Rfs with GDM?

Monitoring?

Back 266

1- need insulin or glyburide

HTN

Prev demise

2- NST & AFI 2/wk starting at 32 week

Front 267

Wu of gestational DM?

Back 267

Front 268

Antepartum maternal assessment of overt DM?

Back 268

1- HbA1c

2- 24 hr urine

3- retinal exam

4- home glucose monitoring

Front 269

Fetal anomalies associated with DM?

Back 269

Only with overt DM . Not with true GDM (as hpl Inc in later half of preg )

1- NTDs

2- congenital heart defects

3- sacral agenesis/caudal regression syn 200* Inc in overt DM

Front 270

Electrolyte Dec due to DM in preg?

Back 270

Ca

Front 271

Px of cholestasis of preg?

Rx?

Back 271

Front 272

Px of acute fatty liver of preg?

Rx?

Back 272

Front 273

Thrombophilia in preg px?

MCCs?

Rx?

Back 273

AP=> LMWH is stopped at 36 wk & UFH is continued from there as it can be reversed with protamine sulfate in case of C/S

PP=> anticoagulation can be started 6 hrs after vag delivery & 12 hrs after C/S.

Front 274

Highest risk of preg associated thrombophilia at what time?

Back 274

1st week postpartum

Front 275

Obs complications if;

1- hypothyroidism left untreated

2-hyperthyroidism left untreated

Back 275

1- anovulation, spontaneous abortion

2- thyroid storm, IUGR

Front 276

Rx of hypothyroidism in preg?

Back 276

Inc throxine dose by 30% above prepreg dose

Front 277

Symmetrical vs asymmetrical IUGR?

Back 277

Front 278

Macrosomia definition?

Management?

Back 278

1- >90% percentile, >4000 gm

2- scheduled C/S if:

a- fetal wt >4500 gm in DM

b- >5000 gm if no DM

Front 279

Uterus < or > dates. NBSIM?

Causes?

Back 279

Front 280

MCC of non reactive NST?

Back 280

Sleeping baby

Front 281

NBSIM If

1- negative CST

2- Positive CST

Back 281

Front 282

Doppler flow studies in MCA & UA in normal & IUGR?

Back 282

Front 283

Position of fetal head during

1- start of labor

2-when comes out,

3-after coming out?

Back 283

Front 284

Stages of labor?

Back 284

Front 285

Wu of abnormal 1st stage of labor?

Back 285

Front 286

Comparison of OB anesthesia?

Back 286

Front 287

Maternal meds that can cause

1- fetal Brady

2- fetal tachy

Back 287

1- beta blockers+ local anesthesics

2- beta agonists+ parasympatholytics

Front 288

UC prolapse px?

Back 288

Malpresentation/ unengaged fetal px part=> UC delivers thru cervix ahead of px fetal part=> persistent variable deceleration & severe brady

Front 289

Delay in Rx of acute cervicitis can result in?

Back 289

1- ascending infections

2- preg complications eg preterm birth

Front 290

Uterine size-date discrepancy?

Back 290

1->2 cm diff in fundal height measurement from gestational age

Front 291

Urinary protein excretion that is considered abnormal in preg?

Back 291

1->300

2- 2+ on urine dipstick

Front 292

Anemia def in preg?

Back 292

1st & 3rd trimester=> <11

2nd trimester=> <10.5

Front 293

Pao2 & paco² in preg?

Back 293

PaO2=> 100-110

Paco2=> 27-32

Front 294

CI to exercise in preg?

Back 294

Front 295

Exercise recommendation in preg?

Back 295

Low-mod intensity exercise for >30 min , 5-7 days/wk

Front 296

Antepartum fetal assessment of overt DM?

Back 296

1- quad screen at 16-18

2- US at 18-20

3- fetal echo at 22-24

4- monthly sonogram for fetal wt monitoring

5- if Inc risk of fetal demise=> weekly NST & AFI starting at 32 wks

Front 297

Rx of hyperemesis gravidarum?

Back 297

1- dietary changes

2- hydration

3- ginger

4- pyridoxine± doxylamine

Front 298

MCCs of Wernicke encephalopathy?

Back 298

1- chronic alcoholism

2- malnutrition (AN)

3- Hyperemesis gravidarum

Front 299

Thiamine def in preg associated with?

Back 299

1- Wernicke encephalopathy

2- spontaneous abortion

Front 300

Complications of

1- excessive weight gain

2- inadequate weight gain

Back 300

1- fetal macrosomia+ GDM+ C/S

2- FGR+ preterm delivery

Front 301

R/fs for molar preg?

Back 301

1- extremes of maternal age

2- hx of hydatidiform mole

3- complete mole associated with Vit A deficiency

Front 302

Mc genotype of molar preg?

Back 302

46 XX

Front 303

Management of molar pregm

Back 303

1- D&C

2- Histopath confirmation

3- serial b-hcg levels

4- contraception for 6 mon

Front 304

Confirmation of malignant gestational trophoblastic dz?

Rxm

Back 304

1- quantitative b-hcg

2- MTX & hysterectomy

Front 305

1st Prenatal visit tests?

Back 305

Front 306

HIV positive mom's should be screened for which vaginal pathogen additionally?

Back 306

Trichomonas vaginalis

Front 307

Rx of asymptomatic bacteriuria?

Back 307

1- cephalexin

2- amox clav

3- nitrofurantoin

4- fosfomycin

Front 308

Routine vaccines during preg?

Back 308

1- TDaP

2- inactivated influenza

3- Rho(D) immunoglobulin

Front 309

Vaccines recommended for special circumstances in pregm

Back 309

Hep A & B

SHiN

Post expo varicella zoster

Front 310

Vaccines not recommended in pregm

Back 310

1- HPV

2- MMR

3- Varicella

4- live influenza

5- small pox

Front 311

Rx of syphilis in preg?

Back 311

IM benzathine pen G 1 dose weekly for 3 weeks

Front 312

Unvaccinated preg women with confirmed Rubella expo. NBSIM?

Back 312

Offer termination of preg

If not wishing to do=> IVIG

Front 313

Rfs for septic pelvic thrombophlebitis?

Back 313

1- preg

2- C/S

3- Endometritis

4- ca

5- PID

6- Pelvic surg

Front 314

Px of septic Pelvic thrombophlebitis?

Back 314

1- fever unresponsive to abx

2- no localising signs

3- neg infectious diagnostic evaluation

Front 315

Rx of septic pelvic thrombophlebitis?

Back 315

1- anticoagulation

2- broad spectrum Abx

Front 316

2nd trimester quad screen in

1- trisomy 18

2- NTD

3- abd wall defect

Back 316

1- normal inhibin A

2- Inc AFP

3- Inc AFP

Front 317

Cell free fetal DNA indications?

Applications?

Back 317

Front 318

Inc AFP associated with which renal conditions?

Back 318

1- fetal congenital nephrosis

2- benign obstructive uropathy

Front 319

Complications of chorioamnionitis?

Back 319

1-Maternal=> uterine atony+ PPH+ Endometritis

2-Fetal=> Premature birth+ infection+ enceph+ cerebral palsy+ death

Front 320

Px of malignant gestational trophoblastic dz?

Back 320

1- irregular postpartum bleeding

2- enlarged uterus

3- pelvic pain

Front 321

Sinusoidal FHR tracing characteristics?

Association?

Back 321

1-Category 3 FHR tracing

Fixed amplitude of 5-15/min & frequency 3-5 cycle/min

2- severe fetal anemia

Front 322

Fetal position when early deceleration occurs?

Back 322

Ant fontanel in close contact with cervix (ie cervix ≥5cm dilated & station 0)

Front 323

Late deceleration associated with?

Causes?

Back 323

1- uterplacental insufficiency

2- labor stress(tachysystole)

Abruptio placenta

Placental calcification

Front 324

Causes of variable deceleration?

Back 324

1- cord compression

2- cord prolapse

3- nuchal cord

4- oligohydramnios

Front 325

Characteristics of variable deceleration?

Back 325

1- abrupt <30 sec from start to Nadir

2- decrease ≥15/min; duration ≥15 sec but <2 min

3- have variable depth & duration with each deceleration

4- not necessarily associated with contraction

Front 326

NBSIM if

1- intermittent variable deceleration

2- recurrent variable deceleration

Back 326

1- close obs without intervention

2-

A- maternal repositioning (L lateral position, all fours)

B- Amnioinfusion

C- instrumental delivery if fully dialted

D- Don't use oxytocin

Front 327

Category 1 FHR tracing pattern?

Back 327

1- FHR 110-160

2- Moderate variability => 6-25

3- ± acceleration

4- ± early deceleration

5- no late/variable deceleration

Front 328

Category 3 FHR tracing?

Back 328

≥1 of following

1- absent variability + Brady

2- absent variability + recurrent late deceleration

3- absent variability + recurrent variable deceleration

4- sinusoidal pattern

Front 329

Management of category 3 FHR?

Back 329

Front 330

How to differentiate between monochorionic vs dichorionic on imaging?

Back 330

Differentiated by base shape of intertwin membrane

T sign=> monochorionic

lamDa sign=> Dichorionic

Front 331

FHR Tracing on abruptio placentae?

Back 331

1- no acceleration

2- late deceleration

3- minimal variability

Front 332

Management of placenta previa?

Back 332

1- speculum exam: TAUS followed by TVUS

2- C/S at 36-37 weeks

3- digital vaginal/cervical exam & sex CI

Front 333

R/fs for placenta previa?

Back 333

1- Prev hx of placenta previa

2- prior c/s or other uterine surg

3- multiparity

4- Inc maternal age >35

5- smoking

Front 334

FHR tracing in placenta previa?

Back 334

Early in dz=> normal ie reactive

Continued bleeding=> fetal compromise

Front 335

Rfs for abruptio placentae?

Back 335

1- maternal HTN, preeclampsia, eclampsia

trauma

2- abd trauma

3- cocaine, smoking

4- prior hx of abruptio placentae

Front 336

Rfs for uterine rupture?

Back 336

1- prior uterine surg

2- induction of labor/prolonged labor

3- fetal macrosomia

4- congenital uterine anomalies

Front 337

Cfs of uterine rupture?

Back 337

Front 338

Pt with Prev hx of classical uterine incision/ myomectomy with entry to uterine cavity. NBSIM if

1- pt px b4 labor

2- at labor

Back 338

1- elective c/s at 36-37 wks

2-

A- unruptured=> laparotomy followed by hysterotomy

B- ruptured=> deliver thru rupture site followed by uterine repair

Front 339

Placenta accreta Rfs?

Back 339

1- hx of c/s

2- myomectomy

3- D&C

4- maternal age >35

Front 340

Antenatal US findings in placenta accreta?

Back 340

Irregular or absent myometrial -placental interface & intraplacental villous lakes

Front 341

Management of placenta accreta?

Back 341

Antenatally diagnosed=> planned cesarean hysterectomy

Undiagnosed=> usually results in cord avulsion & needs manual extraction

Front 342

Vasa previa rf?

Back 342

2nd trimester US=> Placenta previa

3rd trimester=> resolves without involution of associated blood vessels

Front 343

FHR Tracing in Vasa previa?

Back 343

Tachy=> Brady=> sinusoidal wave pattern

Front 344

Dx of Vasa previa?

Back 344

Antenatal abd & TV Doppler US

Front 345

Management of Vasa previa?

Back 345

If dx before labor=> C/S

Dx during labor=> emergency C/S

Front 346

Intrauterine adhesions rf?

Evaluation?

Back 346

1- intrauterine infection

intrauterine surg

2- hysteroscopy

Front 347

Intrauterine adhesions result in?

Back 347

Lack of endomet (Asherman syn)

1- light menses

2- 2 amen

3- infertility

4- neg progesterone withdrawal test

5- cyclic pelvic pain

6- recurrent preg loss

Front 348

Rx of intrauterine adhesions?

Back 348

Lysis of adhesions

Front 349

Progesterone withdrawal test?

Back 349

Front 350

Rfs for ectopic pregnancy?

Back 350

1- prior hx of ectopic pregnancy

2- Prev Pelvic/tubal surg

3- PID

Front 351

Rx of ectopic pregnancy?

Back 351

1- MTX=> CI in ruptured

2- Surg

Front 352

Specific Rfs for cornual/ interstitial ectopic pregnancy?

Back 352

1- uterine anomalies eg bicornuate

2- in vitro fertilization

Front 353

Inadequate contractions?

Back 353

<3 in 10 min

Soft to palpate

Front 354

1-Def of arrest of labor in 1st stage ?

2-Rx?

Back 354

1-Dilation ≥6cm with ROM & 1 of following:

A- no cervical change for ≥4 hrs despite adequate contractions

B- no cervical change for ≥6 hrs with inadequate contractions

2- C/S

Front 355

MCC of arrest of 2nd stage?

Back 355

Fetal malposition

Front 356

Precipitous labor?

Most significant r/f?

Back 356

1- spontaneous fetal delivery that occurs within 3 hrs of initiation of contractions. Not caused by oxytocin.

2- multiparity

Front 357

Indications of oxytocin?

SEs?

Back 357

A-

1- induction & augmentation of labor

2-PPH

B-

1- SIADH=>Hyponatremia

2-Hypotension

3-Tachysystole=> FHR tracing abnormalities

4-rupture of unscarred uterus

Front 358

SEs of epidural analgesia?

Back 358

1- hypotension

2- high spinal

3- leakage of CSF

Front 359

Preterm labor def?

Back 359

Regular painful contractions at <37 wks that cause cervical Dilation ≥3 cm &/or effacement length <2 cm

Front 360

Mgso4 given with?

Not given with?

Back 360

1- indomethacin

2- nifedipine

Front 361

Fetal fibronectin low during?

Useful during?

Back 361

22-33 wks for predicting preterm labor

Front 362

Prevention of preterm birth?

Back 362

Front 363

Rfs for preterm labor?

Back 363

6- PPROM

7- Age >40

8- IVF

Front 364

Rfs for PROM?

Back 364

1-Genital tract infection

2- hx of prior PPROM

3- Tobacco use

Front 365

Management of PPROM?

Back 365

Front 366

Indications for operative vaginal delivery?

Back 366

1- protracted 2nd stage of labor

2- FHR abnormalities

3- maternal CI to pushing

Front 367

Fetal complications of operative vaginal delivery?

Back 367

1- laceration

2- cephalohematoma

3- facial N palsy

4- intracranial hemorrhage

5- shoulder dystocia

Front 368

Maternal complications of operative vaginal delivery?

Back 368

1- GUT injury

2-urinary retention

3- rectal sphincter involvement

4- hemorrhage

Front 369

Maternal CI to pushing?

Back 369

1-NM dz

2-If valsalva is CI=> cerebrovascular dz + cardiovascular dz

Front 370

CI to ECV?

Back 370

Front 371

Internal podalic version used in?

Back 371

In twin delivery to convert second twin from oblique/transverse px to breech px for subsequent delivery

Front 372

Septic abortion often follows?

Cfs?

Back 372

1- induced abortions

2- fever

+ malaise

+ signs of sepsis

+ foul smelling vaginal discharge

+ cervical & uterine motion tenderness

Front 373

Products of conception?

Back 373

A solid or sac like bloody white mass

Front 374

Wu of recurrent preg loss?

Back 374

Front 375

Management of spontaneous abortion?

Back 375

Front 376

What is Lochia ?

Types?

Back 376

Shedding of endometrial layer of decidua basalis

Front 377

Lower abd pain 6hrs after a spontaneous vaginal delivery.

Dx?

Rx?

Back 377

1- uterine contractions

2- analgesics

Front 378

Postpartum contraception?

Back 378

Front 379

Postpartum immunizations?

Back 379

Front 380

Causes of postpartum hemorrhage?

Management?

Back 380

Front 381

Placental inspection components

Back 381

1- maternal side=> check for all cotyledons

2- fetal side=> blood vessels usually don't go close to boundary of placenta but if they do think missing accessory lobe

Front 382

Dd of postpartum fever?

Rx?

Back 382

Wind=> water=> womb=> wound=> walk

Front 383

Sequel if Endometritis isn't treated?

Back 383

Endomet=>

endo myo met=>

Endo myo para met=>

Pelvic abscess

Front 384

Rfs for Endometritis, wound infection, septic pelvic thrombophlebitis?

Back 384

Inc vaginal exams

Front 385

Congestive mastitis vs infectious mastitis?

Back 385

Front 386

Thin & thick Endomet stripe ?

Back 386

Front 387

Non-mets vs good prognosis vs poor prognosis gestational trophoblastic neoplasia?

Back 387

Front 388

Ulcer vs no ulcer STD?

Back 388

LGS CH

Front 389

STDs with painful ulcers?

Back 389

1- genital herpes

2- chancroid

Front 390

LGV associated groove sign?

Back 390

Front 391

Indications for GBS Rx?

Back 391

Front 392

1- Definition of FGR?

2- CFs?

Back 392

1- <10% percentile wt for gestational age

2- loose peeling skin

Minimal sub-cut fat

Thin umbilical cord

Large ant fontanel

Meconium stained amniotic fluid

Front 393

Wu of FGR?

Back 393

1- placenta histopath

2- looks syndrome associated=> karyotype

3- urine tox

4- serology

Front 394

Neonatal Complications of FGR?

Back 394

1- polycythemia

2- hypoglycemia

3- hypocalcemia

4- poor thermoregulation

Front 395

FGR Rfs?

Back 395

1- maternal htn

2- pregestational DM

3- Genetic abnormalities

4- congenital inf

Front 396

Wu of antepartum bleeding?

Back 396

1- speculum exam

2- TV US

Front 397

Normal uterine contraction characteristics?

Back 397

1- occurs every 2-3 min

2- lasts for 45-55 sec

3- intrauterine pressure of 55 mmhg

Front 398

ECV performed at?

Back 398

Between >37 wks & labor

Front 399

Mechanism of abortion mcly leading up to septic abortion?

Back 399

Induced abortions

Front 400

Uterotonic used in spontaneous abortion?

Back 400

Misoprostol

Not oxytocin as it's receptors are fewer in 1st & 2nd trimester

Front 401

Px of septic abortion?

Back 401

Front 402

Rx of septic abortion?

Complications?

Back 402

Front 403

Evaluation of IUFD?

Back 403

Front 404

Management of late term preg?

Back 404

1- frequent fetal monitoring=> NST + US for amniotic fluid vol

2- delivery prior to 43 weeks gestation

Front 405

1- Beta 3 agonist used to treat which type of urinary incontinence ?

2- Eg?

Back 405

1- urgency incontinence

2- mirabegron

Front 406

Rx of migraine in preg?

Back 406

NAANO

Front 407

Postpartum management of GDM?

Back 407

Front 408

Heme changes in preg?

Back 408

Front 409

Complications of acute pyelo in preg?

Back 409

1- ARDS

2- preterm labor

3- LBW

Front 410

Rx of UTI in preg.

NBSIM?

Back 410

Test of cure ie a repeat urine culture to check if infection has been eradicated

Front 411

Fetal fibronectin test use?

Back 411

Used to diff between true preterm labor & false labor in pts with preterm contractions

Front 412

Inc AFP value?

Back 412

≥2.5 MoM

Front 413

Normal causes of Inc AFP?

Back 413

1- MCC=> incorrect gestational age dating

2- multiple gestations

Front 414

Rfs for pyelo in preg?

Back 414

1- asymptomatic bacteriuria

2- dm

3- age <20

Front 415

Mc presenting sx of preeclampsia with severe features?

Back 415

Bilat occipital /frontal HA that doesn't improve with acetaminophen & NSAIDs

Front 416

Mc rf for pelvic organ prolapse?

Back 416

Multiparity

Front 417

Degrees of Perineal lacerations?

Back 417

Front 418

1- Round ligament pain pathophys?

2- Px?

Back 418

1- ligament stretched by gravid uterus

2- sharp pain that radiates to vagina

Front 419

Findings?

Back 419

Front 420

Mc type of twin preg?

Back 420

Dichor diamniotic

Front 421

US appearance of a uterine fibroid?

Back 421

Hypoechoic mass with shadowing

Front 422

Complications of Dec wt gain in preg?

Excessive gain in preg?

Back 422

Front 423

Pre-preg wt & Ideal preg wt gain for that category?

Back 423

Front 424

How much extra caloreies needed in 2nd & 3rd trimester?

Back 424

350-450 kcal/day

Front 425

Doppler flow to adnexa during ectopic pregnancy findings?

Back 425

Ring of fire sign=> Inc Doppler flow

Front 426

Short interpreg interval def?

It's complications?

Back 426

Front 427

Sign?

Back 427

Amniotic fluid Ferning

Front 428

Complications of PPROM?

Back 428

Front 429

Pathophys of placental abruption in PPROM?

Back 429

Dec amniotic fluid=> uterine decompression=> maternal decidual vessels shear=> bleeding & placental separation

Front 430

Dx?

Back 430

Double bubble sign of Duodenal atresia + associated polyhydramnios

Front 431

Dx?

Back 431

Rocker bottom feet

Front 432

Dx?

Back 432

Clenched hands with overlapping fingers

Front 433

Cystic mass is?

Probable dx?

Back 433

1- cystic hygromas

2- Turner syn

Front 434

Dx?

Back 434

Ectopic pregnancy

Front 435

Dx?

Back 435

Uterine leiomyoma

Front 436

Px of retained placenta?

Back 436

1- persistent vaginal bleeding

2- malodorous lochia

Front 437

Total fetal blood volume?

Back 437

~250 ml or 1 cup

Front 438

Dx criteria of cervical insufficiency?

Back 438

Front 439

Rx of cervical insufficiency?

Back 439

Prophylactic Cerclage placement at 12-14 wks