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33 Cards in this Set
- Front
- Back
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Medical abortion 1st trimester |
- oral Mefipristone - progesteron agonist - oral Misoprostol - PGE1 - the eralier pregnancy - the higher rate - 2% need vacuum curettage |
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Medical abortion 2nd trimester |
- D&E - most common - cervical dilation 24h prior to prosedure - after 14 weeks fetus removed in pieces - US guidance ensures complete evacuation |
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Late pregnancy bleeding |
1) Abruptio placente (painful) 2) Placenta previa (painless) 3) Vasa previa (painless) 4) Uterine rupture (painful) |
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Teratology Dilantin/Phenitoin |
- Craniofacial dysmorphism - nail hypoplasia |
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Teratology Isotretinoin (Accutane) |
- microtia (small ears) - |
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Teratology Thalidomide |
Phocomelia - limb reduction defect (Day 42-48) |
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Teratology Coumadin |
- Chondrodysplasia punctata - Optic atrophy |
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Autosomal dominant |
- every generation - both sex - anatomical defect - no carrier states |
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Autosomal recessive |
- skip generation - carrier - enzyme disorder - both sex |
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X - linked recessive |
- skip generation - no male - male transmission - only in male - female carriers |
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Threatened abortion |
Cervical os: Closed SONO: Viable Mgmt: Observe |
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Missed abortion |
Cervical os:Closed SONO: Non-Viable Mgmt: D&C (Sched) |
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Inevitable abortion |
Cervical os:Open SONO: Gest sac intact Mgmt: D&C (Emerg) |
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Incomplete abortion |
Cervical os:Open SONO: POC some left Mgmt: D&C (Emerg) |
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Completed abortion |
Cervical os:Open SONO: POC all gone Mgmt: Observe Serial beta-hCG |
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US dating 1st trimester |
Crown Rump Length |
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US dating 2nd & 3d trimester |
1) biparietal diameter (BPD) 2) head circumference (HC) 3) abdominal circumference (AC) 4) femur length (FL) |
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Triple marker screen |
1) MS-AFP 2) b-hCG 3) estriol |
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Electronic Fetal Monitoring Early decelerations |
* Gradual drop of FHR * Gradual return of FHR * Mirror image of contraction - head compression |
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Electronic Fetal Monitoring Late decelerations |
* Gradual drop of FHR * Gradual return of FHR * Delayed in relation to contraction - uteroplacental insufficiency - HTN |
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Electronic Fetal Monitoring Variable decelerations |
* Abrupt drop of FHR * Sudden return of FHR * Variable in relation to contraction - umbilical cord compression first mgmt - change mother position |
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Indication for Primary CS |
- Failure to progress (most common) - Breech presentation - Nonreassuring EFM strip |
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Postpartum Fever |
1. Atelectasis ---------------------------------- 0 d 2. UTI ------------------------------------------1-2 d 3. Endometritis -----------------------------2-3 d 4. Wound Infection ------------------------4-5 d 5. Septic pelvic thrombophlebitis ----5-6 d 6. Infectious mastitis |
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Placenta Previa Risk factors |
- previous cesarean delivery - previous uterine surgery - multiple gestations - previous placenta previa |
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Placental Abruption Risk factors |
- maternal hypertension - prior placental Abruption - maternal cocaine use - maternal external trauma - maternal smoking during pregnancy |
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Return Visit 1. Every 4 wks up to 28 wks 2. Every 2 wks up to 36 wks 3. Every 1 wk until delivery |
1. FEW complications 2. GDM, Anemia, Preeclampsia, Preterm labor, SPROM, IUGR 3. MORE complications |
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Ectopic pregnancy |
- Abdomen: LQ rebound, R > L - Spec exam: blood, no purulence - Cervix: close, tender to motion - Uterus: slightly enlarged and soft - Adnexa: tender on R no masses * Serum beta-hCG: > 1500 mLU * Vaginal SONO: No IU gest sac |
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Post abortal ENDOMETRITIS TREATMENT |
* Broad spectrum IV antibiotics: ampicillin, gentamicin, clindamicin * Suction D&C uterine evacuation * Watch for septic shock |
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RhoGam Indications: |
- Routine at 28 wks - Delivery of Rh+ baby - Amniocentesis, D&C, ectopic pregnancy |
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Kleihauer-Betke Test |
*Complication related to pregnancy. This test is used to predict certain types of pregnancy complications. *Measures fetal cells in maternal circulation. Staining of postpartum maternal blood for identification of percentage of fetal cells present. *Used in assessing for Rh Sensitization ( Maternal blood Rh negative, Large antepartum bleed) *Determine possible fetal maternal hemorrhage in the newborn, aid in diagnosis of certain types of anemia in adults. |
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Biophysical Profile with AFI |
* NST** * Body movement * Breathing movement * Exstension-flexion * AFI** |
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Mild Preeclampsia Treatment |
* No MgSO4 (only when delivery)
* IM Betamethasone if <34 wks * >35 wks - delivery with IV Oxytocin + IV MgSO4 to prevent intrapartum eclampsia |
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Severe Preeclampsia Treatment |
* Start IV MgSO4 to prevent eclampsia * Lower BP - Hydralazine or Lobetalol * IV Oxytocin * No routine C Section MgSO4 can depress respirations and deep tendom reflexes - antidote is: IV calcium gluconate |
