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35 Cards in this Set
- Front
- Back
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Placenta over cervical os |
Placenta previa |
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Painless bleeding after 20 weeks |
Placenta previa |
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Dx with U/S prior to any manual exam |
Placenta previa, however must also U/S on suspected abruptio placenta to be sure you don't worsen a Placenta previa |
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Premature separation of placenta from decidua |
Abruptio placenta |
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Painful bleed after 20 weeks |
Abruptio placenta |
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Dx clinically |
Abruptio placenta |
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Common causes of 3rd trimester bleeding |
Abruptio placenta, Placenta previa |
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Tx for Placenta previa |
Expectant management, hemodynamic support When fetus mature MUST deliver by C-section |
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Tx for placental abruption |
Hemodynamic support If patient is stable = vaginal induction If fetus in distress = urgent c-section |
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When should Rho-GAM be given in pregnancy? |
- At 28 weeks and within 72 hours of delivery - After abortion, stillbirth, ectopic pregnancy - After any procedures that cause transplacental hemorrhage, such as amniocentesis and CVS. |
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Tx if maternal Rh antibody titer is high? |
None. Sensitization has occurred, RhoGAM is of no use. Close monitoring of fetus for hemolytic dz. |
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Who's at lowest risk of Rh incompatibility? |
First pregnancy, sensitization has not occurred |
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WHY should you give RhoGAM |
If mom is Rh- and dad is either Rh+ or unknown. Cannot wait for antibodies, you'll be too late. |
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Criteria for an adequate 4 quadrant amniotic fluid index (AFI)? |
Divide belly into 4 quadrants, measure depth of AF in each quadrant, using deepest point in each, sum all 4 numbers * >5 = normal AFI* Reassuring is 8-25 * < 5 is oligohydramnios (not enough fluid) * > 25 is polyhydramnios (too much) |
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What is value of maternal alpha fetal protein between 16-19/15-20 weeks? |
If it's LOW (Downs, fetal demise, inaccurate dating)
If it's HIGH (neural tube dfx, ventral wall dfx, multiple gestation, inaccurate dating) |
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When should genetic amniocentesis be offered? |
if AFP high US uncertain + Downs screen in 2nd trimester |
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What's an NST? CST? Difference between them? |
Non-stress test Contraction stress test
Presence of contractions |
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Criteria for a REACTIVE NST? |
Moderate variability and normal FHR (120-150) Accelerations follow 15/15/2-20 rule |
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15/15/2-20 rule |
15 BPM accelerations Lasting 15 seconds Occurring 2x in 20 mins |
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Criteria for a Negative CST? |
Baby's decelerations are LATE +/- fetal bradycardia (<110) |
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Reassuring CST? |
3 contractions in 10 mins show: early or variable decels, good FHR |
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Tx for non-reassuring CST? |
Of at 0 or less, c-section +1/+2 use forceps/vaccuum |
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If baby fails NST what's next? |
Try vibroacoustic stim (wake up baby) and try again Else, biophysical profile |
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What composes the BPP? |
NST results AFI U/S: breathing, mm tone, overall movement
all worth 2 points |
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AFI? |
Amniotic fluid index |
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Tx for BPP |
Equal or <2? C-section Equal or >8? Reassurance
3-7? Get a CST |
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Reassuring AFI score? |
8-25 |
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What's considered normal AFI |
>5 |
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What is AFI for oligohydramnios |
<5 |
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What is AFI for polyhydramnios |
>25 |
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Symmetrical IUGR defined as |
20-25%, AKA global growth restriction Fetus affected early on, developed slowly throughout pregnancy, baby's parts are proportional |
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Symmetrical IUGR d/t |
TORCH infxn, chromosomal issues, anemia, FAS |
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Asymmetrical IUGR defined as |
70%, more common Restriction of weight, then length; big head, typically d/t issues in 3rd trimester
(warning: per Wiki) |
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Asymmetrical IUGR d/t |
Mom's chronic HTN, genetic issues, Ehlers-Danlos
(warning: per Wiki) |
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Determination of EDC? |
Nagele's rule LMP + 7 days + 1 year- 3m
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