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42 Cards in this Set
- Front
- Back
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threatened abortion
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- uterine bleeding w/o cervical dilation and no expulsion of tissue
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tx of threatened abortion?
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IV fluids or blood, if needed
bedrest pelvic rest RhoGAM if pt is Rh neg. |
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inevitable abortion
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- uterine bleeding WITH cervical dilation and crampy abdominal pain
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tx of inevitable abortion
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IV fluids
RhoGAM if pt is Rh neg. D&C |
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incomplete abortion
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- passage of some products of conception through cervix
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tx of incomplete abortion
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IV fluids
RhoGAM if pt is Rh neg. D&C |
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complete abortion
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- expulsion of all products of conception from uterus
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tx of complete abortion
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serial hCG testing to make sure it drops to zero
consider D&C give RhoGAM if pt Rh neg. |
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missed abortion
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- fetal death with no expulsion of tissue (often for several wks)
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tx of missed abortion
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D&C if less than 14wks
attempt delivery if more than 14wks RhoGAM if pt Rh neg. |
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induced abortion
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intentional termination of pregnancy <20wks; can be elective or therapeutic
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what is recurrent abortion?
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two or three successive unplanned abortions
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some causes of recurrent abortions?
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- infectious (Listeria, Mycoplasma, Toxoplasma spp., syphilis)
- smoking, drinking, drugs - DM - hypothyroidism - SLE (esp. with positive antiphospholipid/lupus anticoagulant antibodies) - cervical incompetence (look for recurrent 2nd trimester abortions) - congenital female tract abnormalities - fibroids (remove them) - chromosomal abnormalities (maternal or paternal translocations) |
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what MAY help women with antiphospholipid antibodies and previous problem pregnancies?
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low-dose aspirin
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what does low AFP indicate?
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Down syndrome, fetal demise, or inaccurate dates
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what does high AFP indicate?
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- neural tube defects (eg. anencephaly or spina bifida)
- ventral wall defects (eg. omphalocele, gastroschisis) - multiple gestation - inaccurate dates |
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if AFP or triple screen (AFP, estradiol, hCG) is positive at 16-20 wks, what should be done?
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amniocentesis for dx of chromosomal disorders or neural tube defects
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when should you perform chorionic villus sampling (CVS)?
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9-12 wks (earlier than amniocentesis)
done in women with previously affected offspring or known genetic disease |
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can CVS detect neural tube defects?
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no
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when mom is diabetic, what is the best test to detect fetal lung maturity?
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phosphatidylglycerol is better than the lecithin-to-sphingomyelin ratio
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how do you treat TB in pregnancy?
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same as in other cases; give vitamin B6 with isoniazid (don't forget!)
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which of the immunoglobulins crosses the placenta?
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IgG
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how do you treat group B strep carrier mom during pregnancy?
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ampicillin during labor and delivery
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what do you do about herpes in pregnant moms?
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do a C section only if mom has lesions at the time of birth
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tx of hep B in pregnant moms?
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give infant its first hep B vaccine and hep B immunoglobulin at birth
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microcephaly, midfacial hypoplasia, mental retardation, IUGR, cardiac defects.
teratogen? |
alcohol
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bowel atresia, IUGR, microcephaly
teratogen? |
cocaine
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CN VIII damage, ototoxicity
teratogen? |
streptomycin
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tooth discoloration, inhibition of bone growth, small limbs, syndactyly.
teratogen? |
tetracycline
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kernicterus
teratogen? |
sulfonamides
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cartilage damage.
teratogen? |
quinolones
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heart and great vessel defects, craniofacial dysmorphism, deafness.
teratogen? |
isotretinoin
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congenital goiter, hypothyroidism, mental retardation.
teratogen? |
iodide
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CNS malformations, craniofacial dysmorphism, IUGR.
teratogen? |
methotrexate
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clear cell adenocarcinoma of the vagina, cervix, genital tract abnormalities (cervical hood, T-shaped uterus, hypoplastic uterus), cervical incompetence.
teratogen? |
DES
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limb reduction (phocomelia), ear and nasal anomalies, cardiac and lung defects, pyloric or duodenal stenosis, GI atresia.
teratogen? |
thalidomide
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stippling of bone epiphyses, IUGR, nasal hypoplasia, mental retardation.
teratogen? |
coumadin
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oligohydramnios, fetal renal damage.
teratogen? |
ACEIs
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Ebstein's anomaly (tricuspid valve defect), other cardiac defects.
teratogen? |
Lithium
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fingernail hypoplasia, IUGR, microcephaly, neural tube defects.
teratogen? |
carbamazepine
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nail hypoplasia, IUGR, mental retardation, craniofacial dysmorphism, microcephaly.
teratogen? |
phenytoin
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neural tube defects, craniofacial and skeletal defects.
teratogen? |
valproic acid
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