laracrystalo's version from 2016-07-20 19:39


Question Answer
Cardiac changesS3, JVD, cardiomegaly on CXR, low grade SEM
HRmild tachy
renal perfusionincreases
BPdecreases (nadir at 28 wks)
dischargeleukorrhea of pregnancy
nosepolyps, mucosal hyperemia, nose bleeds
tidal volumeincrease
minute ventilationincrease
vital capacityunchanged
expiratory reservedecrease
acid-baserespiratory alkalosis (from progesterone)
LES tonelow
gastric emptyingfaster
poopingconstipated, hemorrhoids
kidney sizeincreased, hydronephrosis R>L
blood volumeincreased
clotting factorsincreased
total T3 and T4increased
thyroid stateeuthyroid but transient hyperthyroidism
what to do with levothyroxine dose?increase dose in pregnancy


Question Answer
initial visitCBC, Rh, T&S, UA, culture, rubella, HBV, PRP, GC, PPD, HIV, Pap
9 - 14 wksPAPP-A, nuchal transparency, free beta hCG, CVS
15 - 22 wksAFP or quad screen (AFP, estriol, beta HCG, inhibit A) +- AMNIO
18 - 20 wksUS for full anatomic screen
24 -28 wks1hr glucose challenge test for GDM
28 - 30 wksRhoGAM for Rh -
35 - 37 wksGBS culture, repeat CBC
34 - 40 wkshigh risk get GC, HIV, RPR
what is the cut-off for 1 hr glucose challenge test?>140 mg/dL is abnormal, follow up with GTT. If GCT is > 200, no need to follow up.
what is the cut-off for GTT? basically anywhere between >95 for fasting and > 140 for 3hr
what are maternal glucose level goals?fasting < 95, 1hr post prandial < 140, 2 hr post prandial < 120
how do you screen post partum for GDM?2 hr GTT 6-12 wks post
what meds can be used for UTI in pregnancy?nitrofurantoin 5-7 days, amoxicillin 3-7 days, single fosfomycin dose
definitive karyotype analysisCVS and AMNIO
which definitive karyotype analysis is more dangerous?CVS
elevated AFPneural tube defects, abdominal wall defects, multiple gestation, incorrect dating, fetal death, placental abnormalities
reduced AFPtrisomy 21 and 18, fetal demise, incorrect dating
Trisomy 18 quad screendecreased AFP, estriol, beta HCG, normal inhibin A
Trisomy 21 quad screen resultsdecreased AFP, estriol, increased beta HCG, inhibin A
neural tube or ab wall quad screen resultsincreased AFP, normal estriol, beta HCG, and inhibin A
CVS timeline> 10 wks (10-12)
AMNIO timeline>15 wks (15-20)
Cell free fetal DNA10 wks
to detect fetal hemolysis in Rh sensitized pregnancy?amnio
most common causes of downs in ordermeiotic nondisjunction --> inherited robertsonian translocation(if hx of other children with downs), mosaicism
how to treat magnesium toxicity?calcium gluconate
HTN increases risk of...preeclampsia, abruptio placenta, IUGR, preterm labor, still birth
risk for abruptio placentamaternal trauma, chronic HTN, smoker, external cephalic version, cocaine
risk for uterine rupturemultiparty, AMA, previous classical CS, myomectomy
risk for polyhydramniosfetal malformations, genetic disorders, mom DM, multiple gestations, fetal anemia
IUFD protocolUS and get coag studies to r/o DIC. Induce labor ASAP
symmetric IUGRfetal --> small head, small abdomen --> fetal anomalies, abnormal karyotype, early maternal viral infection
asymmetric IUGRmaternal --> normal head, small abdomen --> later find due to maternal vascular disease, HTN, DM, smoking


Question Answer
normal HR110 - 160
tachygreater than 160
bradyless than 110
variable decelcord compression/prolaplse, oligohydramnios. no association with contraction.
cord compression variable decel
cord prolapsevariable decel
oligohydramniosvariable decel
early decelhead compression, vagal stimulation
head compressionearly decal
placental insufficiencylate decels
accelerationsnormal fetal oxygenation
late decelsplacental insufficiency (could be from placental abruption)
repetitive late decals tx?CS emergently
nadir aligns with peak of contractionearly decel
nadir occurs after peak of contractionlate decel
decrease in FHR more than 15 ppm from baseline in more than 15 secondsvariable decel
recurrent variable decelsfetal acidemia
tx variable decelsmaternal repositioning (L lateral), then amnioinfusion
look like W or Vvariable decal
nuchal cordvariable decal
post-term pregnanciesuretoplacental insufficiency / late decals
what causes bradycardia?uterine hyper stimulation, cord prolapse, rapid fetal descent
what causes tachycardia?hypoxia, maternal fever, fetal anemia
what causes minimal variability?hypoxia, opioids, magnesium, sleep cycle
sinusoidal variability?fetal anemia or meperidine use in mom
what is a reactive NST?2 accelerations > 15 ppm above baseline for at least 15 seconds
what is a nonreactive NST?isufficient accelerations over a 40 minute period
what to do if NST is nonreactive?more tests like BPP
what do you do for evaluation of IUGR babies?doppler sono of the umbilical artery
components of BPP?NST, amniotic fluid volume, fetal mvmvnts, fetal tone, fetal breathing movements
what kind of CST is good?negative
what is normal AFI?5-25
when does latent labor become active?at 6cm dilated
what is arrest of labor?no cervical change for > 4 hrs despite adequate contractions or no cervical change for > 6 hrs with inadequate contractions
what to do when tachysystoly or tetanic ctx?tocolytics to relax uterus (terbutaline)


Question Answer
painless bleedingplacenta previa, vasa previa
painful bleedingabruptio placenta, uterine rupture
placenta previa txCS
placenta implants across the osplacenta previa
titanic sawtooth uterine contractionsabruptio placenta
MVA and tx?abruptio placenta give IVF and put mom in lateral decubitus position for uterine displacement to optimize circulation
cocaine useabruptio placenta
HTNabruptio placenta
absent contractionsuterine rupture
previous CSabruptio placenta / placenta accreta
recession of fetal stationuterine rupture
accessory lobevasa previa
occurs with rupture of membranesvasa previa
tachysystoleabruptio placenta
frequent contractionsabruptio placenta
sinusoidal tracingvasa previa
fetal bradycardiavasa previa
inability to separate the placenta from uterusplacenta accreta
baby's bloodplacenta previa and vasa previa
mom's bloodplacental abruption
placenta previa protocoldx on US at 18-20wks, may resolve by 3rd trimester due to growth of lower uterine segment. tx: pelvic rest, abstinence from intercourse, avoid cervical exam. L&D contraindicated, schedule CS 36-37 wks


Question Answer
chorio sxmaternal fever + 1 sign (uterine tenderness, tachycardia, malodorous fluid/discharge)
tx chorioantibiotics and delivery, oxytocin to accelerate if necessary
tx for post part endometritis?polymicrobial IV clinda and gent
amniotic fluid embolism signsrapid onset resp failure, severe hypotension, DIC immediately post partum
tx amniotic fluid embolismintubate and mechanically ventilate, supportive care