35-37 weeks with a swab (also get cervical GC/chlamydia culture/RPR/HIV in at risk pops)
when to screen for down syndrome?
15-19 wks triple marker screen/quadruple test (triple + inhibin A), can also offer amnio for >35yo
When to give rhogam in pregnancy
give to Rh- pts at 28 weeks
CVS vs amniocentesis?
CVS can be done earlier at 10-12 weeks (rather than 15-20 wks) to screen for genetic dz (risk fetal loss 1-5%)
early vs late decelerations?
early decel begins/ends at same time as contractions= fetal head compression (no distress), late is when decels begin after onset of contractions and persist until after contractions are finished (>30s) and indicates fetal hypoxia
variable decel signifies?
umbilical cord compression
managing sugars during labor for diabetics
if pre-gestational DM then use D5+/- insulin drip w/checks q1-2 hours
Key features hyperemesis gravidarum
metabolic alkalosis, hyponatremia, ketonuria.
tx of eclampsia seizures
features of gestational trophoblastic dz (moles)
1st tri uterine bleeding, grape-like molar clusters into vagina, "snowstorm" on u/s w/no sac or fetus or heart tones, very high beta-hcg >100,000