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Criado por Jaimie Shah
quase 11 anos atrás
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when is gestational sac present on US
when is fetal heart motion seen
fetal heart sounds heard with doppler
fetal movements felt when
review first tirmester screening chart
review second trimester screening table
inc MS-AFP
dec in MS-AFP
dec MS-AFP, dec estriol, inc BHCG
trisomy 18
if dating is correct and MS AFP is elevated what next?
if dating correct and MSAFP low what to do next?
review routine third trimester testing
Antiemetics safe in pregnancy
cause of bleeding after 20wks gestation
late decels and bradycardia are seen in fetal compromise when?
when do you give Rhogam in negative mothers
never perform an exam on preg woman with late preg bleed till you do US to r/o placenta previa
inital mgmt steps for late preg bleed
clue to dx of abruption if the bleeding is concelaed
vasa previa
so if mother in labor and no ROM do an US...
placenta accreta<increta<percreta
signs of urterine rupture
review table of late trimester bleeding causes
tx of GBS
when do we give abx for GBS
when do you not give abx for GBS
congenital toxo triade
RF or toxo
prevent toxo
dx of toxo
biggest risk factor for varicella passing to the infant from mother
s/s of neonatal varicella infection
prevent varicella to the neonate
maternal varicella treatement
congenital varicella
congenital rubella
S/S of congenital rubella
prevention of congenital rubella
CMV is the most common cause of what in the US
about 10% of infants have symptomatic CMV at birth, S/S?
in mother check IGG and IGM for CMV and check viral culture from urine or body fluids in first 2wks of life and PCR
tx CMV
only two active disease warrant C-section
neonatal HSV infection
other prevention of HSV
acyclovir is treatment in primary infection in patient
prevent passing of HIV to neonate
HIV prevention in neonate
there is no immunity from syphillus infection and reinfection can always happen
can pass to baby if primary or secondary and much lower with tertiary or latent syphilis
syphilis acquired in first trimester s/s
late acq syphilis s/s appear at 2 yrs of age
c section prevents spread of congenital syphilis
dx of syphilis
tx syphilis in mothers
how do neonates contract HBV
if mothers are e antigen positve what percent risk is there for passage..and if not what is the percent to pass hep to the baby?
prevent spread to neonate of hep B
tx of hep in infant
review breakdown of HTN in pregnancy
never give ACE i of thiazides in preg to control BP
HELLP can occur...
risk factor of HELLP different from preeclampsia
tx of HELLP
complications of HELLP
never use an ACE I or ARB during pregnancy
loop diuretics, nitrates, BB may be continued
digoxin can be used to control HF symps in pregnancy but it does not effect outcome
use rate control in preg patients; do not give amiodarone or coumadin
Endocarditis ppx is the same as nonpreg pts, don't need ppx for actual delivery or c section
regurgitant lesions are fine in preg but stenotic lesions are exacerbated and increase materal/fetal mortality
mital stenosis in preg has increased risk pulm edema and afib
PE is leading cause of maternal death in US; 50% who get it have a hypercoagulable disease...when do we give DVT/PE ppx
in patient with prior history or reason of anticoagulation what do we give?
hyperthyroid in preg causes
hypothyroid in preg causes
preg does not effect S/S of hyper or hypothyroidism and normal lab values of free T4/TSH
increase thyroid hormone dose in hypothyroid in preg by 25-30%
drug of choice for hypothyroid in preg
symptomatic hyperthyroid use
tx grave's dz in preg
maternal TSIG can cross the placenta and cause
target BS in preg
Diabetes mgmt in preg
routine monitoring in preg patients
GDM post partum care
rare congenital abn in over DM mother
A1C>8.5 in first trimester assoc with what
labor mgmt in diabetic patient
fetal problems with diabetic mother
european preg patient with twins, has intractable puritis worse at night on palms and soles and elevated Bili
acute fatty liver in pregnancy
tx asx bacturia in preg
tx of pyelonephritis in preg
when can D and C be done for abortion
when can we use misoprostol for abortion
second trimester methods of abortion
spontaneous birth occurs when <20wks adn <500g fetus
fetal demise
half of preg complicated by threatened abortion go to term
pregnant woman with bleeding, painful cramps and dilated cervix on exam
loss of early preg but no S/S, and no cardiac activity on US
mgmt of incomplete abortion
mgmt of complete abortion
what is a complication that needs to be ruled out with fetal demise
tx of ectopic preg
when do you use MTX in ectopic
what do you need to r/o before perform cerclage for cervical insuff
tx of cervical insuff
short cervix on exam at 16 wks, but no symps or dilated cervix what do we do?
define IUGR
review IUGR chart
define macrosomia
Diagnose PROM or ROM
clinical dx of Chorioamnionitis
what to do with PROM<24 wks gestation
PROM mgmt at 24-33weeks
PROM mgmt at 34wks
review stage of labor
mgmt umbilical cord prolapse
changes in FHR on monitor are related to the following
nl FHR
FHR tachy/ brady due to the following
Acceleration on monitor
Early deceleration on monitor
variable decleration on monitor
late deceleration on monitor
variability on monitor
stepwise approach to nonreassuring fetal trace
optimum time for external version
breast feeding buys you 3 months off birthcontrol
Diaphragm and IUD should no be placed for 6 wk after del
combined birth control
progesterone only can be used right after del
review post partum fever chart