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Weekly appts with pregnant pts
- q4w until week 28
- biweekly until week 36
- weekly after that
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How soon can US detect pregnancy? (via fetal heart beat)
5-6 weeks
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u/s measurement of nuchal space
10-13 weeks
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When is CVS done?
b/w 10-13 weeks
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abnl high levels of AFP
increased risk for neural tube defects
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amniocentesis is generally performed when?
15-18 weeks
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normal stress test
two accelerations of fetal HR in 20 mins of up to 15 bpm from the baseline heart rate for a duration of 15 seconds and the absence of decelerations
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m/c cause of ectopic pregnancy
occlusion of the tube secondary to adhesions
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biggest risk factors for ectopic
previous ectopic, previous salpinigitis (PID), previous abdominal or tubal surgery, use of an IUD, and assisted reproduction
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labs in ectopic
- serum hCG nl double q24h, if increase is less than expected, suspect ectopic
- women with hCG titer >2000 should show evidence of a developing intrauterine gestation on TVUS
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tx of ectopic
- methotrexate (hcg >5k, mass <3.5 cm, hemodynamicall stable, compliant for f/u)
- surgery (laparoscopy)
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abortion vs miscarriage
abortion <20 weeks
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m/c form of GTD
complete molar pregnancies
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m/c presentation of molar pregnancy
abnl vaginal bleeding, uterine size > dates, hyperemesis gravidarium, pre-eclampsia like sx
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risk of developing diabetes after having GDM
50%
-
DM screening
initially, then 24-28 weeks
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preterm delivery
<37 weeks gestation
-
mag sulfate
tocolytic, stops contractions
-
PROM
rupture of amniotic membranes before onset of labor at or beond 37 weeks
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when are steroids administered?
<34 weeks
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PIH
HTN that presents after 20 weeks gestation
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when is rhogam administered?
28-29 weeks to all Rh- mothers
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m/c cause of 3T bleeding
abruptio placentae
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definitive tx of abruptio placentae
delivery
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With what placental issue are cervical examinations CI?
placenta previa, bc it can incite severe bleeding
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hallmark of placenta previa
painless vaginal bleeding
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how long is the first stage of labor?
6-20 hours for nulliparous women, 2-14 hours for multiparous women
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second stage of labor is how long?
30m-3h for nulliparous, 5-60 mins for multiparous
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early decelerations
fetal head compression
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late decels
uteroplacental insufficiency
-
variable decels
cord compression
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tx of endometritis
- clinda plus gent first line
- add amp if no response within 24-48 hours
- flagyl if sepsis is present
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When does the uterus shrink/involute?
2 days after delivery
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When does the uterus descend into the pelvic cavity?
after 2 weeks
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When does uterus go back to antenatal size?
6 weeks
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How long can lochia last?
4-5 weeks post partum
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