Mom/Baby

• follicular: ovaries are preparing to release and egg.
• lutial: begins on day of ovulation and ends with 1st day of period (bleeding).
• For purposes of contraception or conception, the last 5 days plus day of ovulation are considered the fertility window. Fuck with caution.

Spike in temp. 

• thromboembolitic disorders
• CVA or heart disease
• BRCA or other estrogen dependent CA
• Smoking >15 cigarettes/day
• Impaired liver function
• pregnancy
• vaginal bleeding 

• Adb pain
• chest pain
• headache
• weakness/numbness/pain/swelling in extremities
• visual problems

• Non-medicated: 10 years
• medicated: 5 years

• The "zoles" 
• nystatin 

• topical flagel
• nfxn presents rist for preterm labor

• Pelvic Inflammatory Disease
• Fever, pelvic pain, abnormal d/c, n/v, irregular vaginal bleeding. 

• Most women are asymptomatic
• burning pee
• purulent yellow-green d/c
• bleeding
• Complications include:
• --PROM
• --preterm
• --chorioamnionitis
• --neonatal sepsis
• --IUGR
• --Maternal pp sepsis

• False, you fiend! It can cross at any time during prenancy!
• Can cause PTD(preterm delivery), deformity, neuro defects, stillbirth, death.
• Tx with penis-ill'n. 

• HPV: Most prevalent in ambulatory care setting. Can be transmitted without body fluid exchange making it the most boring of STIs to contract. Can cause resperitory papillomas in fetus.
• HSV I & II: Herpes=painful blisters on your naughty parts. Transmission to fetus 30-50% if aquired close to delivery. If transmitted, 50-60% mortality if complications are neurological. 
• HIV
• HepB

Pathogens capable of crossing placenta. 

• Toxoplasma
• Other nfxns (hepatitis, syphilis)
• Rubella
• Cytomegalovirus
• HSV

• T: SAB (), v birth weight, hepatospenomegaly, anema, neuros
• O: HepB
• R: deafness, eye defects, CnS problems, severe cardiac malformations
• C LBW/IUGR, hearing impairment, microcephaly, CNSs
• H: fatality, neuros.

• Missed period.
• Abd pain, diffuse one side, low
• Vaginal spotting
• Rupture-->abd pain (see above)
• vBhCG levels
• No gestational sac on ultra sound u/s. 

• Methotrexate: cancer drug (tetarogenic) so it attacks rapidly dividing cells (zygote/embrio)
• Surgery to remove

• Complete: egg lacks nucleus, then gets fertilized. Vasculature of placenta looks like a cluster of white grapes. These are hydropic vessles and are diagnostic of gestational trophoblastic disease (GTD). 
• Partial: Two sperm fertilize one egg-->3 chromos/pair

Both can lead to choriocarcinoma and must be treated with chemo, but most common with complete.

Usually seen in late 1st, early 2nd TM aeb dark "prune juice" bleeding. 

• Vaginal bleeding (prune juicy)
• cramping
• passing of hydropic vesicles
• ^ hCG levels
• ^n/v
• SnSs of preecampsia, but if <20wks, think GTD.

• Remove mole
• Monitor hCG for 6mo to detect neoplasia
• NO PREGNANCY FOR 1 YEAR to reduce risk of choriocarcinoma. 

• Used to mechanically close an incompetent cervix, which can also be treated with:
• bed rest
• progesterone supplements
• antibiotics
• anti-inflamatories (may cause closure of patent ductus arteriosus and v amniotic fluid)

• ^hCG levels
• Tx with: 
• zogran, ginger, genergan, reglan
• replace fluids/e-lytes/nutrition (esp vit B).
• Unisom
• Fast relief of symptoms by 3L fluid over 24 hours. 

• HTN after 20 weeks gestation + proteinuria > 300mg in 24hrs or >30mg/dL (at least 1+ on dipstick) in 2 or more random samples collects 6 hours apart. 
• If <20wks, think GTD. 

• Chronic HTN with superimposed preeclampsia: Preexisting HTN with developement of proteinuria in the 1st 20 weeks of gestation. 25% HTN patient will develope superimposed preeclampsia (the proteinuria component). 
• Gestational HTN:  HTN for first time after 20 weeks gestation but without proteinuria. Diagnosis is made pp.

• nulliparity
• 1st kid w/new dad
• obesity
• Hx of preE
• DM
• African American
• Multiple feti. 

• 2nd half of pregnancy
• diffuse vasospasm and endothelial damage/swelling
• edema
• microinarction
• microhemorrhage
• reduces organ perfusion

• brain: HA not relieved with Tylenol because cerebral edema/hemorrhage. Also look for hyperreflexia.
• kidney: oliguria, v CC, calcium clearance, and uric acid. ^ protein in urine. 
• liver: epigastric pain, fat deposits, periportal hepatic necrosis-->subcaspular hematoma (RUQ pain)
• lungs
• heart
• uterus
• eyes: blurring/x2 vision
• Coagulation disorders: Not an organ, but didn't want to make a new card just for this. thrombocytopenia activated by coagulation cascade-->depletion of available platelets-->v platelet count-->possible hemorrhage.

• SGA
• fetal hypoxia
• abruption
• prematurity

• Bed rest, left lateral is best
• monitor BP, weight, and urine protein daily. 
• NSTs
• CBCs, LFTs, serum creatinine, uric acid
• Mg++ sulfate (for s/z, does not address HTN)
• fluid restriction
• Hydralizine (for HTN)
• DELIVERY (only cure)

• CNS depression
• Treat with calcium gluconate wide open. 

• cerebral:
• --vasospasm
• --hemorrhage
• --ischemia
• --edema

• abcs
• lower HOB and turn head to side, prepare for suction
• doc time, duration, type of sz. 
• call md.
• padded side rails. 
• MgSO⁴

Peace, truth, and the American way. Or maybe its...

• Hemolysis
• Elevated Liver Enzymes
• Low Platelets

The above occur as a result of severe preeclampsia. 

1st 24hrs. 

• Tests for Rh antibodies
• Indirect: Tested on mom. Looks for IgG antibodies in blood
• Critical value is 1:16 or <
• Direct: Tested on baby. Will look for presence of antibodies or RBC surface

• Phototherapy
• transfuse
• RhoGAM (@28 wks if unsensitized, w/in 72hrs post delivery if sensitized)

• after birth of Rh+ baby
• after abortion
• after ectopic
• after invasive procedure during pregnancy
• after maternal trauma, but w/in 72hrs. 

• >2000mL amniotic fluid
• uterine distention
• dyspnea
• edema of lower extremities
• Tx with amniocentesis

• <500mL fluid during 2nd/3rd TM
• Risks include:
• --cord compression
• --deformities
• --pulmonary hypoplasia
• Tx with amnioinfusion