SG F3 E5 > OB 4 > Flashcards

OB 4 Flashcards

(38 cards)

Study These Flashcards
1
Q
  • What is the MC type of multiple gestation?
  • What 5 things increase the likelihood of multiple gestation?
A
  • Dizygotic Twins (Fraternal) (70%)
  1. Fertility tx
  2. Advanced maternal age
  3. Increasing parity
  4. Fam hx (either parent)
  5. Obese (BMI >30) + Tall (>5’4”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe Dizygotic “Fraternal Twins”

  • How many oocytes are ovulated & fertilized?
  • How many chorions & amniotic sacs?
A
  • 2 oocytes are fertilized
  • 2 chorions / 2 amniotic sacs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe Monozygotic “Identical Twins”

  • Ovulation & fertilization of how many oocytes?
  • What determines “placentation?”
  • How many chorions & amniotic sacs?
A
  • A single oocyte is ovulated/fertilized
  • Timing of egg division determines placentation
  • 1 chorion, 1 amniotic sac = monoamniotic
  • 1 chorion, 2 amniotic sacs = diamniotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  • What is the ONLY method for DEFINITIVE dx of multiple gestation?
  • What are the 2 different “signs” you can see?
A
  • Ultrasound
    • Gives accurate gestational age
    • Determines chorionicity/amnionicity
    • Best if done in 1st trimester >7 weeks
  • “Lamda Sign” = Dichorionic twins
  • “T Sign” = Monochorionic twins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is this?

A

Multiple Gestation

  • US of intertwin membrane showing “Lambda Sign” = Dichorionic twins
  • Fraternal Twins (Dizygotic)
  • Diamniotic = 2 amniotic sacs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is this?

A

Multiple Gestation

  • US of intertwin membrane showing “T Sign” = Monochorionic twins
  • Identical Twins (Monozygotic)
  • Diamniotic (2 amniotic sacs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Multiple Gestation

  • What are the 7 complications?
  • Which 2 complications are MC?
A
  1. Preterm delivery** (60% before 37 weeks)
  2. Low BW** (57% are <5.5 lbs)
  3. Gestational diabetes
  4. Pregnancy induced HTN
  5. Pre-eclampsia
  6. Post-partum hemorrhage
  7. Higher C-section rate

“PL - HHCG”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MOST SERIOUS complication of multiple gestation?** (probably on exam)

Describe it…

A

Twin-Twin Transfusion Syndrome

  • Only occurs w/ monochorionic gestation (fetuses share 1 placenta & blood supply is unevenly distributed)
  • One fetus is small w/ little amniotic fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition of what? Dx criteria?

  • Cervical shortening which can lead to preterm spontaneous delivery
A

Cervical Incompetence

  • US to see cervical length in 2nd trimester
  • 20mm or less in women w/ NO prior pre-term delivery
  • 25mm or less in women WITH a prior pre-term delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the tx for cervical incompetence?

A
  • Placement of cervical cerclage
  • Removed at 37 weeks gestation or onset of rupture of membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which type of HTN?

  • >140/90 PRIOR to 20 weeks gestation
A

Chronic HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which type of HTN?

  • New HTN (>140/90) presenting AFTER 20 weeks gestation w/ NO proteinuria
A

Pregnancy-Induced HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which type of HTN?

  • New onset HTN & Proteinuria AFTER 20 weeks
  • BP reading criteria for dx?
A

Pre-Eclampsia

  • BP readings elevated on at least 2 occasions, at least 6 hours apart
  • Systolic 140+ or Diastolic 90+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which type of HTN?

  • HTN, Proteinuria, & seizures in woman w/ pre-eclampsia
A

Eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some RFs for Pre-Eclampsia?

A
  • Nulliparity
  • Pre-eclampsia in prev pregnancy
  • Advanced maternal age
  • Multiple gestation
  • Diabetes
  • Chronic HTN
  • Chronic renal dz
  • Family hx of pre-eclampsia
  • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • HTN
  • Epigastric pain
  • HA
  • Visual sxs: blurred vision, flashing lights, sparks
  • Edema
  • Hyper-reflexia
  • Oliguria

Dx?

Study These Flashcards
A

Pre-eclampsia

17
Q

Describe criteria for Mild Pre-eclampsia

Study These Flashcards
A
  • Systolic BP 140+ OR diastolic 90+
  • AND proteinuria of 0.3g+ in 24-h urine specimen
18
Q

Describe criteria for severe pre-eclampsia

Study These Flashcards
A
  • Systolic 160+ or Diastolic 110+
  • Oliguria <500cc in 24 hrs
  • 3+ proteinuria (5+ grams on 24 h urine)
  • End organ damage
  • Fetal compromise
19
Q
  • SBP 160+ or DBP 110+
  • Severe HA “worse ever had”
  • Pulmonary Edema
  • AMS
  • Photopsia, scotomata, retinal vasospasm

Dx?

Study These Flashcards
A

Severe features/Complications of Pre-eclampsia

20
Q

What are 3 possible findings in Pre-Eclampsia or Eclampsia?

Study These Flashcards
A

HELLP

  • Hemolysis
  • Elevated Liver enzymes
  • Low Platelet count
21
Q
  • What labs/imaging should be done for Pre-Eclampsia?
  • How often?
Study These Flashcards
A
  • CBC, Creatinine, Liver enzymes
  • 24hr urine & Urine dipstick
  • Fetal NST
  • US (amniotic fluid volume / fetal weight)

Repeat weekly IF NO SIGNS of severe features

22
Q
  • Obese pregnant women 36 y/o w/ DM and HTN presents w/ blurred vision, flashing lights, HTN, epigastric pain, oliguria, proteinuria 5g, and “worse HA she’s ever had.”
  • BP is 162/112

Dx & Tx?

Study These Flashcards
A

Severe Pre-Eclampsia

  • Tx is ALWAYS indicated if severe (to ↓ maternal stroke)
  • Use Beta Blockers (IV Labetalol)
  • AVOID: ACE, ARB, diuretics
23
Q

T/F

  • All antihypertensive meds cross the placenta
Study These Flashcards
A

True!

Use Beta Blockers (=

DO NOT USE: ACE, ARB, diuretics )=

24
Q

What are the 3 causes of mortality for the mother w/ pre-eclampsia?

Study These Flashcards
A
  • Acute MI
  • Stroke
  • Cardiac failure
25
What are the 6 causes of mortality in newborn when mom has pre-eclampsia?
* Poor oxygen transfer * Fetal growth restriction * Pre-term birth * Placental abruption * Stillbirth * Neonatal death
26
_G1P0_ _37_ y/o pregnant female at _19 weeks_ gestation w/ hx of _chronic renal dz_ presents w/ BP of _162/110._ Dx and Tx?
**_Chronic HTN / Severe Pre-eclampsia_** _Chronic bc:_ \<20 weeks, nulliparity **Tx bc/ above 160/105!!** **1st line:** Labetalol (Do not tx if below 160/105 w/ no evidence of end organ damage)
27
New HTN (162/112) in a 37 y/o female at 21 weeks gestation. She has no proteinuria. _Dx and Tx?_
**_Pregnancy Induced HTN - Severe Pre-eclampsia_** _Preg-induced bc:_ \>20 weeks w/ no proteinuria Tx bc/ SBP 160+ or DBP 110+ **1st line:** Labetalol
28
37 y/o female w/ new onset HTN (140/90) w/ proteinuria of 0.3g in a 24 hr urine, at 24 weeks gestation. BP measured on 2 occasions 6 hours apart. _Dx and Tx?_
**_Mild Pre-Eclampsia_** * Antihypertensives ARE NOT indicated if BP is consistently \<150/100. * **Tx:** Expectant management / ambulatory BP measurements
29
40 y/o pregnant woman at 25 weeks gestation, w/ BP (162/112), oliguria \<500cc, 5g proteinuria on 24 hr urine, signs of end organ damage. _Dx and tx? (3)_
**_Severe Pre-eclampsia_** * Admit for BP monitoring * IV labetalol or hydralazine * Prompt delivery for failed medical management
30
40 y/o pregnant woman at 25 weeks gestation, w/ BP (162/112), oliguria \<500cc, 5g proteinuria on 24 hr urine, signs of end organ damage. Patient was admitted and tx w/ IV labetalol which failed. _What is dx and next steps (3) in therapy?_
**_Severe Pre-Eclampsia_** * Add Betamethasone bc/ under 34 weeks gestation (used to enhance fetal lung capacity) * Add MgSO4 (magnesium sulfate) (6g, then 2g/hour) * **AND a PROMPT delivery**
31
What 2 things does pregnancy cause which leads to Gestational Diabetes?
* Hyperinsulinemia * Insulin resistance
32
6 RF of GDM (Gestational Diabetes Mellitus)
1. Obesity 2. +FH of DM 3. \>25 y/o 4. Glucosuria 5. Prev hx of GDM 6. Hx of macrosomia (BW of 8lb 13oz = large baby)
33
What is the #1 "medical complication" in pregnancy?
GDM
34
How is GDM diagnosed?
1. 50g 1 hour glucose challenge test administered at 24-28 w gestation. Positive/Failed test = \>130 2. 100g 3 hour OGTT, blood glucose measured at fasting, 1hr, 2hr, 3hr. (2/4 + values = GDM dx)
35
What are 2 major complications of GDM?
* **Congenital anomalies (3-4 fold ↑)** * **Pregnancy induced HTN (2 fold ↑)** * _Others:_ macrosomia, placental abruption, prematurity, fetal demise, delayed fetal lung maturity, pre-eclampsia)
36
Patient has blood glucose of 140 at 1 hour and 3 hour post 100mg OGTT. _What is dx and tx?_ _Blood monitoring goals?_
**GDM** * _1st line:_ Insulin * Monitor capillary blood glucose at fasting & 2 hours post meal (4x/day) * Goal of fasting is \<95-105 * Goal of 2hr postprandial is \<120
37
Patient has blood glucose of 120 w/ 3 hour OGTT at fasting and 3 hour. _What is dx?_
None. Patient does not have GDM bc/ glucose is not \>130...
38
Besides insulin and monitoring blood gucose, what is the treatment for GDM? (5)
* ADA diet (diabetic diet) * Moderate exercise program * Nutrition cosult (usually has poor diet) * Fetal monitoring w/ NST and BPP (US) * **Perform 2-hour glucose tolerance test at 6 weeks postpartum\*\*\*** (this visit is to make sure GDM has resolved, incase pt entered pregnancy w/ undiagnosed DM2)
SG F3 E5
flashcards
Decks in class (23)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions