Depleted in DIC:
platelets & fibrinogen (1)
- fibrinogen to fibrin(1a) via thrombin
What push you to C-section with decels?
Head not engaged (-1 station for example)
- arrest of descent = no movement in 3 hrs G1
- or 2 hours in G2+
PMP symptoms
Estrogen deficiency
- vasomotor flushes
- vaginal dryness & atrophy
- osteoporosis/osteopenia
- decreased sexual functioning
Symptoms of Chorioamnionitis?
Fever > 100.4 Maternal and fetal tachycardia Leukocytosis Foul smelling amnionic fluid Uterine tenderness
Why check abdominal circumference to monitor IUGR?
Most sensitive indicator of intrauterine growth restriction b/c other areas get priority blood flow (e.g. head). Abdomen does not get priority blood flow so you will see growth restriction here even if don’t see it elsewhere.
When give aspirin + heparin in pregger?
Antiphospholipid antibody syndrome
- hyper coagulable state
- due to antibodies vs phospholipids on plasma membranes
- can be 2/2 SLE or other AI disorders
Biopsy findings and treatment for lichen sclerosus of vulvar?
Inflammation, thinning of epidermis, hyperkeratosis
Tx: clobetasol propionate (corticosteroid)
Treatment for PP endometritis?
Clindamycin + gentamicin
- a Gentleman helps a PP women become clean
White blood cell casts:
Pyelonephritis:
- ascending UTI: urinary frequency, urgency, dysuria, hematuria, suprapubic pain
- CVA tenderness + Fever + N/V
Can you do transvaginal U/S to confirm twin pregnancy in 1st Trimester?
Yes - want to see two+ fetal poles
Seizure disorder in women, then pregnancy, what likely?
Neural tube defects
- Valproate
- Carbamazepine
Isotonic resuscitation fluids:
Normal saline 0.9% NaCl, preferred if blood not available
Lactated Ringer’s, but this can’t be put through same IV as as blood products
Cause of uterine atony?
Lack of contraction of spiral arteries supplying the placental bed
What contraception can you use in a 35yo smoker?
Depot medroxygrogesterone acetate (DMPA)
- progesterone-only
- can’t have anything w/ Estrogen
- due to risk thromboembolism
Smooth philtrum, thin vermillion border
Short palpebral fissure length
What heart findings?
What disease?
Holosystolic murmur
VSD
Fetal alcohol syndrome #1 cause preventable mental retardation
What kind of murmur normal in preg?
Flow murmur - systolic!!
Odorless d/c (white/clear)
Increased vaginal itching
Erythematous vulva
Recent hx of?
Benign yeast infection
- recent hx antibiotic use
Irritated, red, swollen vulva
Tender, enlarged, boggy uterus…
Adenomyosis
- need tissue analysis to see…
- endometrial gland & stroma w/in myometrium
- maybe see heterogenous myometrium on MRI or TV U/S
Fetal problem decreased by using Anti-Rh(D) immune globulin vaccination?
Less hydrops fetalis in the US
- fluid collection w/in fetus
- usu results in fetal demise
LCIS on Pap smear
At what age do you watch for 1 year
At what age do you do colposcopy?
25 years and older = colposcopy
Bloody needs biopsy
FNA biopsy = bloody from breast mass
- excisional biopsy needed regardless of imaging results.
- also do excisional for persistent, complex cysts
- also do if positive cytology
Gold standard to prove disease that causes cyclical pelvic pain + dysmenorrhea + dyspareunia +/- bowel/bladder symptoms?
Endometriosis
- diagnostic laparoscopy
- Biopsy-proven endometriosis at time of laparoscopy = gold standard for diagnosis
When is urine hCG able to detect pregnancy?
8-9 days after conception
- so after sexual assault, do pregnancy text in a few weeks.
Mifepristone & Misoprostol 2-3 days later for abortion up to what gestational age?
Methotrexate can be used but then need to give misoprostol 3-7 days later (complete termination takes longer)
Before 7 weeks (49 days)
