External Cephalic Version
Operative Vaginal Birth
Antiphospholipid Syndrome
TERNS TRIVIA!!!!
100
Fetal presentation should be assessed and documented beginning at ... weeks of gestation
36 0/7 weeks
100
Forceps vs vacuum: which one is more likely to achieve a vaginal delivery?
Forceps
Vacuum is more likely to fail compared with forceps
100
Med students - True or false: women with APS should use estrogen-containing contraceptives.
FALSE. Should avoid estrogen-containing forms of contraceptives.
100
You will never find this intern without her trusted sun hat.
THU
She's a legend. She's an icon. And she is the moment.
200
If spontaneous version is going to occur, it is likely to have taken place by ... weeks of gestation.
37 0/7 weeks
200
True or false: operative vaginal birth for infants with suspected macrosomia is contraindicated.
False - suspected macrosomia alone is not contraindication
EFW can be inaccurate - need to also consider maternal pelvis adequacy and the progress of labor
200
What are the three antiphospholipid antibodies that contribute to the dx of APS?
1. Lupus anticoagulant
2. Anticardiolipin
3. Anti-B2-glycoprotein-1
200
This tern grew up on an asparagus farm 🥦
Megan
300
What placental location has a higher association with ECV failure than other locations?
Anterior placenta
Nulliparity, advanced dilation, fetal weight <2500 grams, anterior placenta, low station were also more often associated with failure
300
Vacuum extraction is discouraged for gestational age less than ... weeks
<34 weeks
300
Name three obstetric complications patients with APS are at risk of.
Fetal/recurrent pregnancy loss, IUGR, Pre-E, preterm delivery, placental insufficiency
(would also accept thromboembolism, ITP, TIA, AI hemolytic anemia, livedo reticularis, ulcers, infarct dementia, transverse myelitis)
300
Match the spooky szn badge to the tern
Ghost - Megan
Pumpkin - Meghan
Cat - Thu
400
Name 3 adverse effects that a patient undergoing ECV is at risk of.
Abruptio placentae, umbilical cord prolapse, rupture of membranes, stillbirth, fetomaternal hemorrhage
400
Name three contraindications to performing an operative vaginal delivery.
Fetal head unengaged, position of fetal head unknown, fetus suspected to have bone demineralizing condition (osteogenesis imperfecta), or bleeding disorder (vWD, hemophilia, etc.)
400
Name two scenarios in which a patient should be tested for antiphospholipid syndrome
1. Women with prior unexplained TE
2. Women with a new TE in pregnancy
3. Those with hx of VTE who have not been tested previously
4. History of one fetal loss OR 3+ recurrent embryonic or fetal losses
400
This tern lost her OG front two teeth face planting in gym class and now has crowns 😁
Meghan
500
What two fetal presentations are associated with higher ECV success rates?
Transverse
Oblique
500
Name four prerequisites for an operative vaginal birth.
Cervix fully dilated, membranes ruptured, fetal head engaged, fetal weight estimation performed, pelvis adequate for vaginal birth, adequate analgesia, maternal bladder emptied, patient agrees, provider is willing to abandon trial of operative vaginal delivery and back up plan is in place
500
Next step in diagnosis of APS if Lupus anticoagulant, anticardiolipin antibody or anti-B2-glycoprotein 1 come back positive on initial testing?
Repeat laboratory testing at least 12 weeks later
500
What is this puppy's name and who is the owner?
Artemis (Thu's baby)