Contraceptions
How can you tell if an IUD has become dislodged?
You can't feel the string anymore, or the string has dropped down low
Hypertension >20 weeks and resolves by 12 weeks postpartum
Gestational Hypertension
What resolves gestational diabetes?
Delivery of baby
Normal platelet values
Bonus points if you know the critical value during pregnancy
Normal Range: 150,000-400,000
Critical: Less than 100,000
What are symptoms of Hypoglycemia in the newborn? There's two!
Jitteriness and respiratory depression
Can use with a small amount of spermicidal jelly, water-based lubricant, and inserted with an empty bladder
Diaphragm
Usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. It can lead to serious, even fatal, complications for both mother and baby. *Most common cause of maternal and fetal death*
Preeclampsia
When do you screen for gestational diabetes?
24-28 weeks
11-15 mg/dL
Normal hemoglobin levels during pregnancy
Rhogam IM is given prophylactically to all Rh-negative woman between _____ to _____ weeks gestation to prevent alloimmunization in pregnancy
24 to 28 weeks
How long should a diaphragm be inserted prior to intercourse and how long must it be left in place after intercourse?
6 hours prior
6 hours after (at least)
DO NOT exceed a total time of 24 hours!
Preeclampsia is diagnosed by what 2 factors?
Elevated blood pressure and proteinuria
What are fetal & newborn issues related to gestational diabetes? give at least 3 answers for full credit
- Increased perinatal mortality
- Macrosomia
- Respiratory Distress Syndrome (RDS)
- Hyperbilirubinemia
- Hypoglycemia
- Polycythemia
Normal WBC levels during pregnancy
Bonus points if you know the postpartum value
5,000-15,000 (up to 25,000 postpartum)
Gestational trophoblastic neoplasm usually resulting from fertilization of an egg that has no nucleus or an inactivated nucleus, prevent the embryo from growing causing DARK BROWN VAGINAL DISCHARGE
Hydatidiform Mole (Molar Pregnancy)
What is an IUD contraindicated for? Name both for full points
History of endometritis or tubal pregnancy
What are symptoms of severe preeclampsia? Name 4
- Severe headache
- Blurred vision due to arteriolar vasopasm
- Flashes of light
- Nausea & vomiting
- Malaise
- Epigastric pain
- Proteinuria > 500 mg in 24 hours
- Decreased urine output, minimal 30/hr
- DTRs 4+
- Sudden cough could indicate heart failure
What are maternal risks in pregnancy involved with gestational diabetes? give at least two answers
- Hydramnios: excessive amniotic fluid
- Increased risk for Preeclampsisa-Eclampsia
- Hyperglycemia
- Shoulder Dystocia: impacts both mother and baby
Normal fasting glucose range during pregnancy
60-105 mg/dL
What are symptoms of Hypoglycemia in the newborn?
Hemolysis
Elevated Liver enzymes
Low Platelet count
What are combined oral contraceptives contraindicated for? Name at least 3
- Pregnancy
- Previous history of thromboembolic disease (DVT)
- Heavy smoking
- Hypertension
- Migraine with visual disturbances
- Cholecystitis (inflammation of the gallbladder)
- Diabetes
What are some medications for Preeclampsia? Name at least 3, if you get all 4 extra points!
- Labetalol : Most common
- Hydralazine: Second most common
- Nifedipine (smooth muscle relaxant): third most common, if patient has horrible veins and can't get IV use this
- Magnesium sulfate: used to prevent seizures in preeclampsia, stop preterm labor as well
How is gestational diabetes diagnosed? Full answers only.
•1-hour random glucose tolerance test: 50 gm Glucola
–>130-140 mg/dl indicates completing a 3-hour GTT
–
•3-hour fasting Glucose Tolerance Test GTT: 100 gm Glucola
–GDM is diagnosed if 2 of the 4 levels exceed the threshold
Normal hematocrit levels during pregnancy
33-40%
Presence of fetal fibronectin between 20-34 weeks gestation indicates what?
A 99% probability of a pre-term birth within the following 2 weeks if interventions aren't attempted