Breastfeeding
Cesarean Delivery
Pregnancy Complications
Prenatal Care
Potpourri
100
How many days postpartum does milk production typically occur?
2-3 days
100
When is a classical cesarean section indicated, and what are the anatomical landmarks that define this?
Early preterm birth with lack of development of the lower uterine segment, to avoid an area of abnormal placentation or fibroids. Above the round ligaments.
100
What are some risk factors for developing gestational diabetes?
Obesity, First degree relative w/ DM, prior pregnancy with gestational diabetes, age >25 yrs, multiple gestation, previous unexplained stillbirth, previous delivery of a macrosomic neonate
100
What is the recommended daily intake of folic acid in the preconception period and during pregnancy?
400mcg
100
What is the most common cause of postpartum hemorrhage?
Uterine Atony
200
What is the first line of treatment for mastitis?
Increased milk expression, NSAIDs, warm compresses
200
What is the name of a low transverse uterine incision?
Kerr incision
200
What are some fetal and neonatal complications of gestational diabetes?
Fetal: stillbirth, macrosomia, polyhydramnios, congenital heart defects, preeclampsia Neonatal: hypoglycemia, hypocalcemia, hypomagnesemia, hyperbilirubinemia, polycythemia, RDS, cardiomyopathy
200
What are the weight gain recommendations for women in pregnancy according to the Institute of Medicine, for a singleton gestation?
Underweight: 28-40lbs Normal Weight: 25-35lbs Overweight: 15-25lbs Obese: 11-20lbs
200
What is the onset of action and half life of Pitocin?
Onset of action: 1min (IV) Half Life: 5min
300
Which antibiotics are used to treat mastitis? What is the primary infectious agent you are treating?
Dicloxacillin, Cephalexin, Clindamycin S. aureus
300
When is a low vertical uterine incision indicated (Kronig)?
Transverse back up fetal presentation
300
What are the laboratory criteria for preeclampsia with severe features?
Platelets <100,000 Cr>1.1 or doubling from baseline LFTs greater then twice normal
300
What is the recommended daily intake of iron in pregnancy?
15-30mg
300
What are the components of the Apgar score?
Heart Rate Respiratory Effort Muscle Tone Reflex Irritability Color
400
Which antibody type is secreted in breastmilk?
Ig A
400
What are the recommended preoperative antibiotics prior to cesarean, and when should they be given?
Narrow Spectrum Antibiotics: cefazolin, or ampicillin-sulbactam, or gentamicin + vancomycin or gentamicin, aztreonam, or metronidazole + gentamicin Within 60 minutes prior to skin incision
400
What is the mechanism of action of: a) Labetalol b) Nifedipine c) Hydralazine
a) Beta and Alpha antagonist b) Calcium Channel Blocker c) Direct Acting Arterial Vasodilator
400
What threshold for daily caffeine consumption has been associated with miscarriage, preterm birth, and growth restrction?
200-300mg/day
400
Name the dosing and drug class of the following uterotonics: a) misoprostol b) Hemabate c) Methergine
a) misoprostol: PGE1, 400-1000mcg rectally, orally, or sublingually b) Hemabate: Carboprost- PGF2alpha-250mcg IM- q15-90 min, total of 8 doses c) Methergine: methylergonovine: ergot, 0.2mg IM q2-4 hours, or 0.2mg PO q4 x6 doses
500
What are the regulatory mechanisms of milk production?
Primarily breast emptying but also prolactin, feedback inhibition, and lactose synthesis
500
What are the estimated rates of uterine dehiscence with each of the following uterine incisions? a) Kerr b) Classical c) Kronig
a) 0.7-1.5% b) 4-9% c) 1-7%
500
Which maternal antibodies are associated with congenital heart block?
Anti-Ro/SS-A Anti-La/SS-B Present in SLE or Sjogren's
500
What is the definition of asymptomatic bactiuria? Who should be routinely screened?
>100,000 CFU of a single organism on two consecutive clean catch specimens, or >1000 CFU from a cath specimen All patients at first OB, pregestational diabetics, sickle cell disease
500
What percentage of deliveries complicated by shoulder dystocia have no identifiable risk factors?
50%
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