OB Basics
A woman states the first day of her last menstrual period was April 20, 2025. When is her due date?
Using Naegele's rule: Add 1 year, subtract 3 months, then add 1 week. Her due date is January 27, 2026.
At how many weeks is a fetal heartrate detectable by ultrasound?
6 weeks
There is a variable deceleration on your patient's fetal monitor strip. What should you do?
Reposition the patient.
A postpartum mom asks you when she should expect her milk to "come in." You tell her in ______ days.
3 to 5
A new mother asks you why her newborn's stool is black. You tell her___________
This is a normal baby stool and is called meconium.
A pregnant patient states that she feels her baby moving. The medical term for this is __________?
Quickening
Why is a glucose tolerance test done between 24 to 28 weeks during pregnancy?
To rule out gestational diabetes.
A 35 year old primipara at 38 weeks gestation calls the L&D department complaining of a headache, seeing flashes of light, and upper abdominal pain. You suspect she may have ___________ and advise her to come to the hospital to be evaluated.
Preeclampsia
A postpartum mom complains of uterine cramping with breastfeeding. What causes this to occur?
The hormone oxytocin, which is released during breastfeeding and stimulates the uterus to contract
When assessing your patient's perineum postpartum, use the mnemonic REEDA to help you remember what to look for. What does REEDA stand for?
Redness, Edema, Ecchymosis, Drainage, Approximation
Chadwick's sign, Hegar's sign, Ballottement, and positive pregnancy test are all considered________?
Probable signs of pregnancy.
VDRL is a screening test done during pregnancy. When is it done?
At the initial prenatal visit with prenatal labs and during the third trimester in communities with syphilis outbreaks. (San Joaquin County).
A gravida 10, para 10 now mother has just delivered vaginally. She complains of feeling "sweat" on her back. On inspection, you can see that her nightgown and bedsheets are covered with blood. What is the most likely cause of her postpartum hemorrhage?
Uterine atony
A postpartum patient tests positive for THC in her urine and is planning to breastfeed. How do you advise her?
She should bottle feed her baby if she is using cannabis.
Your postpartum patient plans to breastfeed. She delivered her baby at 30 weeks gestation and the baby is in the NICU and is NPO. How do you counsel her regarding breastfeeding.
You provide her with a breast pump, instruct her on how to use it, and tell her that any colostrum or milk obtained will be frozen and saved until the baby can receive oral nutrition.
GTPAL is a mnemonic for what?
Gravida, Term, Preterm, Abortion, and Living
Fundal height measurements from the pubic bone to the top of the uterine fundus should begin at about 20 weeks gestation. Your patient is measuring 24 centimeters. How many weeks gestation does this equal?
24 weeks
What medications are given and in what order to a patient with a postpartum hemorrhage due to uterine atony?
Oxytocin, methergine, misoprostol (Cytotec), Hemabate
"Oh my, mother hemorrhage!"
During discharge teaching your patient asks when they can resume sexual relations. You tell them_____
4 to 6 weeks
Your postpartum patient is complaining of unilateral calf tenderness. Upon examination, you note that there is redness and increased warmth in the back of the calf. What might be going on with your patient?
Thromblophlebitis
A patient has three children which includes a set of twins. She has been pregnant twice. What is her gravida and para?
Gravida 2, Para 2, the twin pregnancy counts as one completed pregnancy at 20 weeks or greater.
A maternal serum alpha-fetoprotein test is done as part of routine prenatal screening. An elevated level may be indicative of ___________
A neural tube defect
A patient with a postpartum hemorrhage has been given oxytocin, methergine, misoprostol, and hemabate, her uterus is firm but is still experiencing heavy bleeding. What might be causing this bleeding?
Trauma, Tissue (retained placenta or fragments), Thrombin (bleeding disorder).
A postpartum patient who is Rh negative gives birth to an Rh positive baby and is told that she needs to receive a dose of Rhogam. The patient tells you that this is her last pregnancy and that she doesn't need it. What do you tell the patient.
She should receive the Rhogam because her body may make antibodies against her baby's blood and it may be difficult to crossmatch her in the future should she need a blood transfusion.
Your patient asks when will the baby's cord fall off. You tell them in _________ days.
7-10 days