Hypertension
Name 3 risk factors for Pre-eclampsia
CHTN, age <18 or >35, obesity, DM, multiple gestation, smoking, hx PEC
Describe the difference between accreta, increta, percreta
Accreta: too deeply in uterine wall, Increta: myometrium, Percreta through wall and to other organs
4 signs/symptoms of chorioamnionitis
4 interventions for PPROM 24 - 32 w
delivery location, BMZ, steroids, magnesium sulfate
Name the 7 cardinal movements of labor
Engagement, descent, flexion, internal rotation, extension, extension, external rotation, expulsion
Dx criteria PEC
Name 3 risk factors for placental abnormalities
Previous c/s, placenta Previa, myomas, multiple gestation
Treatment of Chorioamionitis:
ABX: amp 2g q6 + gent 5mg/kg q 24h, Antipyretics, Hydration, Expedite delivery
Describe GBS prophylaxis indications in labor, treatment
Full term GBS positive or preterm for delivery treatment with PCN as first line; treat GBS unknown by risk factor
Risks of obesity in labor / CDC weight gain recommendations by BMI
Increased risk of shoulder dystocia and hemorrhage;
<18.5=28-40; 18.5-24.9=25-35; 25-29.9=15-25;>30=11-20
Dx criteria PEC with severe features
Severe range BP 160/110, thrombocytopenia, elevated liver enzymes, decreased renal function (creatinine>1)
Name 3 risk factors for placental abruption
HTN, smoking/cocaine, AMA, trauma, previous history
Name 3 risk factors for chorioamnionitis
PROM/PPROM, multiple exams, IUPC/FSE, prolonged labor, GBS
Name uterotonics used for PPH, dosage and contraindications
Pitocin 10uIM or 20-40u IV, Meth 0.2mg IMq 2-4h (no HTN), Hemabate 250mcg IM q15-90m max 2mg (no asthma),miso 800-1g rectal/buccal, TXA 1g over 10-20min
4 Types and causes of jaundice
Breastfeeding Jaundice, Physiological Jaundice, Breast Milk Jaundice, Pathological Jaundice
What is the delivery recommendation for gestational hypertension or PEC without severe features
For stable GHTN Delivery at 37w unless abnormal fetal testing or growth
Name 4 Priority interventions placental abruption
2 IV access, order blood product, assess fetal / maternal status, expedite delivery
What is endometritis and treatment
Infection of uterine lining after delivery/SAB, more common after cs, Tx Clinda 900/q8 + Gent 5mg/kg q 24
What is the purpose and administration of betamethasone / when do you use caution
BMZ 12mg q 24h x 2 doses. Use with caution in DM
Name types of fluid abnormalities, cause & tx and risks
Oligo (placental insuff), Poly (DM or fetal anomaly), Chorio (infection), Amniotic fluid embolism
What is the doseage and purpose of magnesium given PEC with SF
Seizure / stroke pox 4-6g IV over 15-30 min then 1-2g/ hour
What is the overall placental concern with fetal growth restriction, DMs, HTNs, AMA, post date pregnancies
Concerned with placental insufficiency resulting in possible fetal injury or IUFD
Treatment for uncomplicated subinvolution of uterus (3 steps)
Methergine series, consider Clinda/Gent, consider ultrasound
When can you not give Macrobid for tx of UTI in pregnancy and why
1st trimester birth defects, at term risk of hemolytic anemia in the fetus or jaundice
Define active labor according to Zhang?
6cm