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Obstetrics & Gynecology | Medicine (MD/DO) School Study Aid
Gestational Hypertension
- New-Onset Hypertension
- > 20 Weeks Gestation
- Risk Factors
- Nulliparity
- Obesity
- African American Females
- > 35 years Old
- Multiple Gestations
- Family History of Gestational HTN (or Preeclampsia)
- Complications
- IUGR
- Prematurity
- Abruptio Placentae
- Management
- Fetal Monitoring
- Alpha-Methyldopa
- Beta-Blockers (Labetalol)
- Calcium Channel Blockers
- Hydralazine
4 mins
Preeclampsia Assessment
- After 20 Weeks of Pregnancy
- Mild
- Hypertension > 140/90
- Proteinuria or End-Organ Dysfunction
- Severe
- Hypertension > 160/110
- Progressive Renal Insufficiency
- Vision Changes
- HELLP Syndrome
- Pulmonary Edema
2 mins
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
1 min
Eclampsia
- Mechanism of Action
- Increased Central Nervous System Irritability
- Signs and Symptoms
- Hyperreflexia
- Positive Ankle Clonus
- Headaches
- Visual Disturbances
- Epigastric or RUQ Pain
- Seizures
- Coma
- Considerations
- Don't Leave Bedside
- Magnesium Sulfate
2 mins
Severe Preeclampsia
- Mechanism of Action
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Signs and Symptoms
- Hypertension
- Proteinuria or End-Organ Dysfunction
- HELLP Syndrome
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
3 mins
Hyperemesis Gravidarum
- Signs and Symptoms
- Excessive Vomiting
- Significant Weight Loss
- Dehydration
- Hypotension
- Electrolyte Imbalance
- Interventions
- Antiemetics
- Frequent Small Meals
- IV Therapy
2 mins
Chorioamnionitis
- Fever
- Maternal or fetal tachycardia
- Leukocytosis
- Foul Odor to Amniotic Fluid
- Treatment: Antibiotics
- Monitor uterine tenderness, contractions and fetal activity
- Monitor maternal vital signs & FHR
2 mins
Spontaneous Abortion Overview
- Assessment
- Bleeding < 20 weeks Gestation
- Interventions
- Identify Type
- Bed Rest
- Monitor for Hemorrhage
- Save Pads and Linens
- RhoGAM
- Dilation and Curettage (DandC)
- Cerclage
- Emotional Support
2 mins
Spontaneous Abortion Types
- Missed Abortion
- No Fetal Heartbeat, No Cervical Dilation, No Bleeding
- Threatened Abortion
- No Cervical Dilation and Minimal Bleeding
- Inevitable Abortion
- Bleeding and Cervical Dilation with No Loss of Products of Conception
- Incomplete Abortion
- Bleeding and Cervical Dilation with Loss of Some Products of Conception
- Complete Abortion
- Bleeding with No Cervical Dilation, with Loss of All Products of Conception
2 mins
Hydatidiform Mole (Molar Pregnancy)
- Cause/Mechanism
- Abnormal Fertilization
- Assessment
- Symptoms of Pregnancy
- Elevated hCG
- Vaginal Bleeding
- Inappropriate Uterine Growth
- No Fetal Heart Rate (FHR)
- Interventions
- Dilation and Curettage (D&C)
- Emotional Support
- Considerations
- No Pregnancy 1 Year
- Hysterectomy
3 mins
Complete Hydatidiform Mole
- Characteristics
- Gestational Trophoblastic Disease
- Fertilization of Enucleated Egg
- Diploid Fetal Karyotypes
- Hydropic Chorionic Villi
- Presentation
- Vaginal Bleeding
- Preeclampsia
- Diagnosis
- Increased Beta hCG
- "Snowstorm" / "Bunch of Grapes" Appearance
- Theca Lutein Cysts
- Considerations
- Dilation and Curettage (D&C)
- Methotrexate
- Increased Risk of Choriocarcinoma
3 mins
Gestational Diabetes
- Signs and Symptoms
- Usually Asymptomatic
- Fetal Macrosomia
- Polyhydramnios
- Diagnosis
- Glucose Intolerance After 24 Weeks Gestation
- 3-hr 100g Glucose Tolerance Test
- Treatment
- Diet and Exercise
- Close Glucose Monitoring
- Insulin
- Ultrasound (or Nonstress Test (NST))
- Delivery
2 mins
Fetal Macrosomia
- Pathophysiology
- Increased Birth Weight
- > 4500 g
- Causes
- Maternal Obesity
- Gestational Diabetes
- Diagnosis
- Weigh Newborn at Birth
- Ultrasound
- Hadlock's Formula
- Complications
- Birth Canal Trauma
- Neonatal Hypoglycemia
- Shoulder Dystocia
- Treatment
- Planned Cesarean Section
2 mins
Polyhydramnios
- Pathophysiology
- Increased Amniotic Fluid
- Causes
- Duodenal Atresia (or Gastrointestinal Atresias)
- Maternal Diabetes
- Multiple Gestations
- Anencephaly
- Hydrops Fetalis
- Diagnosis
- Ultrasound
- Amniotic Fluid Index (AFI) > 25 cm
- Treatment
- Weekly Nonstress Test (NST) and Biophysical Profile (BPP)
- Amnioreduction
- Indomethacin
3 mins
Oligohydramnios
- Decreased Amniotic Fluid
- Etiologies
- Renal Agenesis (Fetal Urinary Tract Abnormalities)
- Uteroplacental Insufficiency
- Premature Rupture of Membranes (PROM)
- Diagnosis
- Ultrasound
- Amniotic Fluid Index (AFI) < 5 cm
- Complications
- Spontaneous Abortion
- Pulmonary Hypoplasia
- Musculoskeletal Abnormalities
- Intrauterine Growth Restriction (IUGR)
- Treatment
- Treat Underlying Cause
- Delivery (When Viable)
2 mins
Intrauterine Growth Restriction (IUGR)
- Pathophysiology
- Slowed Fetal Growth
- Symmetric Type
- Factors Early in Pregnancy
- Genetic (Chromosomal) Abnormalities
- Congenital Infections
- Asymmetric Type
- Preserved Head Circumference
- Factors Late in Pregnancy (2nd / 3rd trimester)
- Placental Insufficiency
- Diagnosis
- Ultrasound
- < 10th Percentile (for SGA)
- Decreased Fundal Height
- Complications
- Increased Perinatal (Fetal) Morbidity and Mortality
2 mins
Ectopic Pregnancy
- Signs and Symptoms
- Lower Abdominal Pain
- Delayed Menses
- Abnormal Vaginal Bleeding
- Shock
- Referred Shoulder Pain
- Cullen Sign
- Considerations
- Methotrexate
- Surgery
- RhoGAM
2 mins
Placental Implantation Abnormalities
- Mechanism
- Placenta Adheres Directly to Myometrium
- Placenta Accreta
- Placenta Increta
- Placenta Percreta
- Caused by Scar Tissue
- Hemorrhage
- Diagnosis
- Ultrasound is First-line, then MRI
- Treatment
- C-section Delivery
- Artery Ligation or Embolization
2 mins
Potter Sequence
- PATHOGENESIS
- Oligohydramnios
- clinical findings
- Limb Deformities
- Facial Anomalies
- Pulmonary Hypoplasia (Most Common Cause of Death)
- Etiologies
- Autosomal Recessive Polycystic Kidney Disease (ARPKD)
- Posterior Urethral Valves
- Chronic Placental Insufficiency
- Bilateral Renal Agenesis
3 mins
Pregnant Diabetic Patient Interventions
- First Trimester
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Second Trimester
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Third Trimester
- Double or Quadruple Insulin
- Early Delivery
- Postpartum
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia
3 mins
Partial Hydatidiform Mole
- Characteristics
- Gestational Trophoblastic Disease
- Dual Fertilization of Haploid Egg
- Triploid Fetal Karyotypes
- Hydropic Chorionic Villi
- Presentation
- Vaginal Bleeding
- Diagnosis
- Increased Beta hCG
- Fetal Structures
- Considerations
- Dilation and Curettage (D&C)
- Methotrexate
2 mins
Twin-Twin Transfusion Syndrome
- Pathophysiology
- Shared Placenta
- Monochorionic Twins
- Unbalanced Arteriovenous Anastomoses
- Signs and Symptoms
- Donor
- Hypovolemia
- Oligohydramnios
- Recipient
- Hypervolemia
- Polyhydramnios
2 mins
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