OB Final Exam 2022 (Answered) Verified
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Presumptive pregnancy signs
amenorrhea, fatigue, N/V, urinary frequency, breast chages, quickening,uterine
enlargement
Probable pregnancy signs
abd enlargement
hegar sign softening of the uterine
Chadwick sign violet/bluish colored cervix
goodell softening of the cervical tip
ballottment rebound fetus
braxton hicks, positive pregnancy test, fetal outline
Positive pregnancy signs
fetal heart tones, visualization on ultrasounds, fetal movement palpated from provider.
Nageal's Rule
he rule estimates the expected date of delivery (EDD) by adding a year, subtracting
three months, and adding seven days to the origin of gestational age
Discomfort of 1st trimester
urinary frequency, incontinence, fatigue, nausea and vomiting, breast tenderness,
constipation, nasal stuffiness, bleeding gums, cravings, leukorrhea.
Discomfort of 2nd trimester
backache, variscosities of the leg and vulva, hemorrhoids, flatulence with bloating
Discomfort of 3rd trimester
return of 1st trimester discomforts, SOB, dyspena, heartburn, dependent edema
Amniocentisis
amniotic fluid is aspirated from the sac- safety concerns are infection, loss of fetus, fetal
needle injuries, done if chromosomal dna markers are abnormal, growth abnormalities
indicated.
done at 15-20 weeks.
maternal risks: hemorrhage, fetomaternal hemorrhage, infection, contractions/labor,
abruptio placentae, damage to intestines or bladder, amniotic fluid emoblism
fetal risks: death, hemorrhage, infection, direct injury from the needle, miscarriage, and
preterm, leakage of amniotic fluid
Can trigger early labor - #1 reason why women refuse. Bleeding, transfer of Rh
factor, infection, fetal distress.
Biophysical profile (BPP)
Used to assess intrauterine compromise. Done as follow up to ultrasound if there are
fetal concerns.
Late amniocentesis
Done to detect lung maturity - for fetal viability- presence of surfactant
Non-stress test
, Observing for acceleration of fetal heart rate with movement. Shows intact central and
autonomic nervous systems.
Non-stress test = Non-reactive BAD
Non-stress test = Reactive GOOD
Folic acid
600mg a day, reduces neural tube defects
Molar pregnancy
1:1000 pregnancies
2 types: hydatiform mole & choriocarcinoma
risk prior molar pregnancy teen or over 40
treat immediate evacuation (D&C) long term follow up and monitoring of serial HCG
manifest similar to spontaneous abortions at 12 weeks, prune juice discharge
Cervical insufficency
premature dilation of the cervix
cause unknown, use bed rest, pelvic rest, avoid heavy lifting, use a cervical cerclage
risk short labors, prior preg loss, advance cervical dilation, pink tinged discharge
continue surveillance
Placental abruption
painful DARK red bleeding boardlike, tender abd
uterine hypertonicity, fetal distress, abd pain.
risk previous abruption, HTN, smoking, trauma, cocaine/drug use
management fetal monitoring, emergency surgery, replace blood
Placental Previa
The placenta attaches and grows, possibly covering the cervical os. painless vaginal
bleeding that is BRIGHT RED soft uterus
care Control of blood loss and blood replacement, surgery if cannot be stopped
AVOID VAGINAL EXAMS
Gestational Diabetes complications
What it is: glucose intolerance that begins or is first recognized in pregnancy
complications fetal hyperlgycemia and fetal hyperinsulinemia promotes storage of
excess nutrients
this is what results in macrosomia and delayed pulmonary maturation
*Blood sugar normal abnormal is > 140 mg/dL
if it is over 200 mg/dL you treat it as diabetes*
When to give Rhogam shots
at 28 weeks and 72 hours of rh negative mother delivery of rh positive baby, and also
any invasive procedure/ complication where placental and maternal blood cross.
Ectopic pregnancy
Ovum implants outside the uterus, due to an obstruction or slow passage of ovum
through the tube. 1:50 pregnancies.
risk tubal scarring, chlamydia, tubal surgery, infertility, previous fetal loss, previous
ectopic, IUD, fibroid, tubal, smoker, progesterone
hallmark sign abd pain w/ spotting within 6-8 weeks after missed period, signs of
hemorrhage or shock
management treat pain, education, surgery
drugs methotrexate, actinomycin to shrink the embryo to allow passage.
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