Comprehensive OB-Gyn & Pregnancy Review

These question-and-answer flashcards cover critical concepts from sperm physiology through postpartum care, providing a thorough review for OB-Gyn pregnancy examinations.

What is the normal semen volume produced per ejaculation?

1.5 mL or more (average 3–5 mL).

Where are sperm produced?

In the seminiferous tubules of the testes.

Which two hormones primarily regulate spermatogenesis?

Testosterone and luteinizing hormone (LH).

For how long are sperm typically viable inside the female tract?

48–72 hours.

What sperm count defines oligospermia?

Less than 15 million sperm per milliliter.

Name three medical causes of low sperm count.

Varicocele, hormonal imbalances, genetic disorders (others include tumors, infection, medications).

Give two environmental causes of decreased sperm production.

Radiation/X-rays and exposure to heavy metals or industrial chemicals.

List two lifestyle choices that negatively affect sperm count.

Smoking and alcohol consumption (also drug use, stress, overheating testicles).

What hormone triggers ovulation?

Luteinizing hormone (LH).

When does ovulation usually occur in a 28-day cycle?

Approximately day 14 (14 days before the next period).

What cervical mucus characteristic indicates peak fertility?

Clear, stretchy ‘Spinnbarkeit’ mucus.

What ovarian disorder is a common cause of anovulation and infertility?

Polycystic ovarian syndrome (PCOS).

Define menarche.

The first menstrual period, typically at 10–12 years of age.

How many follicles remain at birth and at puberty?

About 1 million at birth; 400,000–500,000 at puberty.

Describe the proliferative phase of the menstrual cycle.

Endometrium thickens under estrogen after menses, preparing for implantation.

Which hormone predominates in the secretory phase?

Progesterone, produced by the corpus luteum.

Where does fertilization most commonly occur?

Ampullary region of the fallopian tube.

What is an ectopic pregnancy?

Any pregnancy implanted outside the uterine cavity, most (≈95 %) in the fallopian tube.

Define endometriosis.

Presence of endometrial tissue outside the uterus, often causing pain and infertility.

What is the normal implantation site of the blastocyst?

Posterior fundal endometrium, 7–10 days after fertilization.

Minimum hCG level detectable by most pregnancy tests?

≈20 mIU/mL.

When is hCG highest and linked to morning sickness?

During the first trimester, peaking at 10–12 weeks.

Name the primary exchange organ between mother and fetus.

The placenta.

What placental hormone opposes maternal insulin?

Human placental lactogen (HPL).

Normal umbilical cord vessel composition?

Two arteries (deoxygenated blood) and one vein (oxygenated).

What does a two-vessel cord suggest?

Possible renal agenesis or cardiovascular anomalies.

Define oligohydramnios by volume or AFI.

Define polyhydramnios by volume or AFI.

1500 mL or AFI >24 cm.

Green meconium-stained amniotic fluid indicates what?

Fetal distress/hypoxia.

At 20 weeks gestation, average amniotic fluid volume is?

Approximately 400 mL.

Which germ layer forms the skin and nervous system?

Ectoderm.

At how many weeks is fetal heart tone audible by fetoscope?

About 20 weeks.

Define quickening.

Mother’s first perception of fetal movement (≈20 wks primigravida; 16 wks multigravida).

What is the normal fetal heart rate range?

120–160 beats per minute.

What lung maturity ratio is desired before birth?

Lecithin : Sphingomyelin ratio of 2 : 1.

Presumptive signs of pregnancy include?

Amenorrhea, breast changes, nausea/vomiting, quickening, urinary frequency, fatigue, skin changes.

Chadwick’s sign refers to what change?

Bluish discoloration of the vagina and cervix from increased vascularity.

Positive signs of pregnancy (diagnostic)?

Fetal heart sounds separate from mother, ultrasound visualization, fetal movements felt by examiner.

Which anticoagulant is safest in pregnancy?

Heparin.

Recommended daily iron intake during pregnancy?

27–30 mg/day.

What positional technique reduces supine hypotension syndrome?

Left side-lying position.

Normal total pregnancy weight gain for singleton?

25–30 pounds (≈11–14 kg).

Nagele’s rule calculation steps?

Subtract 3 months, add 7 days, add 1 year to first day of LMP.

Define Gravida and Para.

Gravida: total pregnancies; Para: pregnancies reaching viability (≥20–24 wks).

Schedule of routine antenatal visits after 32 weeks?

Weekly until delivery (every 2 days if post-term).

What maternal serum marker screens for neural tube defects?

Maternal serum alpha-fetoprotein (MSAFP); elevated value >2.5 MoM suggests NTD.

Which infection is screened at 35–37 weeks with vaginal swab?

Group B Streptococcus.

Purpose of indirect Coombs test in pregnancy?

Detect maternal Rh antibodies in Rh-negative women.

When is Rhogam routinely administered?

At 28 weeks and within 72 hours postpartum if baby is Rh-positive.

Diagnostic gold standard for gestational diabetes?

Oral glucose tolerance test (OGTT).

Thresholds for positive 3-hour OGTT (Carpenter-Coustan)?

Fasting ≥95, 1 h ≥180, 2 h ≥155, 3 h ≥140 mg/dL (any 2 elevated = GDM).

What non-invasive test assesses FHR accelerations with movement?

Non-stress test (NST).

Interpretation of a reactive NST?

At least two accelerations of ≥15 bpm for ≥15 s within 20 minutes.

What contraction test result is reassuring?

Negative CST (no late decelerations).

Late decelerations indicate what?

Uteroplacental insufficiency.

Variable decelerations are usually caused by?

Umbilical cord compression.

Recommended extra caloric intake during 2nd trimester?

≈300 kcal/day above baseline.

Which vitamin overdose (retinoids) is teratogenic?

Vitamin A/Retinol.

Safest pain reliever during pregnancy?

Acetaminophen (Paracetamol).

Danger sign: painless vaginal bleeding in 3rd trimester suggests?

Placenta previa.

Primary danger signs of severe PIH?

Persistent headache, blurred vision, facial/hand edema, proteinuria, hypertension.

Termination of pregnancy before 20 weeks is called?

Abortion (spontaneous or induced).

Define threatened abortion clinical features.

Spotting, mild cramps, closed cervix; pregnancy may still continue.

Management of incomplete abortion with retained products <12 wks?

Dilation and curettage (D&C).

Most common site of ectopic pregnancy?

Ampulla of the fallopian tube.

Classic triad of ectopic pregnancy?

Abdominal pain, amenorrhea, vaginal bleeding.

What is a hydatidiform mole?

Gestational trophoblastic disease: abnormal proliferation of chorionic villi with high hCG, no viable fetus.

Persistent high hCG after mole evacuation raises concern for?

Choriocarcinoma.

Cervical cerclage is placed at what gestational age for incompetent cervix?

Around 12–14 weeks.

Define pre-eclampsia.

New-onset hypertension plus proteinuria ± organ dysfunction after 20 weeks gestation.

Typical presentation of placenta previa?

Sudden painless bright-red bleeding in late pregnancy.

Placental abruption key symptom?

Severe abdominal pain with rigid uterus and possible concealed bleeding.

First-line management for placenta previa with heavy bleeding near term?

Cesarean section.

Primary fetal risk of GDM?

Macrosomia leading to birth trauma and neonatal hypoglycemia.

What maternal diet minimum prevents hypoglycemia in GDM?

Not less than 1800 kcal/day with balanced carbohydrates.

Name the four stages of labor.

Dilation, Expulsion, Placental, Recovery (Fourth stage).

Define engagement in labor mechanics.

Fetal presenting part reaches the level of ischial spines (station 0).

Best pelvic type for vaginal birth?

Gynecoid pelvis.

Ritgen’s maneuver purpose?

Control delivery of the fetal head to prevent perineal trauma.

APGAR is assessed at what times?

1 and 5 minutes after birth.

Shiny Schultz vs. Dirty Duncan delivery refers to?

Placenta presenting fetal side first (Schultz) or maternal side first (Duncan).

Normal sequence of postpartum lochia?

Rubra (days 1-3), Serosa (4-7), Alba (8-10).

Postpartum ‘taking-in’ phase characteristic?

Mother relives birth experience and is dependent for care.

What exercise helps prevent urinary stress incontinence postpartum?

Kegel’s pelvic floor exercises.

Function of Wharton’s jelly in the cord?

Protects vessels from compression.

Difference between occult and overt cord prolapse?

Occult: cord beside presenting part; Overt: cord below presenting part after ROM.

Immediate action for cord prolapse?

Reposition mother (knee-chest or Trendelenburg) to relieve pressure until delivery.

Define funic presentation.

Umbilical cord lies between presenting part and cervix with membranes intact.

Most common cause of postpartum hemorrhage?

Uterine atony (failure to contract).

What hormone causes maternal GI motility decrease?

Progesterone.

Which anticoagulant antidote is protamine sulfate used for?

Heparin reversal.

Function of human placental lactogen (HPL) on glucose metabolism?

Acts as insulin antagonist, increasing maternal insulin resistance.

Why is tetracycline avoided in pregnancy?

Causes fetal bone growth inhibition and tooth discoloration.

Ideal presentation and position for vaginal birth?

Cephalic vertex, occiput anterior (LOA or ROA).

Couvade syndrome refers to what?

Expectant father experiencing pregnancy-like symptoms.

Definition of macrosomia.

Birth weight >4000 g (or >90th percentile).

Which fetal sense develops first and disappears last?

Hearing.

What is the safest antihypertensive for acute severe BP in pregnancy?

Hydralazine (IV) or labetalol; note: guidelines vary.

Purpose of antenatal corticosteroids at 28–34 weeks?

Accelerate fetal lung maturity by increasing surfactant.

Best method for iron transport from mother to fetus?

Active transport across the placenta (≈50 % of maternal intake goes to fetus).