Maternal second half of prelims from deepseek

High-Risk Pregnancy

A pregnancy where the mother, fetus, or newborn is at an increased risk of morbidity or mortality before, during, or after delivery

Abortion (Spontaneous Abortion/Miscarriage)

The spontaneous loss of a pregnancy before 20 weeks of gestation

Threatened Abortion

Vaginal bleeding with a closed cervical os; pregnancy may continue

Inevitable Abortion

Vaginal bleeding with an open cervical os; miscarriage cannot be stopped

Incomplete Abortion

Expulsion of some, but not all, products of conception; requires medical intervention

Complete Abortion

Expulsion of all products of conception; bleeding subsides

Missed Abortion

Fetal demise occurs but the products are retained in the uterus; closed os

Septic Abortion

Any abortion complicated by infection; a medical emergency

Recurrent Pregnancy Loss (RPL)

Three or more consecutive spontaneous abortions

Ectopic Pregnancy

Implantation of a fertilized ovum outside the uterine cavity, most often in the fallopian tube

Ectopic Pregnancy Classic Triad

1) Abdominal/pelvic pain, 2) Vaginal bleeding, 3) Amenorrhea with a positive pregnancy test

Ectopic Pregnancy Management (Medical)

Methotrexate injection for stable, non-ruptured ectopics

Ectopic Pregnancy Management (Surgical)

Salpingostomy (tube preserved) or Salpingectomy (tube removed)

Gestational Trophoblastic Disease (GTD)

A spectrum of disorders arising from abnormal proliferation of trophoblastic tissue

Hydatidiform Mole (Molar Pregnancy)

The most common form of GTD, characterized by abnormal placental tissue

Complete Mole

Karyotype 46,XX (paternal only); no fetal tissue; uterus often larger than dates

Partial Mole

Triploid karyotype (69,XXX/XXY); some abnormal fetal tissue; uterus often smaller than dates

Molar Pregnancy Management

Suction D&C evacuation followed by strict β-hCG monitoring for 6-12 months

Placenta Previa

Implantation of the placenta over or near the internal cervical os

Placenta Previa Classic Sign

Painless, bright red vaginal bleeding in the 2nd or 3rd trimester

Placenta Previa Management

Cesarean delivery; absolute contraindication for vaginal exam or delivery

Abruptio Placentae (Placental Abruption)

Premature separation of a normally implanted placenta from the uterine wall

Abruptio Placentae Classic Sign

Painful, dark red vaginal bleeding (may be concealed); woody, tender uterus

Abruptio Placentae Major Risk Factor

Maternal hypertension (chronic or preeclamptic)

Abruptio Placentae Complication

Disseminated Intravascular Coagulation (DIC)

Preeclampsia

A multisystem disorder characterized by new-onset hypertension and proteinuria after 20 weeks of gestation

Preeclampsia Diagnostic Criteria

Systolic BP ≥140 or Diastolic BP ≥90 AND proteinuria ≥300 mg/24hrs or new systemic signs

Preeclampsia Management

Definitive treatment is delivery; Magnesium Sulfate for seizure prophylaxis; antihypertensives for severe BP

HELLP Syndrome

A severe variant of preeclampsia characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets

HELLP Syndrome Management

Immediate delivery, Magnesium Sulfate, and intensive supportive care

Magnesium Sulfate

Drug of choice for preventing and treating eclamptic seizures; it is not an antihypertensive

Rh Incompatibility

Condition where an Rh-negative mother produces antibodies against an Rh-positive fetus's red blood cells

Hemolytic Disease of the Fetus and Newborn (HDFN)

The result of maternal antibodies attacking and destroying fetal red blood cells

Rho(D) Immune Globulin (RhoGAM)

Medication given to Rh-negative mothers to prevent the formation of anti-D antibodies

ABO Incompatibility

Condition where a mother with blood type O carries a fetus with blood type A, B, or AB; causes mild HDFN

Gestational Diabetes Mellitus (GDM)

Glucose intolerance with onset or first recognition during pregnancy

GDM Screening (One-Step)

75g OGTT; diagnosis if one value meets/exceeds: Fasting 92, 1-hr 180, 2-hr 153

GDM Screening (Two-Step)

1) 50g challenge, if positive then 2) 100g OGTT; diagnosis if two or more values are exceeded

GDM Management

First-line: Diet and exercise; Second-line: Insulin or oral agents (Metformin, Glyburide)

Iron Deficiency Anemia

The most common anemia in pregnancy, caused by increased iron demands

Iron Deficiency Anemia Diagnosis

Hemoglobin <11 g/dL, microcytic/hypochromic RBCs, low serum ferritin

Iron Deficiency Anemia Treatment

Ferrous Sulfate supplementation (325 mg provides

65 mg elemental iron)

Folic Acid Deficiency Anemia

Megaloblastic anemia caused by a deficiency in Vitamin B9, essential for DNA synthesis

Folic Acid Deficiency Key Finding

Macrocytic RBCs (high MCV) and hyper-segmented neutrophils on smear

Folic Acid Deficiency Major Complication

Neural Tube Defects (NTDs) in the developing fetus

Folic Acid Prevention

All women of childbearing age should consume 400-800 mcg of folic acid daily

Cytomegalovirus (CMV)

The most common congenital viral infection; can cause sensorineural hearing loss and neuro deficits

Rubella (German Measles)

Viral infection causing Congenital Rubella Syndrome: deafness, eye defects, heart disease

Herpes Simplex Virus (HSV) Management

Cesarean delivery indicated if active genital lesions are present at delivery

Human Immunodeficiency Virus (HIV) Goal

Prevent mother-to-child transmission (MTCT) via Antiretroviral Therapy (ART)

Varicella-Zoster Virus (Chickenpox)

Can cause Congenital Varicella Syndrome: limb hypoplasia, scars, neurological damage

Bacterial Vaginosis (BV)

Overgrowth of anaerobic bacteria; associated with preterm labor and PROM

Group B Streptococcus (GBS)

A bacterium that is the leading cause of life-threatening neonatal infection (e.g., sepsis, meningitis)

GBS Management

Intrapartum Antibiotic Prophylaxis (IAP) with Penicillin G given IV during labor to GBS-positive mothers

Chorioamnionitis

Infection of the amniotic fluid and fetal membranes; presents with maternal fever and uterine tenderness

Chorioamnionitis Management

Immediate delivery and administration of broad-spectrum IV antibiotics