Obstetrics - Preterm Labor, Fetal Growth Disorders, Abortion, GTD and Ectopic Pregnancy

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61 Terms

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18 months

Intervals shorter than __ between pregnancies have been associated with an increased risk for preterm birth

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True

True or False: Placenta previa is one of the most common causes of indicated preterm birth

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Preterm labor

Regular contractions associated with cervical change before 37 weeks AOG

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Premature

Neonate that has the function expected of a newborn at <37 weeks with underdeveloped organ functions (i.e. pulmonary function)

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Placenta previa or abruptio placenta

Most common causes of preterm birth

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<18 months
>59 months

Intervals between pregnancies associated with preterm labor

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TVS

Single most powerful predictor of preterm birth

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≤ 25mm

cervical length at 16 to 24 weeks (no contractions) that is predictive of preterm birth

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Nifedipine

Tocolytic agent of choice in preterm labor

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Atosiban

Oxytocin receptor antagonist used in preterm labor

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10-12 weeks AOG

Primary (Prophylactic) cerclage is done at

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Secondary (Therapeutic)

Primary or secondary cerclage: done after detection of early cervical changes with no membrane exposure; high-risk for preterm delivery; short cervix < 2.5 cm

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Betamethasone

Steroid given in preterm labor with a 2-dosage regimen

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2 weeks

Rescue or repeat course of steroids can be given beyond __ after initial dose but still <34 weeks AOG

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Proceed to delivery
GBS prophylaxis

Recommended management of preterm ruptured membranes at 34 weeks or more

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True

True or False: GBS prophylaxis and corticosteroids are not in the recommended management of preterm ruptured membranes before 24 weeks

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24 - 31 completed weeks

Single course corticosteroid use is part of the recommended management of preterm ruptured membranes at

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Fever

Only reliable indicator of clinical chorioamnionitis in women with preterm rupture of fetal membranes

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Co-amoxiclav

Antibiotic not recommended in prolonging latency in preterm rupture of membranes due to risk of NEC

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24 hours

Corticosteroids administered to women at risk for preterm birth have been demonstrated to decrease rates of respiratory distress if the birth is delayed for ___ after the initiation of therapy

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Oligohydramnios

Reversible complication that can be seen when Indomethacin is used for tocolysis longer than 24 to 48 hours

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Cerebral palsy

Intrapartum administration of magnesium sulfate to women who deliver preterm has been demonstrated to reduce rates of

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Symmetrical

Symmetrical or asymmetrical growth disorder: early insult

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Asymmetrical

Symmetrical or asymmetrical growth disorder: disproportionately lagging abdominal growth

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Asymmetrical

Symmetrical or asymmetrical growth disorder: late insult

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Asymmetrical

Symmetrical or asymmetrical growth disorder: brain sparing

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True

True or False: Advancing maternal age is a risk factor for fetal overgrowth

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True

True or False: Multiparity is a risk factor for fetal overgrowth

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Compatible

Size of the uterus in threatened abortion

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Compatible

Size of the uterus in inevitable abortion

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Incompatible

Size of the uterus in incomplete abortion

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Incompatible

Size of the uterus in complete abortion

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Incompatible

Size of the uterus in missed abortion

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Intact

Bag of waters in threatened abortion

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Not appreciated

Bag of waters in complete abortion

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Not appreciated

Bag of waters in missed abortion

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(+) FHT

FHT in threatened abortion

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None

FHT in incomplete abortion

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None

FHT in missed pregnancy

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Bed rest
Tocolytic

Management for Threatened abortion

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Expectant management
Oxytocin
Curettage

Management for Inevitable abortion

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Curettage

Management for Incomplete abortion

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Observation

Management for complete abortion

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Prostaglandin
D&C

Management for Missed abortion

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Complete

Complete or Partial H mole: generalized swelling of the placental villi with marked trophoblastic proliferation

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Partial

Complete or Partial H mole: 1 maternal and 2 paternal chromosomes

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Complete

Complete or Partial H mole: paternal chromosome only plus empty ovum

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Partial

Complete or Partial H mole: with fetal parts

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Methotrexate
Actinomycin D

Given for chemoprophylaxis of GTD

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6 months

Pregnancy, after GTD, is only allowed __ after normal B-hCG

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1

Stage of GTD: confined to the uterus

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2

Stage of GTD: outside the uterus but confined to pelvic organs

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3

Stage of GTD: pulmonary metastases

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4

Stage of GTD: metastasis to other sites

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Etoposide
Methotrexate
Actinomycin D
Cyclophosphamide
Vincristine

Components of the EMACO protocol

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Ampulla

Portion of the tube most commonly involved in Tubal pregnancies

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1. Pelvic and abdominal pain
2. Vaginal bleeding or spotting

Two most common signs and symptoms of Tubal pregnancies

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Laparoscopy

Gold standard in the diagnosis of Tubal pregnancies

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<6 weeks
Mass <3.5 cm
No cardiac activity
Serum B-hCG <10-15,000 mIU/mL

Indications for Methotrexate therapy in Ectopic pregnancy

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Active bleeding
Breastfeeding
Immunodeficiency
Alcoholism
Blood dyscrasia
Liver or renal disease
Pulmonary disease

Contraindications for Methotrexate therapy in Ectopic pregnancy

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Leucovorin

Additional drug given with Methotrexate in multidose regimen of Medical Treatment for Ectopic pregnancy