Chapt 10 Stucy Guide: Complications of Pregnancy Practice Flashcards

Comprehensive practice questions covering high-risk pregnancy, hemorrhagic conditions, hypertensive disorders, gestational diabetes, and TORCH infections based on the lecture notes.

How is a high-risk pregnancy defined?

A pregnancy in which the mother, baby, or both are at increased risk for complications, illness, injury, or death.

What is the gestational cutoff used to distinguish between a spontaneous abortion (miscarriage) and stillbirth or fetal demise?

$20$ weeks of gestation.

Approximately what percentage of first-trimester miscarriages are attributed to chromosomal abnormalities?

$$50\%$$

Which type of miscarriage is characterized by vaginal bleeding before $20$ weeks with a closed cervix, where the pregnancy may still continue?

Threatened Miscarriage

What medical treatments are mentioned for an incomplete miscarriage to help expel products of conception?

Dilation and curettage (D&C) and medications including oxytocin, methergine, and cyotec.

What is the most common site for an ectopic pregnancy, accounting for $90-95\%$ of cases?

Fallopian tubes

What classic symptom of ectopic pregnancy is caused by blood irritating the diaphragm?

Referred shoulder pain (scapular pain)

What medication is used for early, stable ectopic pregnancy to act as a folic acid antagonist and stop cell growth?

Methotrexate

What is the hallmark ultrasound finding for Gestational Trophoblastic Disease (Molar Pregnancy)?

A \text{"snowstorm appearance"}

How long should a patient avoid pregnancy after a molar pregnancy to ensure accurate interpretation of serial hCG levels?

At least one year

What is the classic clinical presentation of placenta previa?

Sudden, painless vaginal bleeding after $20$ weeks gestation (usually bright red).

What specific physical examination must be avoided when placenta previa is suspected?

Digital vaginal exams (until ruled out by ultrasound)

What is the defining characteristic of the uterus in cases of Abruptio Placentae?

The uterus may feel firm, rigid, or \text{"board-like"} due to increased tone.

What diagnostic findings distinguish Hyperemesis Gravidarum from typical morning sickness?

Persistent vomiting resulting in significant weight loss, dehydration, ketonuria, and electrolyte disturbances.

What are the blood pressure thresholds for diagnosing Gestational Hypertension?

Systolic BP $\geq 140\,mmHg$ or diastolic BP $\geq 90\,mmHg$ on two occasions at least $4$ hours apart after $20$ weeks gestation.

In addition to hypertension, what must be present to diagnose Preeclampsia according to the organ involvement criteria?

Proteinuria ($\geq 300\,mg$ in $24$-hour urine or $2+$ on dipstick), thrombocytopenia ($< 100,000/\mu L$), impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral/visual disturbances.

What are the blood pressure and proteinuria criteria for Severe Preeclampsia?

BP $\geq 160/110\,mmHg$ (two occasions $\geq 6$ hours apart) and significant proteinuria ($\geq 300\,mg$ in $24$-hour urine or $\geq 3+$ on dipstick).

What is the therapeutic range for Magnesium Sulfate when used as an anticonvulsant in preeclampsia?

$$4-8\,mg/dL$$

What is the antidote for Magnesium Sulfate toxicity, which should be available at the bedside?

Calcium gluconate

What does the acronym HELLP stand for in the context of preeclampsia complications?

Hemolysis, Elevated Liver enzymes, and Low Platelets

When should Rh-negative mothers receive RhoGAM prophylactically?

Between $28-32$ weeks gestation and postpartum within $72$ hours if the infant is Rh-positive.

What are the normal values for a 3-hour Oral Glucose Tolerance Test (OGTT)?

Fasting $< 95\,mg/dL$, 1-hr $< 180\,mg/dL$, 2-hr $< 155\,mg/dL$, and 3-hr $< 140\,mg/dL$.

What fetal/neonatal complication causes the infant's pancreas to overproduce insulin after birth due to high maternal glucose supply being removed?

Neonatal Hypoglycemia

What is the recommended weight gain for a woman entering pregnancy with obesity?

$11-20$ pounds

What are the components of the TORCH acronym for maternal-fetal infections?

Toxoplasmosis, Other (Syphilis, HIV, Varicella), Rubella, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV).

When is screening for Group Beta Streptococcus (GBS) typically performed in pregnancy?

Between $34-36$ weeks gestation via vaginal and rectal culture.

What is the primary treatment for Toxoplasmosis in pregnancy?

Spiramycin