Form 8 Review: Maternal and Fetal Health

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Questions and Answers

At what weekly gestation is diabetes screening typically performed during pregnancy?

  • 28-32 weeks
  • 20-24 weeks
  • 24-28 weeks (correct)
  • 36-40 weeks

What is the best approach for a young patient suspected of having an immature hypothalamic-pituitary-ovarian axis with heavy bleeding?

  • Observation without treatment
  • Hormone therapy
  • Immediate surgery
  • Oral contraceptives to stabilize the axis (correct)

Which of the following statements about Rho D immune globulin is true?

  • It is not needed for Rh-negative women
  • It should be repeated if given at 16 weeks or less and at 28 weeks (correct)
  • Single dose is sufficient for the entire pregnancy
  • Effects last for 24 weeks

What is a common presentation of a hydatiform mole in the first trimester?

<p>Bleeding along with bilateral ovarian theca lutein cysts (D)</p> Signup and view all the answers

In which situation is an IVC filter indicated?

<p>Patient with a DVT and a contraindication to anticoagulation (C)</p> Signup and view all the answers

Which condition is associated with chronic endometritis?

<p>Presence of plasma cells in the endometrium (D)</p> Signup and view all the answers

What is the appropriate management for a ruptured ovarian cyst?

<p>Supportive therapy and observation (A)</p> Signup and view all the answers

When can vaginal delivery occur after a history of horizontal cesarean section?

<p>It is generally acceptable (D)</p> Signup and view all the answers

Flashcards

Diabetes Screening in Pregnancy

Diabetes screening is typically performed at 24-28 weeks of pregnancy, unless concerning symptoms arise earlier.

Lipid Studies in Pregnancy

Lipid studies are not recommended during pregnancy.

Antepartum Intrauterine Fetal Demise (IUFD)

Antepartum intrauterine fetal demise (IUFD) can present as a lack of fetal movement and heart tones. Diagnosis is confirmed with ultrasound.

Menopause and Amenorrhea

Menopause typically starts around 50 years old. However, if a woman experiences amenorrhea (absence of menstruation), it's important to rule out pregnancy with a beta-hCG test.

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Immature Hypothalamic-Pituitary-Ovarian Axis

Heavy bleeding in a young patient may indicate an immature hypothalamic-pituitary-ovarian axis. Oral contraceptive pills (OCPs) can help stabilize the axis.

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Variable Decelerations in Fetal Heart Rate

Variable decelerations in fetal heart rate are abrupt drops of at least 15 bpm lasting less than 2 minutes. They are not directly related to uterine contractions.

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Light Vaginal Bleeding in Early Pregnancy

Light vaginal bleeding can occur early in pregnancy.

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IVC Filters and DVT

IVC filters are used only if a patient with a deep vein thrombosis (DVT) has a contraindication to anticoagulation.

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Study Notes

Form 8 Review

  • Diabetes screening: Done at 24-28 weeks, unless concerning symptoms appear earlier. Lipid studies are not recommended during pregnancy.
  • Genetic Screening: Performed during the first prenatal visit. Conditions like cystic fibrosis, SMA, and Tay-Sachs are examples.
  • Antepartum Fetal Demise: Characterized by decreased fetal movement and lack of fetal heart tones; this is confirmed by US.
  • Menopause: Typically begins around age 50; but if a woman has amenorrhea, pregnancy should be ruled out through a pregnancy test (blood test for B-hCG).
  • Immature Hypothalamic-Pituitary-Ovarian Axis: If a young woman presents with heavy bleeding, treatment to stabilize the axis may include OCPs.
  • Variable Decelerations: Abrupt decreases in fetal heart rate (FHR) of at least 15 bpm lasting 15 seconds or less. These have no relation to uterine contractions.
  • Light Vaginal Bleeding: May occur early in pregnancy.
  • IVC Filters: Used only if a deep vein thrombosis (DVT) is present and the patient is unable receive anticoagulant therapy.
  • Rho(D) Immune Globulin: Effects last 12 weeks. Another dose may be required at 28 weeks if the first dose was given at 16 weeks or earlier.
  • Ruptured Ovarian Cyst: Treat supportively.
  • Previous Antepartum Intrauterine Fetal Demise: Further evaluation is needed.

Additional Information

  • Placental Abruption: Occurs after 20 weeks gestation.
  • Vitamin A: Is teratogenic (harmful to the fetus) during pregnancy.
  • Vaginal Delivery After Horizontal C-Section: Is okay.
  • Vertical C-Section History: Indicates a vaginal delivery is not expected in the future.
  • Hydatiform Mole: Characterized by first-trimester bleeding with nausea and vomiting (N/V), and bilateral ovarian theca-lutein cysts.
  • Corpus Luteum Cyst: Treated by observation and supportive therapy.
  • Chronic Endometritis: Diagnosis involves observing the presence of plasma cells in the endometrium.
  • Vulvar Hematomas: Result from pudendal artery injury.
  • Folic Acid Deficiency: More likely in pregnant women.
  • Paget Disease of the Breast: Requires a biopsy.
  • Lochia Rubra: Early postpartum vaginal bleeding that is reddish in color; Serosa is the next color phase (creamy, pinkish white), and alba is the final color (off-white).

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