OB/GYN Key Concepts

OB/GYN

• Uterine Atony: Treated with uterine massage and oxytocin. Retained placenta treated with dilation and curettage.
• Tachysystole: More than 5 contractions every 10 minutes can cause fetal distress. Tocolytic (terbutaline) is a beta 2 agonist used to treat it.
• Hemoglobin A2 (HBA2): Increased in beta-thalassemia.
• Good Accelerations: Increased by 15 beats per 15 seconds for acceleration, and 2 per 20 minutes is considered good.
• Endometritis: Characterized by fever, tender uterus, and foul-smelling lochia (vaginal discharge). Treated with ampicillin and gentamicin.
• Chorioamnionitis: Treatable with ampicillin and gentamicin.
• Chancroid: Ceftriaxone or azithromycin is the treatment.
• Chancre: A painless sore, potentially associated with syphilis.
• Placenta Accreta: Placenta attaches to the uterine wall. Types include accreta, increta, and percreta (with increasing invasiveness).
• Intrahepatic Cholestasis of Pregnancy: Treated with ursodiol.
• Acute Fatty Liver of Pregnancy: Associated with hypoglycemia. Diagnosis involves a V/Q scan.
• Pulmonary Embolism (PE): Treated with heparin or rivaroxaban. Diagnosis involves a V/Q scan in pregnant women.
• Amniotic Fluid Embolism: Symptoms are confusion, chest rash/petechiae. Treatment is supportive.
• Magnesium Toxicity: First sign is hyporeflexia.

Infectious Causes in Babies < 3 Months

• B-group Streptococcus (GBS), E. coli, and Listeria are common causes.

Infections in Pregnant Women

• Tubovarian Abscess: Treated with clindamycin and metronidazole.
• Recurrent Variable Decelerations: Maternal repositioning can help, amnioinfusion may be necessary.
• Sinusoidal FHR Pattern: Suggests fetal anemia.
• Normal Amniotic Fluid Volume: 5-25 mm.
• Urinary Tract Infections (UTIs) in Pregnancy: Amoxicillin, cephalosporins or nitrofurantoin (non-pregnant) can be used.

Other OB/GYN Topics

• Prenatal Care and GBS Prevention: Strategies include history of prior GBS infection, urine cultures, prolonged rupture of membranes, and pre-term delivery.
• Vitamin supplementation: Supplement Vitamin K in pregnancy.
• Cancer Screening: Women are screened for breast cancer starting at 40.
• HPV Vaccine: Ages 9-26, and Herpes Zoster at 60.
• Pneumococcal Vaccine: Given to persons at 65.
• HIV Positive Patients: Pap smears are needed annually
• Endometriosis: Associated with dysmenorrhea, dyschezia, and dyspareunia (painful intercourse).
• Lymphogranuloma Venereum: Presents as painful buboes but no ulceration. Treated with doxycycline and ceftriaxone
• Lymphogranuloma Inguinale: Presents with buboes and ulceration. Treated with doxycycline and ceftriaxone.
• Complete/Partial Mole: Complete is 2 sperm + empty egg = 46 or 47 XX or XY. Partial is 2 sperm + 1 egg = 69XXY. Treated with follow-up.
• Septic Abortion: Gentiamycin (not the only antibiotic) and clindamycin are used.
• Breast Nodule: Biopsy is necessary for further analyses no matter the imaging results.
• Ectopic Pregnancy: Stable vs. unstable. TVUS needed to discern ectopic pregnancy, intrauterine pregnancy, or non-diagnostic findings. Blood tests confirm or rule out (serum B-hCG).
• Pregnant Women With Breast Cancer: Screening begins at 25 (breast MRI).
• Polycystic Ovary Syndrome (PCOS): Symptoms include weight loss. First-line treatment is often oral contraceptives (OCPs). Also characterized by gradual hirsutism or deepening of the voice, acne, or balding.
• Kallmann Syndrome: Characterized by the absence of GnRH neurons, leading to infertility. First line treatment is endometrial cancer, followed by hysterectomy if necessary.
• Vagina and Cervix Cells: Squamous cells.