Pregnancy and Ulcerative Colitis Quiz
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Questions and Answers

What is the recommended daily folic acid supplementation for patients with ulcerative colitis?

  • 2-4 mg (correct)
  • 10 mg
  • 0.4 mg
  • 5 mg

Which hormone is produced by the placenta to remodel the reproductive tract for labor?

  • Chorionic gonadotropin (hCG)
  • Human placental lactogen (hPL)
  • Luteinizing hormone (LH)
  • Relaxin (correct)

At what point do hCG levels typically peak during early pregnancy?

  • Week 5
  • Week 8
  • Week 10-12 (correct)
  • Week 15

What is the goal for hemoglobin A1c levels for women with diabetes mellitus prior to conception?

<p>Below 7% (D)</p> Signup and view all the answers

Which subunit of hCG is identical to those of luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone?

<p>α subunit (B)</p> Signup and view all the answers

What physiological change occurs to the total lung capacity (TLC) during pregnancy?

<p>It decreases by 5%. (A)</p> Signup and view all the answers

Which sign indicates softening of the cervix at or after 4 weeks of pregnancy?

<p>Goodell sign (D)</p> Signup and view all the answers

Which symptom is commonly associated with the early stages of pregnancy?

<p>Amenorrhea (D)</p> Signup and view all the answers

What happens to respiratory rate during pregnancy, according to the physiological adaptations?

<p>It remains constant. (D)</p> Signup and view all the answers

During pregnancy, what happens to the functional residual capacity (FRC)?

<p>It decreases by 20-30%. (D)</p> Signup and view all the answers

Which of the following is a sign of early pregnancy observed through physical examination?

<p>Telangiectasias (B)</p> Signup and view all the answers

What is the expected change in arterial oxygen (PaO2) levels during pregnancy?

<p>They increase. (C)</p> Signup and view all the answers

What is a common symptom of pregnancy related to gastrointestinal changes?

<p>Nausea and vomiting (A)</p> Signup and view all the answers

What is the purpose of increased tidal volume during pregnancy?

<p>To increase alveolar oxygen levels. (A)</p> Signup and view all the answers

Which of the following physical changes is NOT typically associated with early pregnancy?

<p>Visible weight gain (B)</p> Signup and view all the answers

Which anatomical site is most commonly associated with ectopic pregnancies?

<p>Ampulla of the fallopian tube (C)</p> Signup and view all the answers

What is the strongest risk factor for ectopic pregnancy?

<p>Prior ectopic pregnancy (D)</p> Signup and view all the answers

What percentage of pregnancies are estimated to be ectopic?

<blockquote> <p>1:100 (C)</p> </blockquote> Signup and view all the answers

Which of the following is a cardinal sign of ectopic pregnancy?

<p>Vaginal bleeding (D)</p> Signup and view all the answers

In treating ectopic pregnancy with methotrexate, what is the maximum number of doses that can be given?

<p>Four doses (D)</p> Signup and view all the answers

What level of serum B-hCG is necessary to trigger an additional dose of methotrexate?

<p>If it declines by less than 15% (C)</p> Signup and view all the answers

Which of the following medications is part of the multi-dose regimen for ectopic pregnancy?

<p>Leucovorin (D)</p> Signup and view all the answers

What is the typical site of implantation for an ectopic pregnancy when it occurs in the fallopian tube?

<p>Ampulla (B)</p> Signup and view all the answers

Which of the following is NOT considered a risk factor for ectopic pregnancy?

<p>Regular exercise (C)</p> Signup and view all the answers

What is the average decline in serum B-hCG levels that indicates successful treatment of ectopic pregnancy with methotrexate?

<p>15% (A)</p> Signup and view all the answers

What does a positive contraction stress test (CST) indicate?

<p>Late fetal heart deceleration (C)</p> Signup and view all the answers

Which fetal condition is evaluated by a nonstress test (NST)?

<p>Overall fetal health (B)</p> Signup and view all the answers

How should the Tdap vaccine be administered during pregnancy?

<p>Two doses IM at intervals of 1-2 months (C)</p> Signup and view all the answers

In the context of quad screening, what does an increased inhibin A level indicate?

<p>Trisomy 21 risk (D)</p> Signup and view all the answers

What is the primary purpose of the oxytocin challenge test?

<p>To evaluate the adequacy of uteroplacental function (B)</p> Signup and view all the answers

Which of the following is a true statement regarding fetal reactivity?

<p>Assessable by fetal heart rate monitoring (B)</p> Signup and view all the answers

When is the highest risk for Trisomy 18 evident according to the quad screening?

<p>Decreased estriol levels (C)</p> Signup and view all the answers

What does an unsatisfactory contraction stress test indicate?

<p>Fewer than 3 contractions in 10 minutes (A)</p> Signup and view all the answers

What defines equivocal-hyperstimulatory readings in fetal heart rate monitoring?

<p>Decelerations with frequent contractions (B)</p> Signup and view all the answers

Which vaccine is contraindicated during pregnancy?

<p>Measles vaccine (C)</p> Signup and view all the answers

What is a common medical management option for ectopic pregnancy?

<p>Methotrexate (D)</p> Signup and view all the answers

What abnormal result might indicate a risk for Patau syndrome in quad screening?

<p>Increased hCG and decreased MSAFP (A)</p> Signup and view all the answers

What is a potential outcome of a negative contraction stress test?

<p>Normal fetal heart rate patterns (D)</p> Signup and view all the answers

What is the significance of a Bishop score greater than 8?

<p>Suggests the cervix is favorable for spontaneous and induced labor (B)</p> Signup and view all the answers

Which maneuver is referred to as the Pelvic grip in Leopold’s maneuvers?

<p>Pelvic grip (B)</p> Signup and view all the answers

What does the obstetrical conjugate measure?

<p>Shortest distance between the sacral promontory and the symphysis pubis (B)</p> Signup and view all the answers

Which of the following best describes face presentation?

<p>Mentum is the reference point (C)</p> Signup and view all the answers

What criteria is used to assess cervical dilation during examination?

<p>Using one or two fingers (D)</p> Signup and view all the answers

In the context of Bishop score, what does a dilation of 3–4 cm correspond to?

<p>Score of 2 (B)</p> Signup and view all the answers

Which grip in the pelvic examination is primarily used to assess the relative position of the fetus in the pelvis?

<p>Pelvic grip (B)</p> Signup and view all the answers

How is the true conjugate typically measured?

<p>From the uppermost margin of the symphysis pubis to the sacral promontory (B)</p> Signup and view all the answers

Which station indicates that the fetal head is level with the ischial spines?

<p>0 (C)</p> Signup and view all the answers

What does effacement refer to in cervical examination?

<p>The length of the cervix remaining (A)</p> Signup and view all the answers

Which of the following describes a complete breech position?

<p>Hips flexed, one or both knees flexed (C)</p> Signup and view all the answers

What aspect of the pelvis does pelvimetry assess?

<p>The dimensions and shape of the pelvis (B)</p> Signup and view all the answers

What is a key characteristic of cervical consistency in the Bishop score?

<p>Firm, medium, or soft (C)</p> Signup and view all the answers

What does the term 'grand multipara' refer to in obstetrics?

<p>A woman who has had at least 5 births at 20 weeks or more (C)</p> Signup and view all the answers

What does 'parity' indicate in the GP-TPAL designation?

<p>The number of pregnancies that have resulted in live births (A)</p> Signup and view all the answers

Which of the following accurately describes 'abortus' in pregnancy terminology?

<p>Pregnancy losses before 20 weeks (C)</p> Signup and view all the answers

What is the significance of the 'LMP' in dating a pregnancy?

<p>It is the date when the last menstrual period started (C)</p> Signup and view all the answers

Which calculation is used to estimate the date of confinement (EDC)?

<p>LMP - 3 months + 7 days (C)</p> Signup and view all the answers

What does 'gestational age' refer to?

<p>The number of weeks since the last menstrual period (B)</p> Signup and view all the answers

At what stage of pregnancy is the fetal heartbeat usually audible via a stethoscope?

<p>At 20 weeks (A)</p> Signup and view all the answers

What does the term 'multiplet pregnancy' count as in GP-TPAL?

<p>Counts as 1 for parity only (C)</p> Signup and view all the answers

When is quickening typically observed during pregnancy?

<p>16-20 weeks (D)</p> Signup and view all the answers

Why is a dating ultrasound performed in early pregnancy?

<p>To estimate gestational age accurately (D)</p> Signup and view all the answers

At what beta-hCG level is the gestational sac typically visible on a transvaginal ultrasound?

<p>1,500-2,000 mIU/mL (B)</p> Signup and view all the answers

What is the expected difference between ultrasound dating and dating based on LMP in the first trimester?

<p>1 week (C)</p> Signup and view all the answers

What does the abbreviation 'GA' stand for in pregnancy terminology?

<p>Gestational age (C)</p> Signup and view all the answers

What is the role of Naegele’s rule in pregnancy?

<p>To estimate the due date based on LMP (B)</p> Signup and view all the answers

At what beta-hCG level is the fetal heartbeat typically detectable via ultrasound?

<p>5,000-6,000 mIU/mL (C)</p> Signup and view all the answers

Flashcards

Gravidity

The number of times a woman has been pregnant.

Parity

The number of pregnancies that resulted in a birth at or beyond 20 weeks gestation.

Abortus

A pregnancy that ends before 20 weeks gestation.

Grand Multipara

A woman who has given birth to 5 or more children.

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Gestational Age (GA)

The number of weeks and days since the last menstrual period (LMP), used to estimate the age of a pregnancy.

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Estimated Date of Confinement (EDC)

The predicted date of delivery, calculated by adding 280 days to the first day of the last menstrual period (LMP).

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Naegele's Rule

A method to calculate the EDC, using LMP minus 3 months and adding 7 days.

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Developmental Age (DA)

The number of weeks and days since conception, often measured by ultrasound.

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Multifetal Gestation

A pregnancy where twins or multiple fetuses are present.

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Ultrasound

A procedure that uses sound waves to visualize a fetus, useful for dating the pregnancy and detecting abnormalities.

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Quickening

The first movements of a fetus felt by the mother, typically around 16-20 weeks gestation.

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Preterm

A pregnancy that ends before 37 weeks gestation.

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Term

A pregnancy that continues for 40 weeks or more.

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Obstetric Hemorrhage

Bleeding from the uterus during or after pregnancy.

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Hypertensive Diseases in Pregnancy

A condition that involves abnormally high blood pressure during pregnancy.

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Chadwick's Sign

Bluish discoloration of the vagina and cervix, occurring during early pregnancy.

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Goodell's Sign

Softening and cyanosis of the cervix, usually occurring after 4 weeks of pregnancy.

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Ladin's Sign

Softening of the uterus, occurring after 6 weeks of pregnancy.

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Hegar's Sign

Softening of the uterine isthmus, occurring after 6 weeks of pregnancy.

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Pulmonary Changes in Pregnancy

Increased tidal volume (TV) and minute ventilation during pregnancy lead to an increase in alveolar (PAO2) and arterial (PaO2) oxygen levels.

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FRC Decrease in Pregnancy

A decrease in expiratory reserve volume (ERV) and functional residual capacity (FRC) during pregnancy due to the elevated diaphragm.

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IC Increases in Pregnancy

Increase in inspiratory capacity (IC) due to increased tidal volume (TV) in pregnancy.

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TLC Decrease in Pregnancy

A decrease in total lung capacity (TLC) by 5% during pregnancy due to the elevated diaphragm.

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Morning Sickness

Nausea and vomiting that often occurs during the first trimester of pregnancy.

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Folic acid supplementation for preconception

Folic acid supplementation of 0.4mg daily is recommended for all women one month prior to conception. This dosage should be increased to 4mg daily for women who have a higher risk of neural tube defects.

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Preconception hemoglobin A1c goal for diabetic women

A hemoglobin A1c level below 7% is recommended for women with diabetes mellitus before pregnancy.

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What is hCG and how does its levels change during pregnancy?

Human chorionic gonadotropin (hCG) is a hormone produced by the placenta. It has an alpha subunit identical to LH, FSH and TSH, but a unique beta subunit. During early pregnancy, hCG levels double every 48 hours. Peak levels are reached at 10-12 weeks, followed by a decline to a steady state after week 15.

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What is relaxin and its role in pregnancy?

Relaxin is a hormone produced by the placenta that remodels the reproductive tract to accommodate childbirth.

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What is the function of human placental lactogen (hPL)?

Human placental lactogen (hPL) is a hormone produced by the placenta that ensures constant nutrient supply to the fetus.

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Ectopic Pregnancy

A pregnancy that occurs outside of the uterus, most commonly in the fallopian tube.

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Methotrexate

A medication commonly used to treat ectopic pregnancies.

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Serum B-hCG

The amount of hCG in the blood, used to monitor the effectiveness of treatment for ectopic pregnancy.

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Pelvic Inflammatory Disease (PID)

A condition that increases the risk of ectopic pregnancy, often caused by sexually transmitted infections or pelvic inflammatory disease.

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Prior Ectopic Pregnancy

A strong risk factor for ectopic pregnancy, increasing the chances of another ectopic pregnancy in the future.

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Tubal Surgery

A type of surgery on the fallopian tubes that increases the risk of ectopic pregnancy.

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Endometriosis

A condition that involves abnormal tissue growth in the pelvic area, increasing the risk of ectopic pregnancy.

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Exogenous Hormones use

The use of hormones like progesterone or estrogen, which can increase the risk of ectopic pregnancy.

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Assisted Reproductive Technologies (ART)

Assisted reproductive technologies like IVF, which have been linked to an increased risk of ectopic pregnancy.

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Diethylstilbestrol (DES)

A drug frequently used during pregnancy, which exposure before birth can increase the risk of ectopic pregnancy.

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Quad Screening

A screening test used to detect chromosomal abnormalities in a fetus. It involves measuring levels of specific substances in the mother's blood, such as alpha-fetoprotein (MSAFP), beta-hCG, estriol, and inhibin A.

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Trisomy 21

A condition where a fetus has an extra copy of chromosome 21, leading to Down syndrome.

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Trisomy 18

A condition where a fetus has an extra copy of chromosome 18, leading to Edwards syndrome.

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Trisomy 13

A condition where a fetus has an extra copy of chromosome 13, leading to Patau syndrome.

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Contraction Stress Test (CST)

A test of the uteroplacental function, performed to assess how well the placenta is supplying oxygen and nutrients to the fetus. It involves inducing contractions and monitoring the fetal heart rate.

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Nonstress Test (NST)

A test of fetal condition, usually performed starting at 32 to 34 weeks of gestation in high-risk pregnancies. It measures fetal heart rate accelerations in response to fetal movement.

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Percutaneous Umbilical Blood Sampling (PUBS)

An invasive procedure used to obtain fetal blood samples from the umbilical cord. It helps diagnose various conditions including chromosome abnormalities, blood disorders, and infection.

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Salpingectomy

A surgical procedure to remove an ectopic pregnancy.

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Methotrexate treatment

A medical treatment for ectopic pregnancy using the drug methotrexate. It's suitable for small ectopic pregnancies.

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Fetal Heart Reactivity

A test of fetal heart rate reactivity, evaluating the response to fetal movement. It's used to assess placental function and fetal well-being.

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Fetal Biophysical Profile

A test of the fetus's ability to move, breathe, and respond to stimuli. It helps assess the fetal nervous system development and function.

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Organogenesis

The period during pregnancy when the fetus's organs and systems are most vulnerable to teratogens (substances that can cause birth defects).

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Fetal Development

The process by which the fetus develops from a single-celled zygote to a full-term infant. It involves cell division, differentiation, and growth.

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What is the obstetrical conjugate?

The shortest distance between the sacral promontory and the symphysis pubis, typically measured to be at least 10 cm. It is an important measurement to determine if the pelvis is adequate for vaginal delivery.

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What is the true conjugate?

The anteroposterior diameter from the uppermost margin of the symphysis pubis to the sacral promontory. It is measured directly during a pelvic examination.

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What is the pelvic grip in Leopold's maneuvers?

The pelvic grip is used to assess the shape and size of the pelvic outlet. It involves placing one hand on each side of the ischial tuberosities and gently pressing them together.

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What is a cervical examination?

A clinical assessment of the cervix using fingers to determine its dilation, effacement, station, consistency, and position. This helps evaluate a pregnant woman's readiness for labor.

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What is the Bishop score?

A scoring system used to assess a woman's cervix and predict the likelihood of successful vaginal delivery. A score greater than 8 indicates a favorable cervix for spontaneous or induced labor.

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What are Leopold's maneuvers?

A clinical technique used to determine the position, attitude, and presentation of the fetus within the uterus. It uses four maneuvers to feel the fetus's movements and shape.

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What is vertex presentation?

This presentation is observed when the fetal occiput is the presenting part, meaning the baby's head is down and facing the birth canal.

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What is breech presentation?

This presentation is observed when the fetal sacrum is the presenting part, meaning the baby's buttocks are facing the birth canal.

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What is a frank breech?

This type of breech presentation involves flexed hips and extended knees, with the feet near the fetal head. It's one of the most favorable breech positions for vaginal delivery.

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What is a complete breech?

This type of breech presentation involves flexed hips and one or both knees flexed, with at least one foot near the breech. It is a common breech presentation.

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What is an incomplete or footling breech?

This type of breech presentation involves one or both hips not flexed, with a foot or knee lying below the breech. It is a less favorable breech position for vaginal delivery.

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What is pelvimetry?

A measurement technique used to assess the size and shape of the bony pelvis. It involves measuring the distance between various landmarks of the pelvis.

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What are the diagonals of the pelvic exam?

These are the measurements that are used to determine the size and shape of the pelvis. They are typically measured during a pelvic examination.

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What is face presentation?

Presenting when the mentum (chin) of the fetus is the reference point, meaning the baby is facing upwards and their chin is the first to be delivered.

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What is shoulder presentation?

Presenting when the acromion (shoulder bone) of the fetus is the reference point, meaning the baby is positioned sideways with their shoulder first.

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Study Notes

Obstetrics and Gynecology Study Notes

  • Pregnancy: The product of conception, typically implanted in the uterus.
  • Embryo: From fertilization to 8 weeks of gestation (10 weeks' gestational age).
  • Fetus: From 8 weeks to birth.
  • 1st trimester: 12-14 weeks' gestation.
  • 2nd trimester: 12-14 to 24-28 weeks' gestation.
  • 3rd trimester: 24-28 to delivery.
  • Infant: From delivery to 1 year.
  • Nulligravida: Woman who has never been pregnant.
  • Gravida: Woman who is or has been pregnant.
  • Nullipara: Woman who has never completed a pregnancy beyond 20 weeks.
  • Primipara: Woman who has delivered one fetus.
  • Multipara: Woman who has delivered two or more fetuses.
  • Grand multipara: Woman who has had five or more births.
  • Gestational age (GA): Age of pregnancy from the last menstrual period (LMP).
  • Estimated date of confinement (EDC)/estimated date of delivery (EDD): Computed via Naegele's rule (LMP - 3 months + 7 days).
  • Ultrasound: Important for assessing GA.
  • Fetal heart tones: Can be heard via stethoscope by 20 weeks or Doppler by 10 weeks.
  • Quickening: Fetal movement felt by the mother (16-20 weeks).

Obstetrics Study Notes

  • Obstetrics Review: Topics include pregnancy, maternal adaptations, preconceptional/prenatal care, pregnancy complications, labor, delivery, fetal complications, multifetal gestation, obstetric hemorrhage, and hypertensive/diabetic diseases.
  • Maternal Adaptations in Pregnancy: Physiological changes in the respiratory, reproductive, cardiovascular, gastrointestinal, renal, and hematological systems.
  • Preconceptional and Prenatal Care: Includes folic acid supplementation, managing pre-existing conditions (diabetes), and vaccination policies.
  • Early Pregnancy Complications: Ectopic pregnancy, abortion, recurrent pregnancy loss, and gestational trophoblastic diseases are examples.
  • Labor Stages: Preparatory, dilatational, and pelvic divisions; latent and active phases within the first stage; expulsion and placental phases (third and fourth stages).
  • Induction and Augmentation of Labor: Stimulating uterine contractions artificially.
  • Delivery: Includes different methods like forceps and vacuum delivery and surgical approaches (caesarean).
  • Complications of Labor and Delivery: Preterm labor, cervical insufficiency, postpartum hemorrhage, and placental issues.
  • Fetal Complications of Pregnancy: Includes small-for-gestational-age (SGA), large-for-gestational-age (LGA), and intrauterine growth restriction (IUGR) fetuses.
  • Multifetal Gestation: Complications of pregnancies with multiples, including twin-to-twin transfusion syndrome.
  • Obstetric Hemorrhage: Includes factors like uterine atony, retained placenta, and lacerations.
  • Hypertensive Diseases in Pregnancy: Pre-eclampsia, eclampsia and chronic hypertension.
  • Gestational Diabetes Mellitus (GDM): Management and monitoring during pregnancy.

Gynecology Study Notes

  • Gynecology Review: Topics include development of sex, errors in sexual differentiation, reproductive anatomy, reproductive endocrinology, menstrual cycle abnormalities, pediatric gynecology, infertility, menopause, and osteoporosis.
  • Developmental Biology of Sex: Determination of genetic, gonadal, and phenotypic sex.

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Description

Test your knowledge on key topics related to pregnancy and ulcerative colitis. This quiz covers essential aspects like folic acid supplementation, hormone production, and hCG levels during early pregnancy. Perfect for students and healthcare professionals alike!

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