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Line 1: − =Abnormal Labor= − *1st stage (painful contractions leading to cervical dilation) − ** Latent Phase (0-6 cm dilation): Protraction of latent phase is defined as greater than '''14 hours (multip) or 20 hours (nullip) without change in dilation'''. − ** Active Phase (6-10 cm dilation): '''Protraction of active phase''' is defined as ≤1 cm dilation in 2 hr; manage with Pitocin. '''Arrest''' is defined as no change in 4 hours (with adequate contractions) or 6 hours (without adequate contractions); management includes placing an IUPC catheter to determine if contractions are adequate, if yes: C-section, if no: AROM or Pitocin. − *2nd stage (active pushing) − ** Arrest is defined as no change in fetal station in 1-3 hrs (depending on parity and use of neuraxial anesthesia); management is to reduce epidural rate, give Pitocin, consider C-section or forceps delivery. − *3rd stage (delivery of the placenta) − − + + + + + + + + + + + + Line 22:
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→Missed Concepts
=Missed Concepts=
=Missed Concepts=
*Obesity is a risk factor for POP, but weight loss is not an effective management option. Instead consider pessary or surgery.
*Obesity is a risk factor for POP, but weight loss is not an effective management option. Instead consider pessary or surgery.
*Scuba diving is not recommended during pregnancy.
*Scuba diving is not recommended during pregnancy.
*It's ok to start a new exercise regimen after becoming pregnancy.
*It's ok to start a new exercise regimen after becoming pregnancy.
*Quad screen results:
*'''Patient's who are at high risk of preeclampsia (SCD, HTN, nephropathy)''' should have early 24 hr protein collection to establish baseline.
*Indications for antibiotic ppx in patients who are GBS unknown: '''< 37 weeks, ROM > 18 hrs, intrapartum fever'''
*Diagnosis of placenta previa in a patient without prenatal care and with current bleeding: TVUS or speculum exam (these are actually safe because they don't go in the endocervical canal)
*Self breast exams are never recommended.
*POP can cause abnormal uterine bleeding.
*Treat cerebral venous sinus thrombosis with '''LMWH (even in the presence of a hemorrhage)'''
*Kleihauer-Betke test calculates '''the percentage of fetal blood cells in the maternal circulation to determine dose of Rhogam'''
*Acute cervicitis is most commonly caused by '''chlamydia or gonorrhea'''
*UTI (and asymptomatic bacteriuria) treatment in pregnancy: get a urine culture; treat with '''Fosfomycin (single dose), Augmentin (5-7 days), Cephalexin or Cefpodoxime (5-7 days)'''; Test for cure one week after completion of antibiotics.
*First line treatment of PCOS is weight loss.
*Ovarian Hyperstimulation Syndrome causes '''hemoconcentration, nausea, vomiting, bilaterally enlarged ovaries with multiple large follicles, rapid weight gain, and ascites'''.
*PPROM increases the risk of '''umbilical cord prolapse'''
{| class="wikitable"
{| class="wikitable"
| Turner (45 X,O) || Low || Low || High || High || '''HI'''gh
| Turner (45 X,O) || Low || Low || High || High || '''HI'''gh
|-
|-
| Edward (trisomy 18) || Low || High || High || Low || HE is low
| Edward (trisomy 18) || High || Low || Low || High || '''HE''' is low
|-
|-
| Patau (trisomy 13) || High || Low || Low || Low || AF'''P'''atau is High
| Patau (trisomy 13) || High || Low || Low || Low || AF'''P'''atau is High
|}
|}
=Abnormal Labor=
*1st stage (painful contractions leading to cervical dilation)
** Latent Phase (0-6 cm dilation): Protraction of latent phase is defined as greater than '''14 hours (multip) or 20 hours (nullip) without change in dilation'''.
** Active Phase (6-10 cm dilation): '''Protraction of active phase''' is defined as ≤1 cm dilation in 2 hr; manage with Pitocin. '''Arrest''' is defined as no change in 4 hours (with adequate contractions) or 6 hours (without adequate contractions); management includes placing an IUPC catheter to determine if contractions are adequate, if yes: C-section, if no: AROM or Pitocin.
*2nd stage (active pushing)
** Arrest is defined as no change in fetal station in 1-3 hrs (depending on parity and use of neuraxial anesthesia); management is to reduce epidural rate, give Pitocin, consider C-section or forceps delivery.
*3rd stage (delivery of the placenta)