Term
| Ddx of spontaneous abortion |
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Definition
Threatened abortion (bleeding before 20 weeks)
Inevitable abortion (dilated cerv os)
Complete abortion (intrauterne content expelled)
Incomplete abortion (intrauterine contents not expelled)
Missed abortion (no dilation of cervical os)
Septic abortion (infection) |
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Term
| Ddx of first trimester bleeding |
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Definition
Spontaneous abortion (cervical os dilated)
idiopathic vaginal bleeding
ectopic pregnancy (acute abdomen)
labs: serial HCG, progesterone, ultrasound
Other: molar pregnancy (placenta acts like tumor), vaginal trauma, cervical abnormalities |
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Term
| Chlamydia clinical features |
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Definition
often insidious and asymp
can lead to urethritis, cervicitis,PID, ectopic pregnancy, infertility, chronic pain.
Causes adverse outcomes if it occurs during pregnancy |
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Term
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Definition
Screen <24 years. Screen >25 years only if at high risk. Regardless of pregnancy.
Inc risk: Age, previous STIs, multiple partners, inconsistent condom use, sex work. |
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Term
| Preconception Visit checklist |
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Definition
Genetic: Folic Acid supplementation, screen ethnic and family background
Treat/immunize: HIV, syphillis, Hep B, rubella, varicella, toxoplasmosis (cats), Cytomegalovirus, parvovirusB19.
Env: smoking/alcohol
Medical assessments: Off ACEi, antiHTN, warfarin,benzos |
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Term
| Signs and Symptoms of pregnancy |
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Definition
| Amennorhea, breast tenderness, nausea, vomiting, softening of cervix, softening of uterus |
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Term
| Studies to get in initial pregnancy evaluation |
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Definition
| HCG, CBC, rubella immunity, Hep B surface antigen, Blood type (Rh), RPR syphillis, HIV status |
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Term
| First Trimester bleeding--studies |
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Definition
| CBC (mainly for Hb), Wet mount for Ghon, chlam, trich, quantitative HCG (to detect ectopic or molar pregnancy), ultrasound (can detect pregnancy when HCG levels are high) |
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Term
| How do you estimate date of delivery? |
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Definition
| Naegele's Rule (LMP+1 year-3 months+1week), ultrasound. US always replaces LMP if diff is >7 days |
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Term
| Management of inevitable abortion |
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Definition
| expectant management, surgical dilation and curettage, medical management (misoprostol) |
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