ABPS Family Medicine Obstetrics flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Preeclampsia severe features

Blood pressure ≥160/110 mmHg, platelets <100,000, liver enzymes >2x normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Fetal growth restriction

Estimated fetal weight below the 10th percentile for gestational age, often due to placental insufficiency; monitor with Doppler and antenatal testing.

Short cervix treatment

Vaginal progesterone 200 mg nightly reduces preterm birth risk in singleton pregnancies with cervical length <25 mm at 16–24 weeks.

Magnesium sulfate neuroprotection

Given for anticipated preterm birth <32 weeks; 4 g IV load then 1 g/h until delivery reduces risk of cerebral palsy.

RhD immune globulin

300 mcg anti-D at 28 weeks and within 72 hours postpartum if infant RhD-positive; prevents alloimmunization in Rh-negative unsensitized mothers.

First-trimester combined screening

Nuchal translucency, free β-hCG, and PAPP-A at 11–14 weeks; detects about 85–90% of trisomy 21 at 5% false-positive rate.

Cell-free DNA screening

Maternal blood test from 10 weeks; high sensitivity for trisomy 21 (>99%) but not diagnostic; positive results require diagnostic testing.

Gestational diabetes screening

50-g glucose challenge at 24–28 weeks; if ≥130–140 mg/dL, follow with 100-g 3-hour OGTT using Carpenter-Coustan or NDDG criteria.

Group B Streptococcus screening

Vaginal-rectal swab at 36 0/7–37 6/7 weeks; positive women receive intrapartum penicillin or ampicillin prophylaxis.

Folic acid supplementation

400 mcg daily for average risk; 4 mg daily starting ≥1 month before conception for women with prior neural tube defect.

Active phase arrest

Cervical dilation ≥6 cm with ruptured membranes and no change for ≥4 hours of adequate contractions or ≥6 hours if inadequate.

Category III fetal heart rate

Absent variability with recurrent late or variable decelerations, bradycardia, or sinusoidal pattern; requires immediate evaluation and possible delivery.

Tachysystole

More than 5 contractions in 10 minutes averaged over 30 minutes; manage by reducing oxytocin, repositioning, IV fluids, and tocolysis if needed.

Shoulder dystocia maneuvers

McRoberts maneuver, suprapubic pressure, internal rotation, posterior arm delivery; avoid fundal pressure and excessive traction.

Postpartum hemorrhage definition

Cumulative blood loss ≥1000 mL or bleeding with signs of hypovolemia within 24 hours after birth; uterine atony is the most common cause.

Postpartum endometritis

Fever ≥38°C on at least two of the first 10 days postpartum with uterine tenderness and foul lochia; treat with clindamycin plus gentamicin.

Lactogenesis stage II

Copious milk production begins around 2–5 days postpartum, triggered by progesterone withdrawal and prolactin rise.

Breastfeeding contraindications

Infant galactosemia, maternal HIV (in resource-rich settings), active untreated TB, certain drugs, and active herpes lesions on the breast.

Postpartum depression screening

Edinburgh Postnatal Depression Scale at 4–6 weeks postpartum; score ≥10 suggests possible depression and warrants further evaluation.

VBAC criteria

One prior low-transverse cesarean, no contraindication, and immediate availability of anesthesia and staff for emergency cesarean; success rate 60–80%.

External cephalic version

Attempted at ≥36 weeks for breech presentation; contraindicated with placenta previa, multiple gestation, ruptured membranes, or nonreassuring fetal status.

Cervical ripening agents

Prostaglandins (misoprostol, dinoprostone) or mechanical Foley balloon; avoid misoprostol with prior cesarean due to uterine rupture risk.

Pregestational diabetes target

HbA1c <6.5% before conception to reduce congenital malformation risk; poor control increases cardiac and neural tube defects.

Asthma in pregnancy

Exacerbations are common; continue controller medications because uncontrolled asthma poses greater fetal risk than medications.

Venous thromboembolism in pregnancy

Pregnancy is hypercoagulable; low-molecular-weight heparin is preferred anticoagulant; warfarin is contraindicated due to teratogenicity.

Preeclampsia seizure prophylaxis

Magnesium sulfate 4–6 g IV load then 1–2 g/h; antihypertensives (labetalol, hydralazine, nifedipine) for BP ≥160/110 mmHg.

Umbilical cord prolapse management

Call for help, elevate presenting part, knee-chest or Trendelenburg position, fill bladder, and proceed to immediate delivery.

Amniotic fluid embolism

Sudden hypoxia, hypotension, and coagulopathy during labor or postpartum; supportive care, CPR, and massive transfusion protocol.

Tdap vaccination in pregnancy

Recommended during each pregnancy at 27–36 weeks to maximize maternal antibody transfer to the infant.

HIV in pregnancy

Universal screening; antiretroviral therapy reduces vertical transmission to <1%; avoid breastfeeding if safe alternatives exist.

Warfarin embryopathy

Nasal hypoplasia and stippled epiphyses; risk highest at 6–9 weeks; use heparin instead during pregnancy.

Informed consent

Patient must be informed of risks, benefits, and alternatives, have capacity, and document the discussion; right to refuse treatment including cesarean.