AOBOG OB-GYN cheat sheet

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.

Estimated blood loss at vaginal delivery averages ~500 mL; cesarean delivery ~1000 mL; postpartum hemorrhage is defined as ≥1000 mL or blood loss with signs of hypovolemia within 24 h of birth.

Magnesium sulfate for eclampsia prophylaxis: 4–6 g IV loading dose over 15–20 min, then 1–2 g/h infusion; monitor deep tendon reflexes, respiratory rate ≥12/min, and urine output ≥30 mL/h; antidote is calcium gluconate 1 g IV.

Gestational hypertension is BP ≥140/90 mmHg arising after 20 weeks without proteinuria; preeclampsia adds proteinuria ≥300 mg/24 h or end-organ dysfunction; severe features include BP ≥160/110, platelets <100,000, AST/ALT >2× normal, creatinine >1.1 mg/dL, pulmonary edema, or new cerebral/visual symptoms.

Antepartum fetal surveillance: contraction stress test is positive (abnormal) when late decelerations accompany ≥50% of contractions; biophysical profile scores 0–10 with 8–10 reassuring and ≤4 prompting delivery evaluation.

First-stage labor arrest: cervical dilation ≥6 cm with ruptured membranes and no dilation change for ≥4 h of adequate contractions (or ≥6 h with inadequate contractions); second stage arrest is no descent after ≥3 h nulliparous or ≥2 h multiparous with epidural.

Rhesus D immune globulin 300 µg (1500 IU) is given at 28 weeks and within 72 h postpartum to unsensitized RhD-negative women with an RhD-positive or unknown infant; dose is increased for large fetomaternal hemorrhage.

Shoulder dystocia maneuvers in sequence: McRoberts positioning with suprapubic pressure, then internal rotation (Rubin II, Woods screw), delivery of posterior arm, and all-fours; avoid fundal pressure.

Gestational diabetes screening: 50-g glucose challenge at 24–28 weeks with a 1-h threshold of 130–140 mg/dL, followed by a 100-g 3-h OGTT requiring two or more elevated values for diagnosis.

Cervical cancer screening: begin at age 21 with cytology every 3 years; from age 30, co-testing (cytology plus HPV) every 5 years or cytology every 3 years is acceptable; screening may stop at age 65 after adequate prior negative results.

Endometrial cancer is the most common gynecologic malignancy; postmenopausal bleeding warrants transvaginal ultrasound (endometrial thickness >4 mm abnormal) and endometrial biopsy.

Ovarian cancer risk: BRCA1 lifetime risk roughly 40–50% and BRCA2 roughly 15–25%; risk-reducing salpingo-oophorectomy is generally offered at ages 35–40 for BRCA1 and 40–45 for BRCA2 after childbearing.

Contraceptive effectiveness (typical use): implant and intrauterine devices >99%, tubal sterilization ~99%, injectable ~94%, oral pills ~91%, male condom ~87%; emergency copper IUD is the most effective postcoital method.

Abnormal uterine bleeding is classified by PALM-COEIN: structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Bacterial vaginosis: Amsel criteria require three of four - homogeneous discharge, vaginal pH >4.5, positive whiff test, and clue cells; first-line treatment is oral metronidazole 500 mg twice daily for 7 days.

Menopause is defined retrospectively after 12 months of amenorrhea; the most effective therapy for vasomotor symptoms is systemic estrogen, which is contraindicated in women with a history of breast cancer, VTE, or unexplained vaginal bleeding.

Ectopic pregnancy: a discriminatory hCG zone of 1500–3500 mIU/mL with an empty uterus on transvaginal ultrasound is suspicious; treatment with methotrexate requires hemodynamic stability, no rupture, and reliable follow-up.