CAQ-OBGYN key terms

New-onset hypertension after 20 weeks' gestation accompanied by signs of organ injury such as platelets below 100,000, transaminases over twice normal, creatinine above 1.1 mg/dL, pulmonary edema, visual or cerebral symptoms, or blood pressure of 160/110 or higher.

A pregnancy complication defined by Hemolysis, Elevated Liver enzymes, and Low Platelets, often occurring with preeclampsia; it can present with right upper quadrant pain, nausea, and malaise, and risks maternal hepatic rupture and placental abruption.

The occurrence of generalized tonic-clonic seizures in a pregnant or postpartum patient with preeclampsia, unexplained by other causes; management centers on magnesium sulfate, blood pressure control, and timely delivery after maternal stabilization.

Intravenous magnesium given to prevent or treat eclamptic seizures in preeclampsia with severe features; toxicity is monitored by deep tendon reflexes, respiratory rate, and urine output, with calcium gluconate as the antidote.

Premature separation of a normally implanted placenta before delivery, causing painful vaginal bleeding, uterine tenderness, hypertonic contractions, and fetal distress; concealed hemorrhage may occur, and consumptive coagulopathy is a complication.

Implantation of the placenta over or very near the internal cervical os, producing painless third-trimester vaginal bleeding; digital vaginal examination is avoided, and delivery is usually by cesarean when the placenta remains over the os.

Fetal blood vessels running through the membranes over the cervix, unprotected by cord or placental tissue; rupture causes rapid fetal exsanguination, so prenatal diagnosis by ultrasound prompts planned cesarean delivery before labor.

Cumulative blood loss of at least 1,000 mL or bleeding with hemodynamic instability within 24 hours of birth; uterine atony is the most common cause, followed by genital tract trauma, retained tissue, and coagulopathy.

Failure of the myometrium to contract and retract after delivery, the leading cause of postpartum hemorrhage; risk factors include prolonged labor, overdistention, high parity, and chorioamnionitis, and treatment begins with uterine massage and uterotonics.

Failure to deliver the fetal shoulders after the head with routine gentle traction, requiring maneuvers such as McRoberts positioning and suprapubic pressure; risks include brachial plexus injury and neonatal hypoxic injury.

A cervical assessment scoring dilation, effacement, consistency, position, and fetal station to predict the likelihood of successful labor induction; higher scores indicate a more favorable cervix and greater chance of vaginal delivery.

Softening and shortening of the cervix before labor, achieved physiologically by prostaglandins and collagen remodeling; clinically induced with prostaglandin agents or mechanical dilators when the Bishop score is unfavorable.

Stimulation of uterine contractions to achieve delivery before spontaneous labor begins, performed for maternal or fetal indications such as post-term gestation, hypertensive disease, or ruptured membranes; success depends heavily on cervical favorability.

Intrapartum intravenous penicillin or ampicillin given to carriers of group B streptococcus to prevent early-onset neonatal sepsis; candidates are identified by antepartum culture or by risk factors such as preterm labor or prolonged membrane rupture.

Intra-amniotic infection producing maternal fever, uterine tenderness, fetal tachycardia, and purulent fluid; treatment is broad-spectrum antibiotics plus delivery, and it raises the risk of uterine atony and neonatal sepsis.

Stretching injury to the nerves supplying the arm, usually from shoulder dystocia or lateral traction at delivery; most resolve spontaneously, but persistent weakness requires pediatric and orthopedic evaluation.

Preinvasive squamous or glandular dysplasia of the cervix graded by the extent of epithelial involvement; high-grade lesions are managed by excision or ablation, while low-grade lesions are often observed because many regress.

Magnified examination of the cervix, vagina, and vulva after application of acetic acid and iodine to identify abnormal epithelium and guide biopsy; it is used to evaluate abnormal cervical cancer screening results.

Removal of the cervical transformation zone with a thin wire loop carrying electrical current, used to treat high-grade dysplasia and to obtain a specimen for histologic diagnosis; it can cause bleeding and cervical stenosis.

Prophylactic immunization against high-risk human papillomavirus types that cause cervical and other anogenital cancers; it is recommended in early adolescence and does not replace routine cervical cancer screening later in life.

A cervical cytology result showing squamous changes that do not clearly meet criteria for a dysplasia; management depends on HPV testing, with positive results triaged to colposcopy and negative results to repeat screening.

Malignancy arising from the uterine lining, usually presenting with postmenopausal bleeding; most cases are estrogen-driven and low grade, while serous and clear cell types are more aggressive and carry a worse prognosis.

Any vaginal bleeding after menopause, which requires evaluation because a substantial minority of cases prove to be endometrial cancer; transvaginal ultrasound and endometrial sampling are the standard initial steps.

Sampling of the uterine lining with a small suction catheter to diagnose hyperplasia, malignancy, or hormonal abnormality; it is the first-line tissue test for abnormal uterine bleeding in older or high-risk patients.

Malignancy of the ovary, most often epithelial and presenting at an advanced stage with bloating, pelvic pain, and ascites; treatment combines surgical cytoreduction with platinum-based chemotherapy.

A serum antigen elevated in many epithelial ovarian cancers but also in endometriosis, fibroids, and pregnancy; it is useful for monitoring treatment response rather than as a stand-alone screening test.

An enlargement of the ovary or fallopian tube detected by examination or imaging; risk assessment uses size, complexity, and markers such as CA-125 to decide between observation and surgical removal.

A spectrum of tumors from placental tissue, including hydatidiform mole and choriocarcinoma, marked by very high human chorionic gonadotropin levels; treatment ranges from uterine evacuation to chemotherapy.

A common endocrine disorder diagnosed by irregular ovulation, elevated androgens, or polycystic ovarian morphology; it causes infertility and menstrual dysfunction and is associated with insulin resistance and endometrial hyperplasia.

Use of medications such as clomiphene or letrozole, or gonadotropins, to restore regular ovulation in anovulatory infertility; therapy requires monitoring because multiple gestation and ovarian hyperstimulation can result.

An iatrogenic complication of ovulation induction or in vitro fertilization marked by ovarian enlargement, capillary leak, ascites, and hemoconcentration; severe cases require fluid management and sometimes paracentesis.

Fertilization of oocytes outside the body after controlled ovarian stimulation and egg retrieval, with transfer of resulting embryos into the uterus; it is used for tubal disease, severe male factor, and other refractory infertility.

Loss of ovarian function before age 40, producing amenorrhea, elevated gonadotropins, and low estrogen; it carries risks of osteoporosis and cardiovascular disease and usually requires hormone therapy and fertility counseling.

The permanent cessation of menstruation after loss of ovarian follicular activity, diagnosed retrospectively after 12 months of amenorrhea; vasomotor symptoms and genitourinary changes are common and may warrant hormone therapy.

Presence of endometrial-like tissue outside the uterus, causing cyclic pelvic pain, dyspareunia, and infertility; diagnosis is often clinical, and treatment includes hormonal suppression, analgesia, or surgical excision.

Invasion of endometrial tissue into the myometrium, producing a bulky, tender uterus with heavy painful periods; it is diagnosed by imaging or after hysterectomy and treated with hormonal therapy or surgery.

A benign smooth muscle tumor of the uterus, often causing heavy bleeding, bulk symptoms, and infertility depending on location; management includes observation, hormonal therapy, myomectomy, or hysterectomy.

Implantation of a fertilized ovum outside the uterine cavity, most often in the fallopian tube; it presents with pain and bleeding and is managed with methotrexate or surgery depending on stability and size.

Twisting of the ovary and its vascular pedicle, causing acute severe unilateral pelvic pain with nausea; it is a surgical emergency because delayed detorsion leads to loss of ovarian function.

Persistent placental or fetal tissue in the uterus after delivery or abortion, causing bleeding, cramping, and infection; diagnosis is by ultrasound and treatment is uterine evacuation with or without antibiotics.