OMSB Obstetrics and Gynecology (OEOG) flashcards

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

Naegele rule

Estimated due date is calculated as the first day of the last menstrual period plus 280 days, or LMP minus 3 months plus 7 days. Ultrasound dating supersedes LMP when discrepancy is significant.

Postpartum hemorrhage definition

Cumulative blood loss of 1000 mL or more, or any blood loss accompanied by signs of hemodynamic instability, within 24 hours of birth. Uterine atony is the most common cause.

Magnesium sulfate toxicity signs

Loss of deep tendon reflexes, respiratory depression, and oliguria signal magnesium toxicity. Calcium gluconate is the antidote, and serum levels are monitored when renal function is impaired.

Preeclampsia severe features

Blood pressure of 160/110 mmHg or higher, platelets under 100,000, transaminases twice normal, creatinine above 1.1 mg/dL, pulmonary edema, or persistent cerebral or visual symptoms.

Antenatal corticosteroids

Betamethasone 12 mg intramuscularly twice 24 hours apart, or dexamethasone 6 mg four times 12 hours apart, given between 24 and 34 weeks to reduce neonatal respiratory distress and mortality.

Shoulder dystocia maneuvers

Sequence begins with calling for help and McRoberts maneuver, then suprapubic pressure, then internal rotation such as the Rubin maneuver. The HELPERR mnemonic organizes the escalating steps.

GBS prophylaxis antibiotic

Intrapartum penicillin G is first-line for group B streptococcus prophylaxis. Cefazolin is used for penicillin allergy without anaphylaxis, and clindamycin only after confirmed susceptibility testing.

PALM-COEIN classification

System for abnormal uterine bleeding: structural causes are polyp, adenomyosis, leiomyoma, malignancy; nonstructural are coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified.

Postmenopausal bleeding evaluation

Any bleeding after menopause requires evaluation. Endometrial thickness of 4 mm or less on transvaginal ultrasound has high negative predictive value, but tissue biopsy remains definitive.

Amsel criteria

Diagnosis of bacterial vaginosis requires three of four: homogeneous discharge, vaginal pH above 4.5, positive whiff test, and clue cells on microscopy.

Emergency contraception options

Copper IUD is most effective and can be placed up to 5 days after intercourse. Levonorgestrel is used within 72 hours, ulipristal acetate within 120 hours.

Ectopic pregnancy discriminatory zone

Beta-hCG level above which a normal intrauterine gestational sac should be visible on transvaginal ultrasound, typically 1500 to 3500 mIU/mL. Absence of a sac warrants close follow-up.

Endometriosis diagnosis

Laparoscopy with visualization and histologic confirmation is the gold standard. GnRH agonists and progestins provide symptom control by suppressing estrogen, but they do not eradicate disease.

Endometrial cancer type I

Endometrioid adenocarcinoma that is estrogen-driven and associated with obesity, diabetes, hypertension, and unopposed estrogen exposure. It generally carries a favorable prognosis.

BRCA risk-reducing surgery

Risk-reducing salpingo-oophorectomy is recommended for BRCA1 carriers by age 35 to 40 and BRCA2 carriers by age 40 to 45, after childbearing is complete.

Ovarian cancer CA-125

CA-125 is useful for monitoring treatment response and detecting recurrence, but it lacks sensitivity and specificity for population screening. It can be elevated by many benign conditions.

Gestational trophoblastic neoplasia treatment

Low-risk disease is treated with single-agent methotrexate or actinomycin D. High-risk disease with a WHO score of 7 or more receives multiagent EMA-CO chemotherapy.

Sentinel node biopsy vulvar cancer

Appropriate for unifocal vulvar squamous cell carcinoma 4 cm or smaller with clinically negative groin nodes. It reduces the morbidity of full inguinofemoral lymphadenectomy.

Cell-free DNA screening

Maternal blood test analyzing placental DNA for trisomy 21, 18, and 13. It has the highest detection rate among screening tests but is not diagnostic; invasive testing confirms positive results.

RhD immune globulin timing

Anti-D immune globulin is given at 28 weeks gestation and within 72 hours of delivery of an RhD-positive infant, plus after amniocentesis, miscarriage, ectopic pregnancy, or abdominal trauma.

Category III fetal heart tracing

Absent baseline variability with recurrent late or variable decelerations, bradycardia, or a sinusoidal pattern. It indicates abnormal fetal status and prompts immediate evaluation or delivery.

Oligohydramnios definition

Amniotic fluid index of 5 cm or less, or deepest vertical pocket under 2 cm. It is associated with fetal renal anomalies, placental insufficiency, and prolonged membrane rupture.

Twin-twin transfusion syndrome

Monochorionic twin pregnancy with oligohydramnios in one sac and polyhydramnios in the other due to unbalanced placental vascular anastomoses. Fetoscopic laser ablation is definitive treatment.

Gestational diabetes diagnostic thresholds

On 75 g oral glucose tolerance test: fasting 92 mg/dL or higher, 1-hour 180 mg/dL or higher, or 2-hour 153 mg/dL or higher. A single abnormal value establishes the diagnosis.

Infertility evaluation timing

Evaluation begins after 12 months of regular unprotected intercourse. It starts at 6 months when the woman is 35 or older, and immediately with oligomenorrhea or known reproductive pathology.

Rotterdam PCOS criteria

Diagnosis requires two of three: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound with 12 or more follicles or ovarian volume above 10 mL.

Letrozole versus clomiphene

Letrozole, an aromatase inhibitor, produces higher live birth rates than clomiphene citrate in women with polycystic ovary syndrome and is increasingly used as first-line ovulation induction.

Ovarian hyperstimulation syndrome

Complication of controlled ovarian stimulation peaking 5 to 9 days after hCG trigger. Features include ovarian enlargement, ascites, hemoconcentration, and oliguria; severe cases need hospitalization.

Primary ovarian insufficiency

Loss of ovarian function before age 40, confirmed by FSH above 40 mIU/mL on two occasions 4 weeks apart. Estrogen replacement is required for bone and cardiovascular health.

POP-Q stage II

Pelvic organ prolapse quantification stage in which the leading point descends between 1 cm above and 1 cm below the hymenal remnant. Stage III extends beyond the hymen.

Midurethral sling

Synthetic mesh tape placed under the midurethra to treat stress urinary incontinence. It is the most commonly performed anti-incontinence surgery; risks include mesh erosion and de novo urgency.

Urodynamic stress incontinence

Involuntary leakage of urine during filling cystometry when intra-abdominal pressure rises, in the absence of a detrusor contraction. It confirms the diagnosis before surgical correction.