-
levels of beta hug, inhibit, maternal afp, estriol in Downs
Edwards
- down- bhcg and inhibit are high
- Edwards-everthins is down
-
x-linked disorder
- bruton
- wiskott aldrich
- fabrys
- GSPD
- Ocular albinism
- Leech nan
- Duchess and becker muscular dystrophy
- Hunter syndrome
- Hemophilia
- Ornithine transcarbamylase deficiency
-
when is testing done for gestational diabetes
- 24-28 week gestation with 1hr 50 gram
- confirmed with 3 hr 100 gram
-
when is triple marker screen done
15-20 weeks
-
how many measurement of 3 hr glucose loading test must be abnormal to diagnose gestational diabetes
- 2
- if only 1 then it is impaired glucose tolerance
-
when is rhodam given
- 28 weeks
- 72 hrs within delivery with major trauma or bleeding
-
initial management of third trimester bleeding
- vitals
- iv fluids
- external fetal monitor
- get abc
- dic work up- coats, d-dimer, fibrinogen,
- type and screen
- ultrasound
-
further steps in management of 3rd trimester bleed
- transfuse
- foley
- vaginal exam
- deliver if >36 weeks
-
high maternal afp is seen in
next step after its elevated
- NTD
- amnio for amniotic fluid alpha feto protein + acetylcholinesterase
-
low msafp, next step
karyotype
-
+ GBS, next step
intrapartum abs
-
how many weeks u measure GBS
35-37 weeks
-
painful 3rd trimester bleeding with hx of HTN or trauma
abruptio placenta
-
complication of abrupt placenta
DIC
-
painless 3rd trimester bleeding
placenta prevue- complete, partial, marginal
-
placenta accrete, intreat, percreta how are they different
- accrete- penetrates endometrium
- intreat- penetrates into the myometrium
- Percreta- penetrates the myometrium and reaches serosa
-
how does placenta accrete occur
Implantation occurs over old uterine scar
-
rx for placenta accreta
c-section hysterectomy
-
rx for vasa prevue
emergency c-section
-
rupture of membranes
painless vaginal bleeding
bradycardia
vasa previa
-
loss of electronic fetal heart rate, uterine contractions, recession of fetal head with hx of uterine scar
uterine rupture
-
rx for vasa prevue and uterine rupture
immediate delivery
-
problem with vasa previa
umbilical cord crosses placental membrane
-
risk factor for uterine rupture
previous classic uterine incision
-
when are abs for gbs indicated
- previous pregnancy with sepsis
- ROM>18 hours
- preterm delivery
- maternal fever
-
when are abs not indicated for GBS
- planned c section without ROM even if Culture +
- culture + on previous pregnancy but not currently
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