Secondary amenorrhea is defined as the absence of menses for at least _(a)_ months in a patient with a previously normal menstruation (or _(b)_ months in patients who were previously oligomenorrheic).
a. 3 months
b. 9 months
What are the components of a basic workup for amenorrhea?
1. pregnancy test
2. serum prolactin
3. FSH
4. LH
5. TSH
Define primary amenorrhea.
Failure of menarche onset by age 15 yo (in the presence of secondary characteristics) or 13 yo (in the absence of 2ry characteristics).
What are Braxton Hicks contractions?
- Braxton Hicks contractions are sporadic uterine contractions that sometimes start around six weeks into a pregnancy.
- They are not usually felt until the second trimester or third trimester of pregnancy.
What is a Nitrazine test?
- a drop of fluid obtained from the vagina onto paper strips containing Nitrazine dye.
- The strips change color depending on the pH of the fluid. The strips will turn blue if the pH is greater than 6.0. A blue strip means it's more likely the membranes have ruptured (premature rupture of membranes or PROM).
This is a premature separation of the placenta from the uterine wall.
Abruptio placentae
- most commonly occurring in the 3rd trimester.
- Classically associated with:
a) severe abdominal pain
b) painful uterine contractions
c) rigid uterus
What is the most common predisposing factor for abruptio placentae?
Maternal hypertension
What is an infection of the amniotic fluid and the membranes surrounding the fetus?
Abruptio placentae
- most commonly occurring in the 3rd trimester.
- Classically associated with:
a) severe abdominal pain
b) painful uterine contractions
c) rigid uterus
What is an infection of the amniotic fluid and the membranes surrounding the fetus?
Chorioamnionitis
- may be associated with a tender, rigid uterus and abdominal pain.
- also associated with:
fevers
maternal tachycardia
leukocytosis
confirmation of the PROM (ex. fern test: pos. indicates leakage of amniotic fluid)
What is a fern test?
Detection of a characteristic 'fern like' pattern of cervical mucus when a specimen of cervical mucus is allowed to dry on a glass slide and is viewed under a low-power microscope.
- evidence of the presence of amniotic fluid and rupture of membranes and the onset of labor.
- occurs due to the presence of sodium chloride in mucus under estrogen effect.
This condition is associated with abnormal placental implantation on or close to the cervical os.
Placenta previa
- associated with painless vaginal bleeding and a non-tender uterus.
This condition occurs when fetal blood vessels traverse over the cervical os.
Vasa previa
- it may cause painless vaginal bleed and fetal distress.