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OB/GYN
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
Discomforts of Pregnancy - First Trimester
Breast Tenderness
Supportive Bra
Nausea and Vomiting
Frequent Small Meals
Urinary Frequency and Urgency
Frequently Empty Bladder
Leukorrhea
Perineal Pad
Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
Supine Hypotension
Side-lying Position
Food Cravings
Heartburn (Pyrosis)
Constipation
Moderate Exercise
Varicose Veins
Elevate Legs
Backache
Pelvic Tilt Exercise
Considerations
Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
Shortness of Breath (SOB)
Rest Periods
Return of Urinary Frequency and Urgency
Empty Bladder Regularly
Leg Cramps
Stretching Exercises
Ankle Edema
Elevate Legs
2 mins
TORCHeS Screening
TORCHES
Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
Syphilis
Considerations
Diagnostic Testing
3 mins
Cytomegalovirus (CMV) TORCH
Signs and Symptoms
Nonspecific TORCH symptoms
Intrauterine Growth Restriction (Retardation)
Deafness
Microcephaly
Seizures
Periventricular Calcifications
Petechial Rash
Blueberry Muffin Rash
Chorioretinitis
Diagnosis
Urine Viral Culture or PCR
2 mins
Syphilis TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Often Results in Stillbirth
Hydrops Fetalis
Saber Shins
Notched Teeth
Saddle Nose
Blindness
Deafness
Hepatitis
3 mins
Rubella TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Patent Ductus Arteriosus
Pulmonary Artery Hypoplasia
Cataracts
Deafness
Blueberry Muffin Rash
Glaucoma
1 min
Toxoplasma gondii TORCH
Signs and Symptoms
Congenital TORCH Infection
Mom Usually Asymptomatic
Rarely Lymphadenopathy
Nonspecific TORCH Signs
Intrauterine Growth Retardation
Hepatosplenomegaly
Deafness
Chorioretinitis
Hydrocephalus
Diagnosis
Calcifications
1 min
Placental Implantation Abnormalities
Mechanism
Placenta Adheres Directly to Myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by Scar Tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section Delivery
Artery Ligation or Embolization
2 mins
Placenta Previa
Mechanism
Placenta Covers Cervical Os
Assessment
Painless
Bright Red Vaginal Bleeding
Interventions
Stable Fetus
Bed Rest
Observation
Unstable Fetus
C-section Delivery
Considerations
Risk for Shock
Magnesium Sulfate
Tocolysis
3 mins
Abruptio Placentae
Mechanism
Premature Separation of Placenta
Assessment
Tearing Pain
Bleeding (Often Concealed)
Rigid Uterus
Contractions
Interventions
Corticosteroids as Needed
Emergent Delivery
Considerations
Increased Risks for Neonate
Rh (Rhesus) Incompatibilities
Increased Risk for Shock
Monitor Fetal Heart Rate
3 mins
Ectopic Pregnancy
Signs and Symptoms
Lower Abdominal Pain
Delayed Menses
Abnormal Vaginal Bleeding
Shock
Referred Shoulder Pain
Cullen Sign
Considerations
Methotrexate
Surgery
RhoGAM
2 mins
Gestational Hypertension
New-Onset Hypertension
> 20 Weeks Gestation
Risk Factors
Nulliparity
Obesity
African American Females
> 35 years Old
Multiple Gestations
Family History of Gestational HTN (or Preeclampsia)
Complications
IUGR
Prematurity
Abruptio Placentae
Management
Fetal Monitoring
Alpha-Methyldopa
Beta-Blockers (Labetalol)
Calcium Channel Blockers
Hydralazine
4 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
1 min
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
2 mins
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
3 mins
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