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Contraction Stress Test
The contraction stress test is interpreted by the presence or absence of late fetal heart rate decelerations. Negative: No late or significant variable decelerations. Positive: Late decelerations following 50 percent or more of contractions (even if th...
Biophysical Profile
Scoring: The non stress test (2), fetal breathing movement (2), Fetal tone (2), Fetal movement (2), amiotic fluid (2) Eight to ten is usually considered normal. Six is considered equivocal (uncertain). Four or less is considered abnormal. To ge...
Fetal Heart Rate Monitoring
BASELINE FHR The normal FHR range is between 120 and 160 beats per minute (bpm). The baseline rate is interpreted as changed if the alteration persists for more than 15 minutes. FHR VARIABILITY Prematurity decreases variability therefore, there is little ra...
Laboratory Values in Pregnancy
Lab values in Pregnancy
Bishop Score
The Bishop score may be used to rate the readiness of the cervix for labor. Scores ≤ 5 suggest an unfavorable cervix, and that induction may be necessary for successful vaginal delivery. Scores 6-7 do not definitively predict whether or not induction will b...
Recurrent Pregnancy Loss
Definition 3 or more consecutive preg losses before 20wk gest or after 2 consecutive losses, esp if age >35 y.o Evaluation Determine actual gestational age at time of miscarriage rather than time of onset sx Ask about hx of thrombosis or prev fetal death, ...
Hyperemesis Gravidarum
Definition Nausea and vomiting in pregnancy that significant enough to cause dehydration, metabolic alkalosis, ketonuria, weight loss (>5%), hypokalemia Risk Factors Multi gestation, Family history or personal hx in prior pregnancy Labs CBC, lytes, UA, TS...
Hypertension in Pregnancy
Definition Chronic HTN: SBP greater equal to 140 or DBP greater equal to 90 prior to 20 weeks or persisting longer than 12w post partum Gestational HTN: SBP greater equal to 140 or DBP greater equal to 90 after 20 weeks with or without proteinuria Pre-eclam...
Vaginal birth after Cesarean
Appropriate candidates Hx 1-2 C-section via low transverse hysterotomy. Inappropriate candidates Previous classical or T-incision, prior uterine rupture, extensive transfundal uterine surgery (ex: myomectomy), and patient with any contraindication to vagin...
Post Dates Management
Review gestational dating AFI/BPP and NST at 41 weeks and repeat once to twice a week Consider membrane stripping at 39 weeks Consider induction at 41 weeks and cervical ripening agents
Gestational Diabetes
Universal screening start at 24-248 weeks. Consider screening earlier in all women with BMI >25 and one or more risk factors: Physical inactivity 1st degree relative with DM High-risk ethnicity (AA, Latino, NA, Asian, Pacific Islander) Previous GDM or pre...
Twins
At risk for hyperemesis, GDM, HTN, hemorrhage, cesaeran, postpartum depression, preeclampsia, preterm delivery, IUGR, birth/genetic defects Pre-term labor education Fetal kick count starting at 28 weeks (10 kicks/movement within 2hrs or less) NST weekly sta...
ER precautions in Term Pregnancy
Regular painful contraction every 5 minutes (nulliparous) or every 10 minutes (multiparous), or sooner if long distance to hospital or history of precipitous delivery Rupture of membrane Vaginal bleeding No or decreased fetal movement (<10 kicks in 2hrs)
Medication in Obstetrics
Minimize all medication use during pregnancy (especially in 1st TM), unless clearly indicated! FDA pregnancy categories A: No risk in controlled human studies B: No risk in controlled animal studies and no risk seen in humans C: Small risk in controlled an...
Developmental Milestones
Newborn Social Language and Self-help: Has periods of wakefulness; looks at parent's eyes when being held Calms when picked up Verbal Language: Communicates discomfort through crying and behaviors such as facial expressions, body movements Moves or calms...
Pre-Training Questionnaire
ACEs Pre-Questionairre Position: Staff Attending MA PGY-1 PGY-2 PGY-3 Have you started/completed the ACE’s Aware training? Yes No What does ACE’s stand for in the medical field? Angiotensin-Conver...
Post Training Questionnaire
ACEs Post-Questionairre What does ACE’s stand for in the medical field? Angiotensin-Converting Enzyme Adult Continuing Education Adverse Childhood Experiences Abstinence Commitment Effect Advocates for Children's Education ...
Pre-Training Data
What does ACE’s stand for in the medical field? ANSWER CHOICES RESPONSES a. Angiotensin-Converting Enzyme 8.11% 3 b. Adult Continuing Education 2.70% 1 c. Adverse Childhood Experiences 83.78% 31 d....
Post Training Questionairre Data
To interpret the data below, please see the numbered questions below corresponding to Q1...Q10. The answers have been truncated to fit onto the table. Please see the preceding Post Training Questionairre for the full responses as well as the answers (bolded). ...
ACEs Aware PowerPoint
https://docs.google.com/presentation/d/13Op55PKSH0PH8cTiWY1G1UnZ7vNlOdJl/edit?usp=sharing&ouid=101540590564494398620&rtpof=true&sd=true