Some ABC’s of OB Notes
Posted by Laura on March 28, 2010
Avoid morphine for woman with asthma who is in labor.
Malignant melanoma: the only cancer that crosses the placenta to the fetus.
Cycle of Violence
Phase 1—building: increased tension, anger, blaming, and arguing
Phase 2—battering: hitting, slapping, kicking, choking, use of objects or weapons; sexual abuse; verbal threats and abuse
Phase 3—calm state (may decrease over time): batterer may deny violence, state he was drunk, say he’s sorry, and “promise it will never happen again,” returns to phase 1.
Fetal Maturity— Assessment
Phosphatidyl glycerol is more accurate indicator of fetal lung maturity in women who are diabetic.
Gestational Diabetes—Assessment the 3 P’s
Heart rate is the most sensitive and reliable indicator of impending heart failure.
Elevated Liver (enzymes)
Hypoglycemia: ≤ 40 mg/dL
Hypoglycemia can lead to maternal mortality.
Hydatidiform Mole or GTD
Complete H. mole: only condition that can lead to maternal cancer.
Systolic: 30+ mm Hg above baseline
Diastolic: 15+ mm Hg above baseline
• Vaginitis: avoid douching during pregnancy.
• STDs in the U.S.: highest prevalence among teens.
• AIDS in the U.S.: fourth leading cause of death among women of reproductive age.
Insulin Requirements in Pregnancy
Trimester one: ↓
Trimester two: ↑
Trimester three: ↑
Vaginal examinations contraindicated with undiagnosed vaginal bleeding.
• Proteinuria differentiates pre-eclampsia from other pregnancy-induced hypertension (PIH) states.
• Pre-eclampsia is a disorder of hypovolemia.
• Home care may eliminate the need for hospitalization
RHoGAM—Give RhoGAM to:
1. RhoGam is given to Rh- mother who gives birth to Rh+ neonate.
2. Rh- mother after spontaneous or induced abortion (> 8 wk).
3. Rh- mother after amniocentesis or chorionic villous sampling (CVS).
4. Rh- mother between 28 and 32 wk gestation.
RhoGAM and Rubella Titer
Since RhoGAM is an immune globulin, rubella vaccination, given at about the same time, may not “take”; rubella titer needs to be redone at 3 mo.
Other (hepatitis A virus [HAV], hepatitis B virus [HBV], group B streptococcus [GBS])
Herpes type 2
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