High-risk pregnancies — Flashcards

Flashcard 621: Among the three outcomes of subsequent pregnancies after C-section, the best outcome is _____, while the worst outcome is _____

Answer: VBAC

Extra: Maternal and neonatal morbidity ranking: Successful VBAC < Planned Repeat Cesarean < Failed Trial of Labor (Emergency Cesarean).

Flashcard 622: _____ fetal growth restriction begins in the first trimester and is typically caused by chromosomal abnormalities or intrauterine infection (TORCH)

Answer: Symmetric

Flashcard 623: Insulin resistance in PCOS is managed with _____

Answer: metformin

Flashcard 624: Newly detectable β-hCG levels within 6 months following suction curettage for a hydatidiform mole is diagnostic for _____

Answer: gestational trophoblastic disease (e.g. choriocarcinoma)

Flashcard 625: What is the most common etiology of spontaneous abortion (SAB)? _____

Answer: Fetal chromosomal abnormalities (~60%)

Flashcard 626: A(n) _____ fetal fibronectin test prior to term is an indicator of high risk for preterm delivery

Answer: positive

Flashcard 627: - Antiphospholipid syndrome is managed with _____ - Antiphospholipid syndrome and pregnancy is managed with _____

Answer: warfarin

Extra: Warfarin is teratogenic (warfarin embryopathy) and is contraindicated in pregnancy. Low-molecular-weight heparin (LMWH) and low-dose aspirin are used in pregnant patients with antiphospholipid syndrome to reduce the risk of recurrent pregnancy loss and other obstetric complications.

Flashcard 628: Gestational diabetes results from an inability to compensate for the increased _____ secondary to elevated levels of _____ during pregnancy.

Answer: insulin resistance

Extra: Pregnancy is a state of physiological insulin resistance, primarily mediated by human placental lactogen (hPL). In response, the maternal pancreas normally undergoes β-cell hyperplasia. Gestational diabetes (GDM) occurs when this compensatory response is insufficient to maintain euglycemia.

Flashcard 629: What causes RUQ pain in HELLP syndrome? _____

Answer: Distension of the hepatic (Glisson's) capsule

Flashcard 630: What is an example of a "markedly elevated β-hCG level" in the context of a hydatiform mole? _____

Answer: >100,000 IU/L