High-risk pregnancies

High-risk pregnancies US Medical PG Question 1: You have been entrusted with the task of finding the causes of low birth weight in infants born in the health jurisdiction for which you are responsible. In 2017, there were 1,500 live births and, upon further inspection of the birth certificates, 108 of these children had a low birth weight (i.e. lower than 2,500 g), while 237 had mothers who smoked continuously during pregnancy. Further calculations have shown that the risk of low birth weight in smokers was 14% and in non-smokers, it was 7%, while the relative risk of low birth weight linked to cigarette smoking during pregnancy was 2%. In other words, women who smoked during pregnancy were twice as likely as those who did not smoke to deliver a low-weight infant. Using this data, you are also asked to calculate how much of the excess risk for low birth weight, in percentage terms, can be attributed to smoking. What is the attributable risk percentage for smoking leading to low birth weight?

• A. 40%
• B. 30%
• C. 20%
• D. 10%
• E. 50% (Correct Answer)

High-risk pregnancies Explanation: ***50%*** - This value is calculated using the formula for **attributable risk percent (ARP)** in the exposed group: ARP = ((Risk in exposed - Risk in unexposed) / Risk in exposed) × 100. - Given that the risk of low birth weight in smokers (exposed) is 14% and in non-smokers (unexposed) is 7%, the calculation is ((0.14 - 0.07) / 0.14) × 100 = (0.07 / 0.14) × 100 = **0.50 × 100 = 50%**. *40%* - This percentage does not align with the provided risk values for low birth weight in smokers (14%) and non-smokers (7%). - A calculation of ((0.14 - 0.07) / 0.14) * 100 does not yield 40%. *30%* - This value is incorrect, as it would suggest a smaller difference in risk between the exposed and unexposed groups relative to the risk in the exposed group than what is presented in the problem. - The calculated attributable risk percent is higher than 30%. *20%* - This option is significantly lower than the true attributable risk percent derived from the given risk figures. - It would imply a much weaker association between smoking and low birth weight in terms of excess risk than what is calculated. *10%* - This value is substantially different from the correct calculation and would suggest a very minor attributable risk. - The attributable risk percent for smoking leading to low birth weight is much higher than 10% based on the provided data.

High-risk pregnancies US Medical PG Question 2: A 26-year-old woman, gravida 2, para 1, at 28 weeks' gestation comes to the physician for a prenatal visit. She feels well. Pregnancy and delivery of her first child were uncomplicated. Her temperature is 37.2°C (99°F) and blood pressure is 163/105 mm Hg. Her blood pressure 10 weeks ago was 128/84 mm Hg. At her last visit two weeks ago, her blood pressure was 142/92 mm Hg. Pelvic examination shows a uterus consistent in size with a 28-week gestation. A complete blood count and serum concentrations of electrolytes, creatinine, and hepatic transaminases are within the reference range. A urinalysis is within normal limits. Which of the following is the most appropriate next step in management?

• A. Oral labetalol therapy (Correct Answer)
• B. Lisinopril therapy
• C. Magnesium sulfate therapy
• D. Complete bed rest
• E. Dietary salt restriction

High-risk pregnancies Explanation: **Oral labetalol therapy** - The patient has developed **gestational hypertension** (blood pressure ≥140/90 mmHg on two occasions at least 4 hours apart after 20 weeks gestation, without proteinuria or other signs of preeclampsia), with her current BP of 163/105 mmHg confirming **severe range hypertension** (systolic ≥160 mmHg or diastolic ≥110 mmHg). - **Labetalol** is a first-line agent for managing hypertension in pregnancy due to its established safety profile and efficacy in lowering blood pressure. *Lisinopril therapy* - **Angiotensin-converting enzyme (ACE) inhibitors** like lisinopril are **contraindicated in pregnancy** as they can cause fetal renal dysfunction, oligohydramnios, and neonatal hypotension. - This medication choice would be harmful to the fetus. *Magnesium sulfate therapy* - **Magnesium sulfate** is indicated for the **prevention and treatment of seizures in preeclampsia/eclampsia**, not for blood pressure control itself. - While the patient has hypertension, there are no signs of preeclampsia (e.g., proteinuria, signs of end-organ damage), making magnesium sulfate inappropriate at this stage. *Complete bed rest* - **Complete bed rest** is no longer recommended for the management of gestational hypertension or preeclampsia, as studies have shown it does not improve maternal or fetal outcomes and can increase the risk of **thromboembolism**. - It can also negatively impact a patient's quality of life without providing therapeutic benefit. *Dietary salt restriction* - While generally recommended for hypertension outside of pregnancy, **severe salt restriction** in pregnancy is **not typically recommended** for gestational hypertension or preeclampsia, as it has not been shown to improve outcomes and could potentially worsen maternal fluid balance. - The primary management for severe range gestational hypertension involves antihypertensive medications.

High-risk pregnancies US Medical PG Question 3: A 27-year-old P1G1 who has had minimal prenatal care delivers a newborn female infant. Exam reveals a dusky child who appears to be in distress. Her neck veins are distended and you note an enlarged v wave. She has a holosystolic murmur. Following echocardiogram, immediate surgery is recommended. For which of the following conditions was the mother likely receiving treatment during pregnancy?

• A. Bipolar disorder (Correct Answer)
• B. Hypothyroidism
• C. Depression
• D. Hypertension
• E. Diabetes

High-risk pregnancies Explanation: ***Bipolar disorder*** - The newborn's symptoms, including a **holosystolic murmur**, **distended neck veins** with an **enlarged v wave**, and cyanosis, are highly suggestive of **Ebstein's anomaly**. - **Ebstein's anomaly** is a congenital heart defect strongly associated with maternal **lithium use** during pregnancy, a common treatment for bipolar disorder. *Hypothyroidism* - Maternal hypothyroidism is associated with an increased risk of miscarriage, stillbirth, and neurodevelopmental problems in the child, but not specifically with Ebstein's anomaly. - Treatment for hypothyroidism primarily involves thyroid hormone replacement, which is not linked to this specific cardiac defect. *Depression* - While various antidepressant medications can be taken during pregnancy, none are specifically linked to Ebstein's anomaly. - Maternal depression itself can impact fetal development due to stress, but not typically through this specific congenital heart defect. *Hypertension* - Maternal hypertension is associated with conditions like **pre-eclampsia**, fetal growth restriction, and preterm birth, but not specifically with Ebstein's anomaly. - Antihypertensive medications generally do not cause this specific congenital heart defect. *Diabetes* - Maternal diabetes can lead to **macrosomia**, **hypoglycemia**, and an increased risk of various congenital anomalies, including **ventricular septal defects** and **transposition of the great arteries**. - However, it is not specifically linked to Ebstein's anomaly, which is more characteristic of lithium exposure.

High-risk pregnancies US Medical PG Question 4: A 35-year-old woman, gravida 2, para 1, at 16 weeks' gestation comes to the office for a prenatal visit. She reports increased urinary frequency but otherwise feels well. Pregnancy and delivery of her first child were uncomplicated. Her vital signs are within normal limits. Pelvic examination shows a uterus consistent in size with a 16-week gestation. Urinalysis shows mild glucosuria. Laboratory studies show a non-fasting serum glucose concentration of 110 mg/dL. Which of the following is the most likely explanation for this patient's glucosuria?

• A. Decreased SGLT2 expression
• B. Increased glomerular filtration barrier permeability
• C. Decreased insulin production
• D. Decreased insulin sensitivity
• E. Increased glomerular filtration rate (Correct Answer)

High-risk pregnancies Explanation: ***Increased glomerular filtration rate*** - During pregnancy, the **glomerular filtration rate (GFR)** significantly increases, leading to a higher filtered load of glucose. - This increased load can exceed the reabsorptive capacity of the renal tubules, resulting in **glucosuria** despite normal blood glucose levels. *Decreased SGLT2 expression* - **SGLT2 inhibitors** are medications that decrease glucose reabsorption in the renal tubules, but there is no physiological decrease in SGLT2 expression during normal pregnancy that would cause glucosuria with normal blood glucose. - SGLT2 expression itself is generally not altered in a way that leads to isolated glucosuria in healthy pregnancy. *Increased glomerular filtration barrier permeability* - Increased permeability of the **glomerular filtration barrier** would primarily lead to **proteinuria**, not glucosuria. - Glucosuria implies glucose passing through the barrier normally but being uncleared by the tubules. *Decreased insulin production* - **Decreased insulin production** would lead to **hyperglycemia** in addition to glucosuria, which is not seen here as the non-fasting glucose is 110 mg/dL, well within the normal range. - The patient's blood glucose is normal, ruling out significant insulin deficiency. *Decreased insulin sensitivity* - **Decreased insulin sensitivity** (insulin resistance) is a hallmark of gestational diabetes, but it would primarily cause **hyperglycemia**, which is not present in this patient (non-fasting glucose 110 mg/dL). - While some insulin resistance occurs in pregnancy, it wouldn't cause glucosuria with normal blood glucose in the absence of other factors.

High-risk pregnancies US Medical PG Question 5: A 35-year-old G1 is brought to the emergency department because of sharp pains in her abdomen. She is at 30 weeks gestation based on ultrasound. She complains of feeling a little uneasy during the last 3 weeks of her pregnancy. She mentions that her abdomen has not been enlarging as expected and her baby is not moving as much as during the earlier part of the pregnancy. If anything, she noticed her abdomen has decreased in size. While she is giving her history, the emergency medicine physician notices that she is restless and is sweating profusely. An ultrasound is performed and her blood is sent for type and match. The blood pressure is 90/60 mm Hg, the pulse is 120/min, and the respiratory rate is 18/min. The fetal ultrasound is significant for no fetal heart motion or fetal movement. Her blood work shows the following: hemoglobin, 10.3 g/dL; platelet count, 1.1*10(5)/ml; bleeding time, 10 minutes; PT, 25 seconds; and PTT, 45 seconds. Which of the following would be the best immediate course of management for this patient?

• A. Low-molecular-weight heparin
• B. Fresh frozen plasma
• C. Initiation of labor
• D. D-dimer assay
• E. IV fluids (Correct Answer)

High-risk pregnancies Explanation: ***IV fluids*** - The patient presents with **hypotension** (90/60 mmHg) and **tachycardia** (120/min), indicating **hypovolemic shock**, likely due to concealed hemorrhage from abruptio placentae. - **IV fluids** are the immediate priority to restore circulating blood volume and stabilize the patient's hemodynamic status. *Low-molecular-weight heparin* - This patient is experiencing signs of **disseminated intravascular coagulation (DIC)**, including thrombocytopenia, prolonged PT/PTT, and increased bleeding time, which makes anticoagulation contraindicated. - Administering heparin would **exacerbate bleeding** and worsen her condition. *Fresh frozen plasma* - While **fresh frozen plasma (FFP)** can replace clotting factors and is indicated for DIC, stabilization of the patient's circulating volume with **IV fluids** is the most immediate life-saving measure in active shock. - FFP should be given after initial fluid resuscitation and once the decision to deliver is made, to correct coagulopathy. *Initiation of labor* - Although the immediate delivery of the fetus is necessary to resolve ongoing placental abruption and DIC, the patient's **hemodynamic instability** must be addressed first. - Stabilizing her with **IV fluids** is crucial before proceeding with labor induction or C-section. *D-dimer assay* - A **D-dimer assay** is a diagnostic test that would likely be elevated in this patient due to DIC, but it does not provide immediate therapeutic benefit. - The patient's clinical presentation and other lab values (prolonged PT/PTT, thrombocytopenia) already strongly suggest DIC, and immediate intervention is required, not further diagnostic testing.

High-risk pregnancies US Medical PG Question 6: A 42-year-old G1P0 woman presents to an obstetrician for her first prenatal visit. She has been pregnant for about 10 weeks and is concerned about how pregnancy will affect her health. Specifically, she is afraid that her complicated medical history will be adversely affected by her pregnancy. Her past medical history is significant for mild polycythemia, obesity hypoventilation syndrome, easy bleeding, multiple sclerosis, and aortic regurgitation. Which of these disorders is most likely to increase in severity during the course of the pregnancy?

• A. Easy bleeding
• B. Hypoventilation (Correct Answer)
• C. Multiple sclerosis
• D. Polycythemia
• E. Heart murmur

High-risk pregnancies Explanation: ***Hypoventilation*** - Pregnancy leads to increased **oxygen consumption** and **carbon dioxide production**, requiring increased ventilation. - In a patient with **obesity hypoventilation syndrome**, the already compromised respiratory drive and mechanics can worsen, leading to increased **hypercapnia** and **hypoxia**. *Easy bleeding* - Pregnancy is a **hypercoagulable state**, which typically reduces the risk of bleeding. - While certain pregnancy complications (e.g., placental abruption) can cause bleeding, the overall physiological changes tend to **decrease primary bleeding tendencies**. *Multiple sclerosis* - Pregnancy typically has an **immunomodulatory effect** that can lead to a decrease in the frequency of MS relapses, especially in the third trimester. - Relapses may increase postpartum, but during pregnancy itself, the condition often **stabilizes or improves**. *Polycythemia* - Pregnancy increases **plasma volume** significantly, which can lead to a relative **hemodilution**. - This physiological change would likely **ameliorate mild polycythemia** rather than worsen it. *Heart murmur* - The murmur is due to **aortic regurgitation**, and while pregnancy increases **cardiac output** and **blood volume**, severe aortic regurgitation can worsen. - However, the overall physiological changes of pregnancy result in **increased minute ventilation**, making hypoventilation a more direct and universally worsened problem with existing **obesity hypoventilation syndrome**.

High-risk pregnancies US Medical PG Question 7: A 24-year-old woman, gravida 1, at 35 weeks gestation is admitted to the hospital with regular contractions and pelvic pressure for the last 5 hours. Her pregnancy has been uncomplicated and she has attended many prenatal appointments and followed the physician's advice about screening for diseases, laboratory testing, diet, and exercise. She has had no history of fluid leakage or bleeding. At the hospital, her temperature is 37.2°C (99.0°F), blood pressure is 108/60 mm Hg, pulse is 88/min, and respirations are 16/min. Cervical examination shows 60% effacement and 5 cm dilation with intact membranes. Cardiotocography shows a contraction amplitude of 220 MVU in 10 minutes. Which of the following is the most appropriate pharmacotherapy at this time?

• A. Magnesium sulfate
• B. No pharmacotherapy at this time (Correct Answer)
• C. Dexamethasone
• D. Oxytocin
• E. Terbutaline

High-risk pregnancies Explanation: ***No pharmacotherapy at this time*** - The patient is at **35 weeks gestation** and in **active labor** (5 cm dilated, 60% effacement, regular contractions with adequate Montevideo units). At this gestational age, labor is typically allowed to progress without intervention unless there are complications. - Pharmacotherapy to stop labor (tocolysis) or induce fetal lung maturity (corticosteroids) is generally not indicated at or beyond 34 weeks gestation in uncomplicated cases. *Magnesium sulfate* - This is primarily used for **fetal neuroprotection** in anticipated preterm birth before 32 weeks gestation, or as a **tocolytic** to inhibit contractions, neither of which is indicated here. - The patient is 35 weeks, beyond the typical window for neuroprotection, and stopping labor is not appropriate given her advanced dilation and gestational age. *Dexamethasone* - **Corticosteroids** like dexamethasone are administered to accelerate **fetal lung maturity** in cases of anticipated preterm birth, typically between 24 and 34 weeks gestation. - At 35 weeks, the benefits of corticosteroids for lung maturity are minimal and generally not recommended. *Oxytocin* - **Oxytocin** is used to **induce or augment labor** if contractions are inadequate or to prevent **postpartum hemorrhage**. - This patient is already in active, effective labor with adequate contractions (220 MVU in 10 minutes), so oxytocin for augmentation is not needed. *Terbutaline* - **Terbutaline** is a **beta-agonist tocolytic** used to relax the uterus and stop preterm labor. - Given the patient's gestational age of 35 weeks and the progression of her labor (5 cm dilated), stopping contractions is not the appropriate management.

High-risk pregnancies US Medical PG Question 8: A 21-year-old primigravida presents to her physician for a prenatal visit. She has a positive pregnancy test 1 week ago. The estimated gestational age is 16 weeks. She has no complaints. She has a history of type 1 diabetes mellitus and takes insulin for glucose control. The urine dipstick test shows 3+ glucose and negative for protein. The blood tests ordered at the last visit 1 week ago are as follows: Fasting glucose 110 mg/dL HbA1c 8.3% Which of the following tests should be highly recommended for this patient?

• A. Chorionic villus sampling
• B. Triple test (Correct Answer)
• C. Serum creatinine
• D. C-peptide assessment
• E. Oral glucose tolerance test

High-risk pregnancies Explanation: ***Triple test*** - This 21-year-old patient with **pre-existing diabetes** and an **HbA1c of 8.3%** has a significantly increased risk of fetal neural tube defects and other chromosomal abnormalities. The triple test, performed between **15 and 20 weeks**, can screen for these risks by measuring **alpha-fetoprotein (AFP)**, **human chorionic gonadotropin (hCG)**, and **unconjugated estriol (uE3)**. - Given the patient's **poor glycemic control** (HbA1c 8.3% indicates consistently high blood glucose levels), the triple test offers a non-invasive screening method to assess these elevated risks. *Chorionic villus sampling* - While CVS can detect chromosomal abnormalities and some genetic disorders, it is an **invasive procedure** associated with a risk of miscarriage and is typically performed earlier in pregnancy (10-13 weeks). - It is usually reserved for cases with **higher risk factors** identified through non-invasive screening or a history of genetic disorders, which are not explicitly stated as the primary concern here compared to the hyperglycemia-related defects. *Serum creatinine* - **Serum creatinine** is used to assess kidney function and is essential in diabetic patients to monitor for nephropathy, but it is **not a screening test for fetal abnormalities**. - While important for the mother's health management, it does not directly address the immediate concern of fetal risk due to uncontrolled diabetes during pregnancy. *C-peptide assessment* - **C-peptide** is a marker of endogenous insulin production and is useful in classifying diabetes type or assessing residual beta-cell function; however, this patient is a known **type 1 diabetic** taking insulin. - While it has diagnostic utility for the mother's condition, it does not provide information about fetal well-being or the risk of congenital anomalies. *Oral glucose tolerance test* - An **oral glucose tolerance test (OGTT)** is used to diagnose **gestational diabetes mellitus** (GDM) in women without pre-existing diabetes, or to confirm it in those with borderline values. - This patient already has a confirmed diagnosis of **type 1 diabetes**; therefore, an OGTT is not indicated for her as she is already being treated for diabetes.

High-risk pregnancies US Medical PG Question 9: A 32-year-old woman, gravida 2, para 1, at 32 weeks' gestation comes to the physician for a prenatal visit. She reports that she has had frequent headaches and dizziness recently. Pregnancy and delivery of her first child were uncomplicated. There is no personal or family history of serious illness. Medications include folic acid and a multivitamin. Her temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 170/100 mm Hg. Pelvic examination shows a uterus consistent in size with a 32-week gestation. Physical examination shows 2+ edema in the lower extremities. Laboratory studies show: Hematocrit 37% Leukocyte count 9000/mm3 Platelet count 60,000/mm3 Serum Na+ 140 mEq/L Cl- 104 mEq/L K+ 4.4 mEq/L Creatinine 1.0 mg/dL Aspartate aminotransferase 20 U/L Alanine aminotransferase 20 U/L Which of the following is the most appropriate next step in management?

• A. Magnesium sulfate and labetalol therapy (Correct Answer)
• B. Lisinopril therapy
• C. Platelet transfusion
• D. Perform C-section
• E. Admit the patient to the ICU

High-risk pregnancies Explanation: ***Magnesium sulfate and labetalol therapy*** - This patient presents with **severe preeclampsia** (new-onset hypertension with systolic BP ≥160 or diastolic BP ≥110, or hypertension with proteinuria and features of end-organ damage such as headache, vision changes, thrombocytopenia, and elevated liver enzymes). - **Magnesium sulfate** is crucial for **seizure prophylaxis** in severe preeclampsia, while **labetalol** is an appropriate **antihypertensive** to manage the dangerously high blood pressure. *Lisinopril therapy* - **ACE inhibitors** like lisinopril are **contraindicated in pregnancy** due to their potential for serious fetal adverse effects, including renal dysfunction and oligohydramnios. - While it lowers blood pressure, its use in pregnancy would be harmful to the fetus. *Platelet transfusion* - Although the patient has **thrombocytopenia** (platelet count 60,000/mm3), a transfusion is generally **not indicated acutely** unless there is active bleeding or the platelet count is critically low (e.g., <10,000-20,000/mm3) or before an invasive procedure. - The primary issue is the underlying severe preeclampsia, which needs to be addressed first. *Perform C-section* - While **delivery** is the definitive treatment for severe preeclampsia, the patient is at **32 weeks' gestation**, and immediate C-section might not be necessary if the condition can be stabilized. - The priority is to **magnesium sulfate for seizure prophylaxis** and **control the blood pressure** before considering the timing and mode of delivery, which would typically be after stabilization and potentially a course of corticosteroids for fetal lung maturity if time permits. *Admit the patient to the ICU* - Although severe preeclampsia warrants close monitoring, **initial management often occurs on a labor and delivery unit** with appropriate nursing and medical staff experienced in obstetric emergencies. - ICU admission might be considered for cases with more severe complications or multi-organ failure, but the immediate next step is to initiate specific therapies for preeclampsia.

High-risk pregnancies US Medical PG Question 10: A 36-year-old primigravid woman at 34 weeks' gestation comes to the physician because of a 1-week history of upper abdominal discomfort, nausea, and malaise. She had a mild upper respiratory tract infection a week ago. She has a 10-year history of polycystic ovarian syndrome and a 3-year history of hypertension. Her medications include metformin, labetalol, folic acid, and a multivitamin. Her pulse is 92/min, respirations are 18/min, and blood pressure is 147/84 mm Hg. Examination shows a nontender uterus consistent in size with a 34-week gestation. There is mild tenderness of the right upper quadrant of the abdomen. The fetal heart rate is reactive with no decelerations. Which of the following is the most appropriate next step in management?

• A. Reassurance and follow-up
• B. Serum transaminase levels and platelet count (Correct Answer)
• C. Serum bile acid levels
• D. HBsAg and IgM anti-HBc serology
• E. Stool antigen assay for H. pylori

High-risk pregnancies Explanation: ***Serum transaminase levels and platelet count*** - The patient presents with symptoms such as **upper abdominal discomfort**, nausea, malaise, and **mild right upper quadrant tenderness**, along with a history of **hypertension** in pregnancy, raising concern for **preeclampsia with severe features** or **HELLP syndrome**. - **Elevated liver transaminases** and **thrombocytopenia (low platelet count)** are hallmarks of HELLP syndrome, which requires urgent evaluation and management. *Reassurance and follow-up* - Given the concerning symptoms and risk factors, simply reassuring the patient without further investigation would be **inappropriate** and could lead to delayed diagnosis and potential harm. - The symptoms described are not typical minor complaints of pregnancy and warrant a prompt workup. *Serum bile acid levels* - Elevated serum bile acid levels are primarily indicative of **intrahepatic cholestasis of pregnancy (ICP)**, which typically presents with **pruritus** (itching), especially on the palms and soles, without significant right upper quadrant pain or other systemic symptoms seen here. - While ICP can cause some abdominal discomfort, the constellation of symptoms in this patient points more strongly towards preeclampsia/HELLP. *HBsAg and IgM anti-HBc serology* - These tests are used to diagnose **Hepatitis B infection**. While hepatitis could cause similar symptoms like nausea and abdominal discomfort, there is no specific risk factor or clinical sign (e.g., jaundice, dark urine) in this patient to prioritize hepatitis screening as the immediate next step over evaluating for preeclampsia/HELLP. - The symptoms are more consistent with pregnancy-related hypertensive disorders. *Stool antigen assay for H. pylori* - This assay is used to diagnose **Helicobacter pylori infection**, which can cause gastritis or peptic ulcer disease. - While H. pylori can cause upper abdominal discomfort and nausea, the patient's existing hypertension, late-stage pregnancy, and lack of symptoms specific to gastritis (e.g., burning pain, response to antacids) make preeclampsia/HELLP a more pressing concern.

High-risk pregnancies Flashcard 1 of 10

Question: Poor maternal glucose control leads to excessive transplacental _____ transfer to the fetus

Answer: glucose

High-risk pregnancies Flashcard 2 of 10

Question: Women who are in the _____ period are at particularly high risk of developing myasthenia gravis

Answer: postpartum

High-risk pregnancies Flashcard 3 of 10

Question: Preeclampsia is caused by abnormal placental _____ arteries, causing endothelial dysfunction, vasoconstriction, and ischemia

Answer: spiral

High-risk pregnancies Flashcard 4 of 10

Question: Preeclampsia typically presents _____ the 20th week of gestation

Answer: after

High-risk pregnancies Flashcard 5 of 10

Question: _____ is a blood pressure >140/90 mmHg after the 20th week of gestation with no proteinuria, pre-existing hypertension, nor end-organ damage

Answer: Gestational hypertension

High-risk pregnancies Flashcard 6 of 10

Question: What is the treatment for preeclampsia or eclampsia to prevent seizures?_____

Answer: IV magnesium sulfate

High-risk pregnancies Flashcard 7 of 10

Question: What volume defines oligohydramnios?

Answer: <0.5 L amniotic fluid

High-risk pregnancies Flashcard 8 of 10

Question: congenital syphilis

Answer: prenatal exposure to T. pallidum

Extra Information: in infant: saber shins, saddle nose, mulberry molars, notched incisors

High-risk pregnancies Flashcard 9 of 10

Question: combined estrogen/progestin

Answer:

Extra Information: contraceptionsmokers > 35 y/o, hx DVT, stroke, ER+ cancerin combination prevents ovulation thrombosis

High-risk pregnancies Flashcard 10 of 10

Question: GYN tumor incidence in US: _____ > _____ > _____

Answer: endometrial