LABOR AND DELIVERY
Testing Modalities (Obstet Gynecol 2009;113:687) • Fetal mvmt count (“kick count”) (Cochrane Database Syst Rev 2007:CD004909) Variable protocols, usually 2 h, 3–7× per week 10 mvmts → reassuring; insuff evid…
GASTROENTEROLOGY
CHOLELITHIASIS Epidemiology • 10–15% prevalence in adults overall; 1–3% of pregnant women • Risk factors: Preg (impaired gallbladder emptying, increased biliary sludge); ↑ estrogen (gender [ 2× > ], obesity,…
GYNECOLOGY
Clinical Manifestations (NEJM 2006;355:1244) • BV: Copious, thin, whitish-gray, fishy-smelling discharge. Less likely pruritus. • Candidiasis: Thick, white, curdy discharge. No odor. + Pruritus, dysuria, vaginal erythema. • Trichomonas: Copious…
AND URINARY TRACT
Clinical Findings & Exam • Uremia, oliguria/anuria, hematuria • Prerenal: Tachy, dry mucous membranes, orthostatic HoTN • Intrarenal: Pulm hemorrhage, palpable purpura → vasculitis + glomerulonephritis, livedo reticularis → atheroembolic…
PREGNANCY AND DELIVERY
Complications • Almost all complications of Preg are more likely w/ multi gestations • Discordance: One twin larger than the other; clinically signif when greater than 20%. Calculate discordance %…
OB-GYN CONSIDERATIONS
• Review of current meds & allergies: Discuss holding NSAIDs, antiplatelet agents, anticoagulant supplements (eg, fish oil); consider bridging long-acting anticoagulants to shorter acting meds (eg, warfarin to heparin) •…
ANESTHESIA
• Laparoscopic & prolonged gynecologic surgeries usually performed under GA Laparoscopic procedures require complete relaxation of abdominal wall (ie, paralysis) Std anesthesia techniques & precautions apply Many laparoscopic procedures require…
AND ADOLESCENT GYNECOLOGY
Figure 6.1 Tanner staging, female developmental stages PRECOCIOUS PUBERTY Definition (N Engl J Med 2008;358:2366) • Dev of breast or pubic hair >2.5 SD below mean age. Traditional definition <8…
