OBGYN COMAT Exam Review
When can fetal heart tones be detected w/doppler? 10-12 weeks
When is fetal movement appreciated? 17-18 weeks
When should you get a "quantitative" beta-hCG -to diagnose & follow ectopic pregnancy
-monitor trophoblastic dz
-screen for fetal aneuploidy
What supplement is given in pregnancy to decrease Folic acid supplements
neural tube defects for all reproductive-age women?
What additional supplements are given for complete vitamin D & vitamin B12
vegeterians
What kind of immunoglobulins can cross the placenta? IgG
Prenatal screening at the initial visit Heme= CBC, Rh factor, Type & Screen
ID= UA & culture, rubella Ab titer, HBsAg, RPR/VDRL, cervical G/C, PPD, IV, Pap
smear (to check for dysplasia).
If indicated: HbA1C, Sickle cell screening. Can also discuss genetic screening
(Tay-Sachs dz, Cystic Fibrosis).
When are prenatal visits conducted? Weeks 0-28= every 4 weeks (7*4=28)
Weeks 29-35= every 2 weeks
Weeks 36-birth= every week
When is a quad screen conducted? 15-22 weeks
When's an ultrasound for full anatomic screen done? 18-20 weeks
When is the 1 hr glucose challenge test for gestational 24-28 weeks
DM done?
When is RhoGAM given to Rh- women? 28-30 weeks
When's GBS culture done? 35-40 weeks or 32-37 weeks
(and cervical culture for N gonorrhoeae & Chlamydia in
selected populations).
when can a nuchal transparency test be ordered? 9-14 weeks
4 elements of the Quad Screen maternal serum AFP
B-hCG
Estradiol
Inhibin A
, OBGYN COMAT Exam Review
What's associated with ELEVATED maternal serum AFP Open neural tube defects (spina bifida, anencephaly)
(MSAFP)? Abdominal wall defects (gastroschisis, omphalocele)
(<2.5 MoMs) Multiple gestation
Incorrect gestational dating
Fetal death
Placental abnormailities (like rupture)
What's associated with REDUCED maternal serufm AFP Trisomy 21 & 18
(MSAFP) Fetal demise
(<0.5 MoM) Inaccurate gestational dating
Quad screen in trisomy 18 all are decreased
(still "UNDERage" at age 18)
Quad screen in Trisomy 21 Decreased AFP
Increased B-hCG
Decreased Estradiol
Increased Inhibin A
earliest screening for down syndrome & trisomy 18? PAPP-A + nuchal transparency +free B-hCG done at 9-14 weeks ("Full
Integrated test")
Note-> nuchal transparency is increased.
(PAPP-A= pregnancy-associated plasma protein A)
At what time (weeks) is CVS vs amniocentesis done? CVS= 10-12 weeks
Amniocentesis= 15-20 weeks
Which is indicated in women who will be >35 yo at time amniocentesis
of delivery?
What are the major infectious organisms that can cross TORCHeS:
the placenta? Toxoplasmosis
Other (parvovirus, varicella, Listeria, TB, malaria, fungi)
Rubella
CMV
Herpes simplex virus
HIV
Syphilis
What's the definition of spontaneous abortion? Loss of products of conception (POC) before 20th week of pregnancy.
Major birth defect caused by lithium Congenital heart disease (Ebstein's anomaly)
Defects associated w/streptomycin & kanamycin Aminoglycosides--> hearing loss & CN VIII damage
Birth defects caused by tetracyclines Permanent yellow-brown discoloration of deciduous teeth; hypoplasia of tooth
enamel.
Major defects associated w/valproic acid Neural tube defects (spina bifida)
Minor craniofacial defects
Which drugs can cause thymic agenesis? Vitamin A & derivatives.
When can fetal heart tones be detected w/doppler? 10-12 weeks
When is fetal movement appreciated? 17-18 weeks
When should you get a "quantitative" beta-hCG -to diagnose & follow ectopic pregnancy
-monitor trophoblastic dz
-screen for fetal aneuploidy
What supplement is given in pregnancy to decrease Folic acid supplements
neural tube defects for all reproductive-age women?
What additional supplements are given for complete vitamin D & vitamin B12
vegeterians
What kind of immunoglobulins can cross the placenta? IgG
Prenatal screening at the initial visit Heme= CBC, Rh factor, Type & Screen
ID= UA & culture, rubella Ab titer, HBsAg, RPR/VDRL, cervical G/C, PPD, IV, Pap
smear (to check for dysplasia).
If indicated: HbA1C, Sickle cell screening. Can also discuss genetic screening
(Tay-Sachs dz, Cystic Fibrosis).
When are prenatal visits conducted? Weeks 0-28= every 4 weeks (7*4=28)
Weeks 29-35= every 2 weeks
Weeks 36-birth= every week
When is a quad screen conducted? 15-22 weeks
When's an ultrasound for full anatomic screen done? 18-20 weeks
When is the 1 hr glucose challenge test for gestational 24-28 weeks
DM done?
When is RhoGAM given to Rh- women? 28-30 weeks
When's GBS culture done? 35-40 weeks or 32-37 weeks
(and cervical culture for N gonorrhoeae & Chlamydia in
selected populations).
when can a nuchal transparency test be ordered? 9-14 weeks
4 elements of the Quad Screen maternal serum AFP
B-hCG
Estradiol
Inhibin A
, OBGYN COMAT Exam Review
What's associated with ELEVATED maternal serum AFP Open neural tube defects (spina bifida, anencephaly)
(MSAFP)? Abdominal wall defects (gastroschisis, omphalocele)
(<2.5 MoMs) Multiple gestation
Incorrect gestational dating
Fetal death
Placental abnormailities (like rupture)
What's associated with REDUCED maternal serufm AFP Trisomy 21 & 18
(MSAFP) Fetal demise
(<0.5 MoM) Inaccurate gestational dating
Quad screen in trisomy 18 all are decreased
(still "UNDERage" at age 18)
Quad screen in Trisomy 21 Decreased AFP
Increased B-hCG
Decreased Estradiol
Increased Inhibin A
earliest screening for down syndrome & trisomy 18? PAPP-A + nuchal transparency +free B-hCG done at 9-14 weeks ("Full
Integrated test")
Note-> nuchal transparency is increased.
(PAPP-A= pregnancy-associated plasma protein A)
At what time (weeks) is CVS vs amniocentesis done? CVS= 10-12 weeks
Amniocentesis= 15-20 weeks
Which is indicated in women who will be >35 yo at time amniocentesis
of delivery?
What are the major infectious organisms that can cross TORCHeS:
the placenta? Toxoplasmosis
Other (parvovirus, varicella, Listeria, TB, malaria, fungi)
Rubella
CMV
Herpes simplex virus
HIV
Syphilis
What's the definition of spontaneous abortion? Loss of products of conception (POC) before 20th week of pregnancy.
Major birth defect caused by lithium Congenital heart disease (Ebstein's anomaly)
Defects associated w/streptomycin & kanamycin Aminoglycosides--> hearing loss & CN VIII damage
Birth defects caused by tetracyclines Permanent yellow-brown discoloration of deciduous teeth; hypoplasia of tooth
enamel.
Major defects associated w/valproic acid Neural tube defects (spina bifida)
Minor craniofacial defects
Which drugs can cause thymic agenesis? Vitamin A & derivatives.
