ACOG PRACTICE BULLETINS Questions
with Correct Answers
Anemia Criteria per Trimester First and third trimester: <11/33%; Second trimester
<10.5/32%
iron deficiency anemia labs
what does ACOG advise for iron def anemia screening? screen ALL pregnant patients and
supplement all patients on PO Iron
Iron Def Anemia has been associated with.. increased risk of low birth rate, preterm
delivery and perinatal mortality
Iron requirements in pregnancy 27 mg/day
Iron requirements in breast feeding 9 mg/dL
,Folic acid requirements during pregnancy 400 MICROg/day (up to 4 mg/day)
Folic acid requirements during pregnancy with total gastrectomy 1,000 micrograms/day
Severe maternal anemia has been associated with... abnormal fetal oxygenation, reduced
AFI, fetal cerebral vasodilation, fetal death
Transfuse if <6
Factors that increase risk for fibroids ○ Premenopausal status
○ Family hx
○ Increasing interval since last birth
○ Hypertension
○ Obesity
Factors that decrease risk of fibroids increased parity, use of OCP or Depo
FIGO grading
,Rx that reduces AUB-L but NOT uterine size GnRH Antagonist
LNG IUD
TXA
OCP/Progestin
GnRH antagonists can be used for how long 2 years with add back therapy
Rx that reduces AUB-L but AND uterine size GnRH Agonist
selective progesterone receptor modulators (Ulipristal, Mife)** not approved in US
Recommended for short term therapy for to bridge until surgery for fibroids gnRH
agonists (Lupron)
Lupron Leuprolide (GnRH agonist) that can use used for up to 3 months for AUB-L and
to reduce fibroid size
uterine artery embolization placement of small gelatin beads into both uterine arteries to
stop blood flow supplying uterine fibroids
, Can control symptoms for up to 5 years
○Limited data on fertility: possible increase in ovarian failure, higher risk of pregnancy loss,
CSN, PPH
Higher risk of reintervention compared to myomectomy or hyst
radiofrequency ablation ○ Laparoscopic, transvaginal or transcervical approach using
ultrasound to target fibroids for coagulative necrosis
○ Laparoscopic most studied w/ FDA approved device (Ascessa)
○ Studies ongoing, inconsistent minor complications and still limited data on reproductive effects
T or F: Recurrence rates are similar for hysteroscopic myomectomy and open myomectomy
T
This location of fibroid has the highest chance of pregnancy after removal submucosal
menorrhagia excessive bleeding during menstruation
metrorrhagia bleeding between periods
with Correct Answers
Anemia Criteria per Trimester First and third trimester: <11/33%; Second trimester
<10.5/32%
iron deficiency anemia labs
what does ACOG advise for iron def anemia screening? screen ALL pregnant patients and
supplement all patients on PO Iron
Iron Def Anemia has been associated with.. increased risk of low birth rate, preterm
delivery and perinatal mortality
Iron requirements in pregnancy 27 mg/day
Iron requirements in breast feeding 9 mg/dL
,Folic acid requirements during pregnancy 400 MICROg/day (up to 4 mg/day)
Folic acid requirements during pregnancy with total gastrectomy 1,000 micrograms/day
Severe maternal anemia has been associated with... abnormal fetal oxygenation, reduced
AFI, fetal cerebral vasodilation, fetal death
Transfuse if <6
Factors that increase risk for fibroids ○ Premenopausal status
○ Family hx
○ Increasing interval since last birth
○ Hypertension
○ Obesity
Factors that decrease risk of fibroids increased parity, use of OCP or Depo
FIGO grading
,Rx that reduces AUB-L but NOT uterine size GnRH Antagonist
LNG IUD
TXA
OCP/Progestin
GnRH antagonists can be used for how long 2 years with add back therapy
Rx that reduces AUB-L but AND uterine size GnRH Agonist
selective progesterone receptor modulators (Ulipristal, Mife)** not approved in US
Recommended for short term therapy for to bridge until surgery for fibroids gnRH
agonists (Lupron)
Lupron Leuprolide (GnRH agonist) that can use used for up to 3 months for AUB-L and
to reduce fibroid size
uterine artery embolization placement of small gelatin beads into both uterine arteries to
stop blood flow supplying uterine fibroids
, Can control symptoms for up to 5 years
○Limited data on fertility: possible increase in ovarian failure, higher risk of pregnancy loss,
CSN, PPH
Higher risk of reintervention compared to myomectomy or hyst
radiofrequency ablation ○ Laparoscopic, transvaginal or transcervical approach using
ultrasound to target fibroids for coagulative necrosis
○ Laparoscopic most studied w/ FDA approved device (Ascessa)
○ Studies ongoing, inconsistent minor complications and still limited data on reproductive effects
T or F: Recurrence rates are similar for hysteroscopic myomectomy and open myomectomy
T
This location of fibroid has the highest chance of pregnancy after removal submucosal
menorrhagia excessive bleeding during menstruation
metrorrhagia bleeding between periods
