1. In postpartum hemorrhage, if massive transfusion is needed, ACOG recommends starting at a ratio of 6:4:1 of pRBCs, FFP and platelets. Generally, 1 unit of pRBCs => 1 g/dL of hemoglobin, 1 unit of platelets=> 5,000-8,000. Cryoprecipitate is a concentrated version of FFP, and has more fibrinogen and vWF.
2.Causes of symmetric IUGR: fetal troubles, such as congenital/chromosome abnormalities, TORCH infections. Asymmetric IUGR: fetus shunts blood to brain, spares abdomen. Usually environmental troubles, such as things that cause placental insufficiency (hypertension, maternal drug/alcohol/cigarettes, clotting diseases, vasculitidies).
3. In pregnancy, penicillin G is the only antibiotic you use to treat syphilis. If mom is allergic, skin test to figure out how allergic. Even for anaphylaxis, you desensitize by giving small amounts. Erythromycin doesn't cross the placenta, and has an >10% fail rate. Tetracyclines are CI in pregnancy, no other abx work.
4. If you get LSIL on a pap, you go to colpo unless they're post menopausal/adolescent (can follow with paps) or pregnant (defer colpo). In premenopausal women, the risk of finding CIN 2/3 in someone with an LSIL pap is nearly 15%. http://www.asccp.org/LinkClick.aspx?fileticket=uUGOqspsCBU=
5. Re:mammogram, ACOG/American cancer society/American college of radiologists recommend annual mammograms starting at 40. The average sojourn time for women in their 40s is 2-2.4 years. The USPSTF recommends screening every 2 years starting at 50, and mammograms for women in their 40s only if there is a family history.
6. Risperidone is an atypical antipsychotic that causes worse hyperprolatincemia than other antipsychotics. It's a dopamine/5HT antagonist
7. Women who are post term need to be followed with twice weekly NST/BPP if the don't want to be induced.
8. For decreased fetal movement, do an NST, if non reactive, likely 2/2 sleeping baby. Wake with vibroacoustic stimulation, and try again. If still non reactive, go to BPP.
9. Minimal variability in a fetal heart tracing can be due to a sleeping baby or to narcotic pain management in mom.
10. Pregnant women don't react to shock in the same way as normal people, especially if they are in the hospital and are being supported on crystalloids. They tend to have stable appearing vitals until they lose about 30% of blood volume, and then they tend to precipitously crash.