Handout+Step+2+OB+Sakala+Jan+2014.ppt4+(1)-Part 1.pdf

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USMLE Step 2 CK Obstetrics-Gynecology OB Supplement – part 1 Elmar P. Sakala, MD, MPH Professor of Gynecology & Obstetrics Loma Linda University School of Medicine October, 2013 © Elmar P. Sakala, MD, MPH (2013) No part of this document can be reproduced or transmitted, in any form, or be any means, without the written permission of the author.

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Routine Prenatal LABS by trimester?

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3-tiered categorization of FHR patterns

Category I

NORMAL

 Baseline rate: 110-160 beats/min  Baseline variability: moderate  Late or Variable decelerations: absent  Early decelerations: present or absent  Accelerations: present or absent

INTERPRETATION: strongly predictive of normal acid-base status at this time ACTION: routine monitoring

INTERPRETATION: not predictive of abnormal acidbase status at this time ACTION: continued surveillance & reevaluation

Category III

ABNORMAL

ABSENT VARIABILITY plus any of following:  Recurrent LATE decelerations  Recurrent VARIABLE decelerations  Bradycardia  Sinusoidal pattern

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INTERPRETATION: strongly predictive of abnormal acid-base status at this time ACTION: intrauterine resuscitation; if no resolution then prompt delivery

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