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MFM Objectives HO2

Page history last edited by Patrick Newman 4 years ago

Pathology and Neoplasi


  • Describe symptoms and physical findings suggestive of malignancy in the pregnant patient.
  • In consultation with a medical or gynecologic oncologist, counsel a patient about treatment options and their impact on pregnancy and the timing of delivery.
    • Williams Obstetrics, Chapter 63, Neoplastic Disorder


Microbiology and Immunology


  • Describe the principal features of the host immunologic response.
  • Describe how maternal immune response is altered by pregnancy.
  • Describe the basic features and timing of development of the fetal immunologic response.
  • Describe the association between genital tract infection and adverse perinatal outcomes, such as: Pre-term labor, Pre-term premature rupture of membranes, Neonate infection, Maternal infection.
    • Williams Obstetrics, Chapter 5, Implantation and Placental Development
      • Immunogenicity of the trophoblasts p.98 
      • Trophoblast HLA Class 1 Expression Uterine Natural Killer Cells
  • Creasy and Resnik, Chapter 6 Immunology of Pregnancy
    • Mother – Placenta – Fetus: A Complex Response to Infection p.91


Diabetes Mellitus


  • Monitor and control blood sugar in the pregnant patient with diabetes mellitus.
    • Creasy and Resnik, Chapter 59, Diabetes in Pregnancy
      • Principals of Glucose Monitoring P.1010
        • Self-Monitoring of Blood Glucose Levels
      • Timing of Capillary Glucose Monitoring p.1011
      • Target Capillary Glucose Levels p.1011


Infectious Diseases


  • Assess the severity of specific infection and its potential maternal, fetal, and neonatal impact.
  • Describe the possible adverse maternal and fetal effects of antibiotics.
    • Williams Obstetrics, Chapter 64, Infectious Diseases p.1239
      • Parvovirus p.1244 
      • Hepatitis B p.1090
      • Hepatitis C p.1091
      • Coxsackie group A and B p.1244
      • Aminoglycosides, nitrofurantoin, tetracyclines, sulfonamides p.248


Cardiopulmonary Disease


  • Classify maternal cardio disease in pregnancy and describe the associated maternal and fetal risks.
  • Order appropriate fetal evaluation in patients with congenital heart disease.
    • Williams Obstetrics, Classification of Functional Heart Disease p.976
      • Table 49-3 WHO Risk Classification of Cardiovascular Disease and Pregnancy p.977
      • Table 49-4 Risk for Fetal Heart Lesions Related to Affected Family Members p.977
    • Creasy and Resnik, Chapter 52 Cardiac Diseases
      • Pulmonary Hypertension p.861
      • Cardiomyopathy p.869-871
      • Marfan Syndrome p.873
      • Fetal Cardiac Malformations and Arrhythmias- Detection, Diagnosis, Management and Prognosis, Chapter 23 p. 281


Gastrointestinal Disease


  • Diagnose and provide initial management of common gastrointestinal diseases in pregnancy.
    • Williams Obstetrics, Chapter 54, Gastrointestinal Disorders p.1069
      • GERD, hyperemesis gravidarum, hiatal hernia, peptic ulcer, upper gastrointestinal bleeding, acute diarrhea.


Endocrine Disorders (excluding diabetes mellitus)


  • Describe the indications for and interpret the results of common diagnostic tests for endocrine disease, such as: Thyroid function tests, adrenal function tests, pituitary function tests, imaging studies.
    • Williams Obstetrics, Chapter 58, Endocrine Disorders p.1147
      • Thyroid Physiology and Pregnancy p.1147
      • Hyperthyroidism p.1148
      • Hypothyroidism p.1152
      • Parathyroid Diseases p.1157
      • Pheochromocytoma p.1159
      • Pituitary Disorders p.1163


Collagen Vascular Disorders 


  • Describe the indications for and interpret the results of common diagnostic tests for collagen vascular disease in pregnancy, such as: serologic tests for rheumatoid factor, Anti-DNA antibodies, Lupus anti-coagulant, Anticardiolipin/ antiphospholipid antibodies, Anti-RO, Anti-LA.
    • Williams Obstetrics, Chapter 59 Connective Tissue Disorders
      • Lupus and Pregnancy p.1170
      • Congenital Heart Block p.1172
      • Antiphospholipid Antibody Syndrome p.1173
      • Rheumatoid Arthritis p.1176
      • Table 59-6 Criteria for Classification of Rheumatoid Arthritis
      • Vasculitis Syndromes p.1179


Hypertension in Pregnancy 


  • Treat hypertensive disorders of pregnancy.
  • Recognize and treat possible maternal complications of hypertension in pregnancy, such as: Cerebrovascular accident, Seizure, Renal failure, Pulmonary edema, HELLP (hemolysis count) syndrome, Abruptio placentae.
  • Counsel patients about recurrence risk for gestational hypertension and pre-eclampsia in a subsequent pregnancy.
    • Williams Obstetrics, Chapter 40 Hypertensive Disorders p. 728


Multiple Gestation 


  • Describe the medical rationale for selective fetal reduction in higher order multiple gestation.
  • Describe, diagnose, and manage the maternal and fetal complications associated with multiple gestation.
  • Perform tests to assess the general well-being of the fetuses of a multiple gestation.
    • Williams Obstetrics, Chapter 45 Multifetal Pregnancy
      • Aberrant Twinning Mechanisms p.902-909
      • Pregnancy Complications p.899
      • Surveillance of Fetal Growth and Health p.912

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