MFM Objectives HO2

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