USMLE | Pregnancy Childbirth & the Peurperium

Normal Processes

Organ structure and function:  pregnancy, including fertilization, implantation, development of embryo, labor and delivery, the puerperium, lactation, gestational uterus, placenta

Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

Prenatal care

• • preconception counseling and care: folate deficiency prevention; immunizations; nutritional assessment, including vitamins; Rh screening
  • prenatal risk assessment/prevention: adolescent pregnancy; antepartum fetal evaluation, including biophysical profile; genetic screening; α-fetoprotein; diabetes mellitus; neural tube defects; Rh isoimmunization
  • supervision of normal pregnancy: assessment of gestational age; iron deficiency prevention; nutrition, including weight management; surveillance, including ultrasonography and assessment of fetal growth; vitamin deficiency prevention; infections, maternal, fetal, newborn (focus on prevention and screening): cytomegalovirus, coxsackievirus, hepatitis B virus, herpes simplex viruses, HIV, influenza virus, parvovirus B19 virus, rubella virus, varicella-zoster virus, Chlamydia trachomatis, Treponema pallidum, Streptococcus agalactiae, Toxoplasma gondii, amnionitis; urinary tract infection

Obstetric complications: abortion, induced, septic, missed, spontaneous, threatened; acute fatty liver of pregnancy; anemia of pregnancy, sickle cell disease, thalassemia in pregnancy; antepartum hemorrhage, including third-trimester bleeding; cardiomyopathy of pregnancy; cervical incompetence, cervical shortening; cholestasis of pregnancy, intrahepatic; congenital abnormalities, maternal (eg, bicornuate uterus); ectopic pregnancy; fetal abnormality affecting management of mother (eg, hydrocephalus, spina bifida); gestational diabetes; intrauterine growth restriction; maternal mortality; multiple gestation; placental abnormalities (abruptio placentae, placenta previa, premature separation of placenta); polyhydramnios, oligohydramnios; preeclampsia, eclampsia, HELLP syndrome, gestational hypertension; prolonged pregnancy; Rh isoimmunization affecting management of mother; vomiting in pregnancy (morning sickness, hyperemesis gravidarum); trauma in pregnancy; infections complicating pregnancy

Labor and delivery: labor and delivery, uncomplicated; labor and delivery, complicated, including shoulder dystocia; cesarean delivery, including complications; cord compression, cord prolapse; fetal malpresentations (eg, breech); intrapartum fetal evaluation, including fetal heart tones; intrapartum prophylaxis (eg, HIV, Chlamydia, gonococcal prophylaxis); premature rupture of membranes; preterm (before 37 weeks' gestation) and postdates labor and delivery; threatened preterm labor

Puerperium, including complications: lactation problems; breast-feeding problems; lochia; postpartum cardiomyopathy; postpartum blues; postpartum hemorrhage; postpartum sepsis; retained placenta, products of conception (eg, placenta accreta); uterine atony

Newborn (birth to 4 weeks of age)

• • normal newborn
    • examination of liveborn at admission to hospital
    • screening, newborn
  • disorders of the newborn: screening, newborn; ABO incompatibility in newborn; hemolytic disease due to Rh incompatibility; birth asphyxia syndrome (liveborn neonate); birth trauma (eg, cord compression, brachial palsy, lacerations); drug withdrawal syndrome in newborn; feeding problems in newborn; fetal growth and development abnormalities, including fetal growth restriction; gastrointestinal obstruction; hypocalcemia of newborn; infections, congenital or peripartum (cytomegalovirus, herpes simplex viruses, HIV, hepatitis B, rubella virus, parvovirus B19 virus, varicella zoster virus, Chlamydia trachomatis, Streptococcus agalactiae, Treponema pallidum, Toxoplasma gondii); intrapartum fetal distress/death including stillborn; jaundice, fetal/neonatal/perinatal; laryngomalacia; macrosomia (large for gestational age); meconium aspiration syndrome; neonatal acne; neonatal Candida infection (thrush); neonatal hypoglycemia; neonatal conjunctivitis and dacryocystitis; ophthalmic gonorrhea; phenylketonuria; premature infant; post- term infant; pseudomembranous colitis of infancy; respiratory distress syndrome (hyaline membrane disease); respiratory problems after birth (eg, bronchopulmonary dysplasia, tracheomalacia; tracheoesophageal fistula in neonates); retinitis of prematurity; seizures in newborn; sudden infant death syndrome (SIDS), apparent life-threatening event (ALTE); tetanus neonatorum

Congenital disorders, neonatal: congenital malformations and anomalies; neonatal hydrocele

Adverse effects of drugs on pregnancy, childbirth, and the puerperium: alcohol, tobacco, and other drugs (ATOD); prenatal radiation exposure; teratology (eg, ACE inhibitors, SSRIs, warfarin, infections, toxins)

Systemic disorders affecting pregnancy, labor and delivery, and puerperium: appendicitis; asthma; carpal tunnel syndrome in pregnancy; cirrhosis; deep venous thrombosis (DVT); diabetes mellitus; heart failure, valvular heart disease; hypertension; myasthenia gravis; obesity; pancreatitis; psychiatric disorders; renal failure/renal disease, including SLE; seizure disorders; thyroid disorders, hypothyroidism, hyperthyroidism

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