Caused by twisting of the ovary and sometimes fallopian tube around the vascular pedicle. This leads to venous and lymphatic obstruction, then arterial compromise → ischemia. It is most often caused by an ovarian cyst or mass (especially >5 cm) Epidemiology * Mostly affects reproductive-age women * Also can occur in children

Oligohydramnios * Definition: Too little amniotic fluid * AFI < 5 cm or Single Deepest Pocket < 2 cm * Key Features: * Poor fetal movement (cord compression) * Potter sequence * ↑ Risk of complications: cord compression, fetal distress, pulmonary hypoplasia * Common Causes: * Renal causes: * Bilateral renal agenesis * Posterior urethral valves * Polycystic kidney disease * Placental insufficiency:

Gestational Hypertension Definition/Cause * New-onset BP ≥140/90 mmHg after 20 weeks gestation * No proteinuria or end-organ damage * Etiology: Unknown; possibly abnormal placentation → vascular dysfunction Clinical Symptoms * Often asymptomatic * No proteinuria, edema may be present * Normal labs Management * Monitor BP and symptoms closely * Weekly labs: CBC, liver function tests, urine

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Herpes Simplex Virus (Genital Herpes) HSV-2 (most common), HSV-1 also possible * Presentation: * Painful grouped vesicles on erythematous base (genital, perianal) * Ulcerations after vesicle rupture * Systemic symptoms: fever, malaise, lymphadenopathy * Tender inguinal nodes * Recurrent outbreaks common * Diagnosis: PCR or viral culture of lesions * Treatment: * Acyclovir, valacyclovir, famciclovir * No cure; suppressive therapy

Combined Hormonal Contraceptives Components: Estrogen + Progestin * Regulates cycles, reduces dysmenorrhea, acne * Decreases risk of endometrial and ovarian cancer Contraindications: * Aura migraine * Aura migraine -> increased risk of blood clots in the brain * Estrogen also increase the risk of clotting -> increase risk of stroke * Clotted history (DVT/PE)

Rh immune globulin is a medication used to prevent alloimmunization in Rh-negative individuals. They prevent the maternal development of anti-D antibodies that can cause hemolytic disease of the fetus and newborn (HDFN) in future Rh-positive pregnancies. If the mother is Rh- and the fetus is Rh+, the Rh antigens from

Uterine Fibroids (Leiomyomas) These are well-circumscribed, benign tumors of myometrial smooth muscle found in the uterus. * Women >35 years, especially African American women * Estrogen-sensitive (grow during pregnancy, shrink after menopause) Symptoms: * Heavy menstrual bleeding (menorrhagia) * Pelvic pressure or pain * Constipation, urinary frequency (mass effect) * Reproductive issues (infertility, miscarriage risk)

Endometriosis Presence of endometrial glands & stroma outside the uterine cavity (e.g., ovaries, peritoneum, fallopian tubes) - ectopic endometrial tissue outside the uterus. This is likely due to retrograde menstruation, metaplasia, or lymphatic spread. * Reproductive-age women * Often nulliparous or infertile EndometriOsis - O stands for outside Symptoms: * Cyclic pelvic

Early Decelerations * Timing: Gradual decrease and return to baseline FHR mirroring uterine contractions. * The lowest point is the same as the peak uterine contraction. * Nadir (lowest point): Occurs at the same time as the peak of the contraction. * Cause: Fetal head compression (vagal stimulation). * Clinical significance: Benign; typically seen in

Occurs when amniotic fluid, fetal cells, hair, or other debris enter the maternal bloodstream, usually during: * Labor or delivery * Cesarean section * Uterine trauma (e.g., rupture, instrumentation) This triggers a systemic inflammatory reaction, anaphylactoid response, and DIC (disseminated intravascular coagulation) * Amniotic fluid contains tissue factor (thromboplastin) and other procoagulant substances

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Preterm labor is defined as labor that occurs between 20 and 37 weeks of pregnancy, before the baby has reached full term. Identifying High-Risk Situations * Cervical dilation: When the cervix has dilated to 3 cm or more * Shortened cervical length combined with a positive fetal fibronectin test: This combination indicates