👶 Obstetrics: 50 Anchor Recall Triggers

MBBS/USMLE Style | Keywords ×3+ | High-Yield Format

🤰 I. Pregnancy & Dating (1–10)

Topic	Anchor Trigger
Missed Period	Amenorrhea + β-hCG ↑ + TVUS confirms gestation = Pregnancy
Dating of Pregnancy	LMP + 1y – 3m + 7d = Naegele's Rule
Early Pregnancy Signs	Goodell (soft cervix) + Chadwick (blue vagina) + Hegar (soft uterus)
Viability on USG	Gestational sac (5w) + Yolk sac (5.5w) + Cardiac flicker (6w)
Quickening	Fetal movements felt at 18–20w (primis) / 16w (multis)
Fundal Height Landmarks	Pubic symphysis (12w) + Umbilicus (20w) + Xiphisternum (36w)
Trimester Cutoffs	T1 (<13w) + T2 (14–27w) + T3 (28w onward)
Normal Weight Gain	11–16 kg (singleton) + ↑BMI = ↓gain
Anemia in Pregnancy	Hb <11 g/dL + MCV↓ = IDA (most common)
Supplementation	Folic acid 400mcg/day (NTD) + Iron 60mg/day (IDA)

🧬 II. Screening & Genetic (11–20)

Topic	Anchor Trigger
NT Scan (11–13w)	↑NT + ↓PAPP-A + ↑β-hCG = Trisomy 21 clue
First Trimester Screen	Combined test = NT + β-hCG + PAPP-A (11–13w)
Quad Screen (15–20w)	↑AFP = NTD + ↓AFP = Down syndrome
CVS vs Amniocentesis	CVS = 10–13w + Amnio = 15–20w
Level 2 Anomaly Scan	18–22w + detects structural defects + mandatory
Rh Isoimmunization	Rh– mother + Rh+ fetus + Indirect Coombs = screen
Down Syndrome Markers	Flat face + sandal gap + AV canal + duodenal atresia = Trisomy 21
Patau Syndrome	Midline defects + holoprosencephaly + polydactyly = Trisomy 13
Edwards Syndrome	Rocker bottom feet + micrognathia + clenched hands = Trisomy 18
NIPT (Noninvasive)	Cell-free fetal DNA (10w+) = best screen for aneuploidy

⚠️ III. Obstetric Complications (21–35)

Topic	Anchor Trigger
Hyperemesis Gravidarum	Severe vomiting + ketonuria + dehydration + ↑β-hCG
PIH	New BP ≥140/90 after 20w + no proteinuria = Gestational HTN
Preeclampsia	HTN + Proteinuria ≥300mg/24h + edema = Preeclampsia
Severe Preeclampsia	BP ≥160/110 + symptoms or labs (↑LFT/↓platelets)
Eclampsia	Seizures + HTN + proteinuria = Eclampsia → MgSO₄
HELLP	Hemolysis + ↑LFTs + ↓Platelets = HELLP syndrome
GDM	24–28w OGTT (75g) + FBS ≥92 = GDM diagnosis
Oligohydramnios	AFI <5 cm + renal agenesis + IUGR link
Polyhydramnios	AFI >25 cm + TE fistula + anencephaly = causes
Abruptio Placentae	Painful bleed + rigid uterus + fetal distress = Abruption
Placenta Previa	Painless bleed + no PV exam + previa on USG
Vasa Previa	Painless bleed + fetal bradycardia + ROM = Emergency!
Preterm Labor	<37w + contractions + cervical change = Preterm labor
PPROM	ROM before 37w without contractions = PPROM
IUGR	EFW <10th centile + ↑Umbilical resistance = IUGR

🤱 IV. Labor & Delivery (36–45)

Topic	Anchor Trigger
True Labor	Regular contractions + progressive dilation + show = True labor
False Labor	Irregular + no change + resolves with rest = Braxton Hicks
3 Stages of Labor	1st = Dilation + 2nd = Expulsion + 3rd = Placental
Partograph Basics	Alert line + action line + plotting cervical dilation vs time
Fetal Stations	0 = ischial spines + negative = above + positive = below
Cephalo-Pelvic Disproportion	Head fails to descend + prolonged labor = CPD
Shoulder Dystocia	Turtle sign + macrosomia + McRoberts + suprapubic pressure
PPH	>500mL bleed (vag) / >1000mL (CS) + uterine atony = most common cause
Active Management 3rd Stage	Oxytocin + controlled cord traction + uterine massage
Retained Placenta	>30 mins + bleeding = Manual removal or D&C

🍼 V. Postpartum & Breast (46–50)

Topic	Anchor Trigger
Lochia Sequence	Rubra (1–3d) → Serosa (4–10d) → Alba (10–14d)
Postpartum Blues	Tearful + <2w + resolves = Blues
Postpartum Depression	Persistent sadness >2w + needs therapy = Depression
Lactational Amenorrhea	No menses + breastfeeding + prolactin = contraceptive
Mastitis/Breast Abscess	Unilateral pain + fever + engorgement = Continue breastfeeding + ABx

🎯 Memory Tips & High-Yield Differentials

Pregnancy Dating Landmarks

• 5-5-6 Rule: Gestational sac (5w), Yolk sac (5.5w), Cardiac activity (6w)
• 12-20-36 Rule: Pubic symphysis (12w), Umbilicus (20w), Xiphisternum (36w)

Trisomy Recognition

• 21 = Down: Flat face, sandal gap, AV canal
• 18 = Edwards: Rocker bottom feet, clenched fists
• 13 = Patau: Midline defects, polydactyly

Bleeding Differential

• Painful + Rigid: Abruption
• Painless + Previa: Placenta previa
• Painless + Fetal distress: Vasa previa

HTN in Pregnancy

• Gestational HTN: BP ≥140/90 after 20w, no proteinuria
• Preeclampsia: Add proteinuria ≥300mg/24h
• Severe: BP ≥160/110 OR symptoms/labs
• Eclampsia: Add seizures → MgSO₄

📥 Download/Print