14,15 OB operations, contraception Flashcards
Mirena IUD
- duration
- mech
- side effects
- 5 years
- Levonorgestrel (a progresterone)–thickens cervical mucus to prevent sperm travel, thins endometrial lining to lower bleeding
- intrauterine infections, atypical bleeding.
Spotting for months.
Episiotomy/lacerations
-describe Grades (4)
grade 1: vagina only
grade 2: +perineum
3: +anal sphincter
4. +anal mucosa
Pudendal nerve block
- blocks what type of pain
- anatomic location to inject
- blocks somatic pain of Stage 2 labor (S2-S4)
- palpate ischial tuberosity
Circlage
- what is it
- when to place, when to remove
- complications/risks
- tie up incompetent cervix (eg for cone biopsy, frequent gyn infections), to prevent repeated 1st trimester losses.
- end of 1st trimester (week 12-14). remove prior to cervical ripening
- stabbing fetus with suture. Also, failure to remove to cause cervical damage upon ripening.
Opioid use for anesthesia in delivery:
Side effects/complications? (2)
- MCC prolonged latent phase
- baby resp depression if given <1 h from birth
How does progesterone-based contraception work to:
- provide contraception
- reduce bleeding
- Thicken cervical mucus, prevent sprem travel
- progesterone thins endometrial lining. This reduces bleeding during periods.
Contraceptives:
What are estrogen effects? (4)
- increased DVT/PE risk
- reduce volume and flow of milk
- reduce PMS symptoms
- protect from ovarian/benign breast dz
Stage 1 vs Stage 2 pain: what’s the difference
Stage 1: visceral pain from T10-12
Stage 2: somatic pain from S2-4
Forceps delivery
-complications (2)
- facial palsy
- cephalohematoma
- both will resolve spontaneously
Which contraceptive has highest increased risk of DVT?
Patch (Ortho Evra)
(E+P)
Paragard IUD
- duration
- mech
- side effects
- 10 yrs
- Copper: 1)proinflamm, and 2)physical barrier
- copper allergy, increased bleeding, possible local inflamm causing pain
Paracervical block
- what is it
- risk of what?
Block pain of cervical dilation with local Lidocaine.
-baby may get some lidocaine and get fetal bradycardia. It will wear off.
What to be careful of if opioids are given to mom within 1 hr of birth?
Baby resp depression. Have naloxone ready for baby.
Implanon
- duration
- mech
- side effects
- 3 years
- a progesterone
- Lots of spotting (worst) for several months. (similar to Mirena). Also, may be difficult to remove from scarring.
emergency contraception Plan B
- what is it
- time interval to use
- high dose hormones prevent implantation
Plan B (levonorgestrel)
- Use within 72 hours of sex
