2nd shifting random questions (Hard) Flashcards
bilateral depressions at the site of lacerations that remain as permanent changes in the cervix
Parous cervix
sign of well contracted uterus
Stony hard
when does uterus begins to shrink?
2 days after delivery
components of the lochia
erythrocytes, decidua, epithelial cells, bacteria
causes of sub involution
pelvic infections
retention of placental fragments
what is Merititis?
retention of placental fragments
Management of Subinvolution
Ergonovine
Methylergonovine
Oxytocin
Curettage
complete extrusion of the placental site is when?
after 6 weeks
cause of late postpartum hemorrhage
Placental polyp
when is the reapperance of ruggae?
after 3 weeks
percent of increase in the plasma red cell volume during pregnancy
15-20%
percent reduction in the FRC via upward displacement of the diaphragm
15% reduction
effect of progsterone to gastric motility and food absorption
decrease
source of contractile pain during the 1st stage labor
uterus
adnexia
(mediated by T10-L1)
cause of pain in the 2nd stage of labor
distention of birth canal, vulva and perineum
mediated by S2-S4
acupuncture is what type of non pharmacologic method of pain relief?
intercutaneous nerve stimulation
regional anesthesia adequate for spontaneous delivery and outlet forceps
Pudendal Block
complication of blockage of Frankenhauser’s Ganglion
Fetal Bradycardia
Paracervical block
hypotension is a common side effect of what anesthetic technique?
Subarachnoid/Spinal Anesthesia
what causes the supine hypotensive syndrome (with risks of MG, polyhaydramnios and DM)
Aortocaval syndrome/ compression
significance of ruptured membranes (3)
- Labor is soon to happen
- Chorioamnionitis
- Cord prolapse/compression
color of positive Nitrazine test and what does in signify?
(+) Blue, Amniotic fluid present in vagina (ruptured na)
duration of 1st stage of labor in a nulliparous and a multiparous px.
N: 7 h
M: 4 h
frequency of FHT monitoring @ the 1st and 2nd stage of labor during High risk pregnancy
1st stage: every 15 minutes
2nd stage: every 5 minutes
“lavativa”
enema
what is the artificial rupture of bag of water? what is its complicatios?
Amniotomy
cord prolapse leading to hypoxemia
duration of 2nd stage of labor in a nulliparous and a multiparous px.
N: 50 mins
M: 20 mins
2 types of pudendal incision
Medial episiotomy
Mediolateral episiotomy
what should be the diameter of vaginal introitus when doing the Ritgen maneuver?
> 5cm
earliest sign of placental separation
Calkin’s sign (glubular and firm Uterus)
predisposing factors of transverse fetal lie (4)
multiparous
placenta previa
hydraminos
uterine anomalies
predisposing factors of transverse fetal lie (4)
multiparous
placenta previa
hydraminos
uterine anomalies
military attitude (type of fetal presentation)
Sinciput (cephalic) presentation
military attitude (type of fetal presentation)
Sinciput (cephalic) presentation
U shaped fetus is what type of fetal presentation?
Frank Breech Presentation
U shaped fetus is what type of fetal presentation?
Frank Breech Presentation
least common fetal position/presentation?
Face presentation (0.3%)
least common fetal position/presentation?
Face presentation (0.3%)
where to auscultate the FHT when the presentation is occiput posterior?
at the back flanks of the mother
where to auscultate the FHT when the presentation is occiput posterior?
at the back flanks of the mother
causes of breech presentation
hydrocephalus placental implantation at the lower uterine segment vertebral extension uterine septum abnormal fetal tone and movement
causes of breech presentation
hydrocephalus placental implantation at the lower uterine segment vertebral extension uterine septum abnormal fetal tone and movement
the relation of fetal parts to one another
Fetal attitude (posture/Habitus)
the relation of fetal parts to one another
Fetal attitude (posture/Habitus)
what is the shape of Bregma?
Diamond
what is the shape of Bregma?
Diamond
palpation to determine the fetal lie
Umbilical grip (2nd leopold’s maneuver)
palpation to determine the fetal lie
Umbilical grip (2nd leopold’s maneuver)
the occipitomental plane being the longest AP diameter is presented
Brow presentation
the occipitomental plane being the longest AP diameter is presented
Brow presentation
what type of drugs may cause anhydramnios?
Antihypertensive drugs (ACE inhibitors)
when is weight gain not expected? (weeks of gestion)
during 1st 12 weeks
Quickening happens when in multiparous? primiparous?
M: 16-18 wks
N: 18-20 wks
position of mother when doing the electronic fetal heart monitoring
Semi-fowlers position
what features of the fetal heart rate indicates a normal and intact pathways?
FHR variability (Short term;Long term)
which FHR decelaration happens at the 2nd stage of labor?
Early deceleration
Sinusoidal pattern of FHR indicates what?
Fetal anemia and maternal use of opiods
when to consider tocolysis (delaying of labor)
normal FHR + Uterine hypercontractions
normal AFI (cm)
5-24 cm.
allowable error in UTZ @ the 2nd trimester for AOG determination
+/- 1 week AOG
diagnostic procedure that has a risk for talipes deformity
Amniocentesis