Chapter 32 Flashcards by Cynthia Carrillo

what is preterm labor

cervical changes and uterine contractions occurring at 20 to 37 weeks of pregnancy

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what is preterm brith

birth that occurs before the completion of 37 weeks (<37 0/7 weeks of gestation)

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what is prematurity

length of gestation regardless of birth weight
more dangerous than LBW because less time in uterus, has immature body systems

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what is low birth weight

less than 2500 grams at birth
caused by many things, preterm, IUGR
can happen at anytime, can be at 40 wks

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what are causes of spontaneous preterm labor and birth

Multifactorial
Infection is the only definitive factor
Placental causes

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how to prevent preterm labor

bedrest, pelvic rest, no sex, tocolytics, magnesium

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what bp med is used for preterm labor

nifedipine (procardia)

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How is uterine activity suppressed

tocolytic medications

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What are antenatal glucocorticoids (betamethasone) used for

promote fetal lung maturity
reduce incidence of RDS, intraventricular hemorrhage, necrotizing enterocolitis, death in neonates

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how is betamethasone given

2 doses given IM, 24 hrs apart
no evidence its effective after 34 wks

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what is premature rupture of membranes (PROM)

Spontaneous rupture of amniotic sac and leakage of fluid prior to the onset of labor at any gestational age

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what is PPROM

membranes rupture before 37 0/7 weeks of gestation

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what is chorioamnionitis

Bacterial infection of the amniotic cavity
Major cause of complications for mothers and newborns at any gestational age

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how is chorionamnionitis diagnosed

maternal fever, maternal and fetal tachycardia, uterine tenderness, foul odor of amniotic fluid, elevated wbc

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postterm infant characteristics

dry skin , peeling, less lanugo and vernix

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preterm infant characteristics

more lanugo and vernix, less body fat/brown fat, immature lungs, less creases on feet

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what is hypotonic uterine dysfunction

not as frequent or as strong contractions, oxytocin given to increase it, may not always work

what is hypertonic uterine dysfunction

too many contractions, risk for uterine rupture

signs of uterine rupture

Intense pain and bleeding, may lose babys heart tones, you wont feel baby when going to check dilation baby will be in abdomen, epidural can mask pain, wont be too obvious

what is a precipitous labor

labor tha lasts less than 3 hrs from onset of contractions to time of birth, dr not in room delivered by nurse

what is pelvic dystocia

Contractures of pelvic diameters that reduce the capacity of the bony pelvis, inlet, midpelvis, or outlet

what is soft tissue dystocia

Results from obstruction of the birth passage by an anatomic abnormality other than that of bony pelvis

what are the fetal causes of dysfunctional labor

Anomalies
Cephalopelvic disproportion (CPD), also called fetopelvic disproportion (FPD)
Malposition
Malpresentation
Multifetal pregnancy

what is external cephalic version (ECV)

An attempt to turn the fetus from a breech or shoulder presentation to a vertex presentation for birth
Ultrasound scanning used during procedure
NST and informed consent before procedure

what are the risks of elected induction

Increased rates of cesarean birth Increased neonatal morbidity Increased cost should not be done until completion of 39 wks

what medications are used to ripen the cervix

misoprostol (Cytotec) given for inductions, given oral or vaginal Cervadil - inserted vaginally and pressed again cervix and vaginal, will help soften and thin out cervix , can cause labor to start with these meds

what other methods are used to stretch cervix

Foley catheter balloon is inflated and forces cervix to thin out

what is augmentation of labor

Stimulation of uterine contractions after labor has started spontaneously and progress is unsatisfactory Common augmentation methods include oxytocin infusion and amniotomy.

what are operative vaginal births

using either forceps or vacuum

what is important to know with vacuum assisted births

Mom still has to push with vacuum Not supposed to have 2 pop offs with vacuum Risk for trauma and hemorrhage ,cephalohematoma, increased risk for jaundice with popoffs

VBAC meaning

vaginal birth after cesarean

TOLAC meaning

trial of labor after cesarean

what is meconium stained amniotic fluid

Indicates fetus has passed stool prior to birth Dark green

what are possible causes of meconium stained fluid

Normal physiologic function of maturity for older baby Breech presentation - pressure applied causes Hypoxia-induced peristalsis - decals for long time Umbilical cord compression

what can be done for thick meconium

amnioinfusion , but risk for infection increased

what is shoulder dystocia

Head is born, but anterior shoulder cannot pass under pubic arch Newborn more likely to experience birth injuries related to asphyxia, brachial plexus damage, and fracture

what is mcroberts maneuver

lay head completely flat, push moms legs up as far as you can go , shifts pelvis up to get shoulder to pass can apply suprapubic pressure and push on mom to help

what is a prolapsed umbilical cord

Occurs when cord lies below the presenting part of the fetus, cord comes out before baby, water will break and cord comes out

what can contribute to prolapsed cord

Long cord (longer than 100 cm) Malpresentation (breech) Transverse lie Unengaged presenting part

What should be done with prolapsed cord

Emergency – vaginal exam and push presenting part up from cord and take to c-section Need pressure off of cord

what are the causes of uterine rupture

Separation of scar of a previous classic cesarean birth Uterine trauma (e.g., accidents, surgery) Congenital uterine anomaly Intense spontaneous uterine contractions Labor stimulation (e.g., oxytocin, prostaglandin) Overdistended uterus (e.g., multifetal gestation) Malpresentation, external or internal version Difficult forceps-assisted birth Occurs more in multigravidas than primigravidas