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MIH Final review > Chapter 32 > Flashcards

Chapter 32 Flashcards

1
Q

what is preterm labor

A

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

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2
Q

what is preterm brith

A

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

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3
Q

what is prematurity

A

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

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4
Q

what is low birth weight

A

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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5
Q

what are causes of spontaneous preterm labor and birth

A

Multifactorial
Infection is the only definitive factor
Placental causes

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6
Q

how to prevent preterm labor

A

bedrest, pelvic rest, no sex, tocolytics, magnesium

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7
Q

what bp med is used for preterm labor

A

nifedipine (procardia)

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8
Q

How is uterine activity suppressed

A

tocolytic medications

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9
Q

What are antenatal glucocorticoids (betamethasone) used for

A

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

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10
Q

how is betamethasone given

A

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

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11
Q

what is premature rupture of membranes (PROM)

A

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

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12
Q

what is PPROM

A

membranes rupture before 37 0/7 weeks of gestation

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13
Q

what is chorioamnionitis

A

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

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14
Q

how is chorionamnionitis diagnosed

A

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

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15
Q

postterm infant characteristics

A

dry skin , peeling, less lanugo and vernix

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16
Q

preterm infant characteristics

A

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

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17
Q

what is hypotonic uterine dysfunction

A

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

18
Q

what is hypertonic uterine dysfunction

A

too many contractions, risk for uterine rupture

19
Q

signs of uterine rupture

A

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

20
Q

what is a precipitous labor

A

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

21
Q

what is pelvic dystocia

A

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

22
Q

what is soft tissue dystocia

A

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

23
Q

what are the fetal causes of dysfunctional labor

A

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

24
Q

what is external cephalic version (ECV)

A

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

25
Q

what are the risks of elected induction

A

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

26
Q

what medications are used to ripen the cervix

A

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

27
Q

what other methods are used to stretch cervix

A

Foley catheter balloon is inflated and forces cervix to thin out

28
Q

what is augmentation of labor

A

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

29
Q

what are operative vaginal births

A

using either forceps or vacuum

30
Q

what is important to know with vacuum assisted births

A

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

31
Q

VBAC meaning

A

vaginal birth after cesarean

32
Q

TOLAC meaning

A

trial of labor after cesarean

33
Q

what is meconium stained amniotic fluid

A

Indicates fetus has passed stool prior to birth
Dark green

34
Q

what are possible causes of meconium stained fluid

A

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

35
Q

what can be done for thick meconium

A

amnioinfusion , but risk for infection increased

36
Q

what is shoulder dystocia

A

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

37
Q

what is mcroberts maneuver

A

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

38
Q

what is a prolapsed umbilical cord

A

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

39
Q

what can contribute to prolapsed cord

A

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

40
Q

What should be done with prolapsed cord

A

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

41
Q

what are the causes of uterine rupture

A

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

MIH Final review (16 decks)

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