Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENDOREPRO II Exam I > [CLMD] Obstetric Complications [Wootton] > Flashcards

[CLMD] Obstetric Complications [Wootton] Flashcards

1
Q

What are some nonmodifiable risk factors for Preterm Labor (PTL)?

A

Socioeconomic Factors – African Americans

Medical and Obstetrical Factors:

Previous HIstory of PTL

History of 2nd trimester abortion

Repeated Spont 1st trimester abortion

bleeding in 1st trimester

UTI

Twins

Uterine Abnormalities

Polyhydraminos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some modifiable risk factors of PTL?

A

Infection

Placental-Vascular

Pyschosocial Stress/Work Strain

Uterine Stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What associations are we considering with Infection/Cervical pathway in terms of modifiable risk factors of PTL?

A

Bacterial Vaginosis

Tx for Group B Strep

Tx for Gonorrhea/Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In terms of cervical length how does it correlate with PTL?

A

As Cervical Length DECREASES; PTL INCREASES

Assess with Ultrasound, or Fetal Fibronectin (FFN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 components to the Placental-Vascular Pathway?

A

Immunological Component

Vascular Component

Low Resistance connection of Spiral A

(Alteration of either of these, results in poor fetal growth –> PTL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the main hormones released in the Stress-Strain pathway that we can help to reduce?

A

Cortisol

Catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Uterine Stretch pathway is a result of increasing volume, and is a risk factor in what 2 things?

A

Polyhydraminos

Multiple Gestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When & How do we diagnose PTL?

What symptoms are expected?

A

20-37 weeks w/ a CERVICAL EXAM, External Monitoring, FHR

Must have: Uterine Contractions, Cervical Dilation of 2cm (80% effacement)

Menstraul like cramping, Backache, Pelvic Pressure, Discharge (bloody), Uterine Contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Once you have done the initial assessment, and before you can confirm PTL, how do you manage the patient?

A

Reevaluate Cervix after an hour

Oral/IV Hydration

Bed Rest

Cultures Taken –> for Group B Strep

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Once you have DIAGNOSED PTL, how do you manage the patient?

A

Begin Tocolysis (MgSO4, Nifedipine, or Indomethacin)

also give Steroids if the baby is preterm (for Lung Growth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the benefit of giving MgSO4?

A

Neuroprotection, (against Cerebral Palsy)

(MgSO4 is given if less than 32 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the benefits of giving Nifedipine for Tocolysis of a PTL patient?

A

Its an Oral agent

Minimal Maternal and Fetal Side affects

(replacing Mg as drug of choice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the benefits/risks of giving Indomethacyin (Prostaglandin Synthetase Inhibitors)?

A

Inhibits Prostaglandin –> induce myometrial contractions

Can be given ORAL or RECTAL

Can result in Oligohydraminios

Can cause premature closure of Fetal DA –> Pul HTN –> HF

Necrotizing Enterocolitis, Intracranial Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drug is not used for primary tx of preterm labor, but is shown to decrease uterine activity?

A

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do you give Glucocorticoids (Betamethasone)?

A

For Fetal Lung Maturation

(given between 24-34 weeks) – lasts 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the Risk Factors for PROM?

A

History of PROM

Vaginal/Cervical Infections

2nd/3rd trimester bleeding

Short Cervix

Low BMI

Low SES

smoking

Nutritional def

17
Q

How do you diagnose PROM?

A

Loss of FLuid

Confirmation of Amniotic Fluid in Vagina

Check for Rupture using Sterile Speculum

(don’t check cervix of PPROM –> increases risk of infection)

18
Q

How do you confirm PROM?

A

Pooling

Nitrazine Paper (turns blue)

Ferning

(US to evaluate amniotic fluid vol)

19
Q

What is the Expectant management of PPROM?

A

Continue pregnancy until lung profile is mature (Check Gestational Age)

Deliver at 34 weeks

Antiobiotic course (Ampicillin, Erythromycin/Azithro)

Tocolytic

Steroids

Amniotic Fluid Index

Fetal/Maternal Status

20
Q

In the case of PPROM, an intact amniotic sac prevents?

A

Chorioamnionitis

21
Q

What is Intrauterine Growth Restriction (IUGR)?

A

When the birth weight of a newborn is below the 10% for a given gestational age

22
Q

What are Growth Restricted fetuses at a higher risk for?

A

Meconium Aspiration

Hypoxia

Stillbirth

Polycethemia

Hypoglycemia

Cognitive Delay

Adult onset HTN. Diabetes, CAD, Stroke

23
Q

How do we detect a fetus who is at risk of IUGR?

A

Physical Exam – Serial Fundal Heigth (primary screening tool)

US

Direct Studies – Amniocentesis, PUBS

Doppler Studies

24
Q

What are placental causes of IUGR?

A

HTN

Renal Dz

Placental/Cord Abnorm

Preexsiting Diabetes

25
Q

What are Fetal causes of IUGR?

A

Infections (TORCH, Listerosis)

Congenital Anomalies

Multiple Gestations

Chrom Abnorm

26
Q

What are maternal causes of IUGR?

A

Bad Nutrtion

Smoking

Drug Abuse

Alcoholism

Cyanotic Heart Dz

Pulmonary Insuff

Antiphospholipid Synd

Hereditary Thrombophilias

Collagen Vascular Dz/Autoimmune Dz

27
Q

Why do we use US for diagnosis of IUGR?

A

To get a weight of the baby

28
Q

How do we manage IUGR, Pre-pregnancy?

Antepartum?

A

Controlling Diabetes, HTN

Deliver BEFORE fetal compromise

Decrease modifying factors

stop smoking

improve nutrtion

bed rest

MONITOR patient

29
Q

What are some of techniques of Fetal Surveilance?

A

NonStress Testing (NST)

Biophysical Profile (BPP)

Doppler Study of Umbilical A

30
Q

is IUGR an indication for C-Section?

A

NO!

31
Q

What is the definition of a post-term pregnancy?

A

>42 weeks

(normal is 38-42 weeks)

32
Q

If the baby is kept over 42 weeks, and isnt affected by palcental insufficiency what are they at a risk for?

A

Macrosomia (greater than 4500 grams)

Abnormal Labor

Shoulder Dystocia

C-Section

33
Q

What causes a Post-Term Pregnancy?

A

Unsure Dates

Fetal Adrenal Hypoplasia

Anencephalic Fetuses

Placental Sulfatase Def

Extra-Uterine Preg

34
Q

What would you do at the 41st week of a suspected Post-Term Preg?

42nd week?

A

Begin Antenatal testing: twice weekly NST and BPP

Induce labor if abnormal!!

————————————–

INDUCE LABOR!

35
Q

What is Intrauterine Fetal Demise (IUFD)?

Causes?

A

Fetal Death after 20 weeks gestation, but before onset of labor

UNKNOWN – lots of associated causes

36
Q

If a baby is kept post-term are they at a greater risk?

A

YES, they have a greater risk of Perinatal mortality,

and Postmaturity Syndrome (loss of subq fat, long fingernails, dry and peeling skin, abundant hair)

ENDOREPRO II Exam I (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions