Complications of Labor and Delivery Flashcards

1
Q

Most common cause of perinatal morbidity and mortality in the US

A

preterm labor

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2
Q

Two biggest risk factors for preterm labor

A

multiple gestation and prior perterm birth

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3
Q

What do you used an ultrasound for to evaluate preterm labor?

A

amt of amniotic fluid and estimation of cervical length if <26 weeks

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4
Q

Not routinely used to evaluate preterm labor, but can determine presence of an intraamniotic infection

A

amniocentesis

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5
Q

given to enhance fetal lung maturity. reduces Fetal respiratory distress, intraventricular hemorrhage, necrotizing enterocolitis. Maximal benefit if given within 7 days of delivery with dosing over 48hrs.

A

corticosteroids

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6
Q

When is a mother screened for group B strep?

A

between 35-37 weeks

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7
Q

Management of a mother with positive group B strep results

A

Penicillin G 5 million U IV then 2.5-3 mil U q 4 hours until delivery. Best if given 4 hours prior to delivery

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8
Q

Alternative abx for group B strep if there’s an allergy

A

cefazolin (if no h/o anaphylaxis to PCN), clindamycin, vancomycin

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9
Q

lack of progressive cervical dilation or lack of descent of fetal head or both

A

dystocia

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10
Q

leading indication for c-section

A

dystocia

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11
Q

Term for a large baby with a mom who has a small pelvis.

A

cephalopelvic disproportion

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12
Q

Expected cervical dilations for normal labor

A

1 cm/hr nulliparous. 1.5 cm /hr multiparous

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13
Q

Normal rate of descent for baby

A

Less than 3 hr if regional anesthesia. Less than 2 hr if no anesthesia

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14
Q

Manual rupture of the membranes. Risks: fetal heart rate decelerations due to cord compression, increased incidence of chorioamnionitis

A

amniotomy

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15
Q

Increase uterine activity to stimulate cervical change and fetal descent but avoid more than 5 contractions in a 10 minute period

A

oxytocin

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16
Q

Three most common indications for c-section

A

failure to progress, nonreassuring fetal status, fetal malpresentation

17
Q

Umbilical cord is palpable on vaginal exam. Pressure on the cord causes fetal bradycardia. Prompt delivery by c-section

A

umbilical cord prolapse

18
Q

What do the following have in common: Examiner’s hand maintained in vagina to elevate the cord. Pt is placed in steep trendelenberg position. Filling the bladder w/ 500-700 ml of NS. Giving a tocolytic such as terbutaline to stop contractions

A

maneuvers to reduce cord pressure in umbilical cord prolapse

19
Q

Obstetric emergency. need for additional obstetric maneuvers to effect delivery of the shoulders at the time of vaginal birth

A

shoulder dystocia

20
Q

Fetal head retracts into the perineum after expulsion. Seen with shoulder dystocia

A

turtle sign

21
Q

adduction of the fetal shoulder, displacing them from the anteroposterior position. done if McRoberts and suprapubic pressure fails

A

Rubin maneuver

22
Q

directing pressure on the anterior shoulder downward away from the pubic bone, in conjunction w/ McRoberts maneuver

A

suprpubic pressure

23
Q

Delivery of the posterior arm for shoulder dystocia.

A

Barnum maneuver

24
Q

Head enters birth canal first. Face is backward toward’s mother’s spine, arms are crossed, chin and neck are bent forward, down toward chest

A

cephalic presentation

25
Turning the baby from a breech presentation to a vertex (normal) presentation by applying external pressure
external cephalic version
26
Defined as a placenta that has not been expelled 30-60 min after delivery of the baby. Major cause of postpartem hemorrhage
retained placenta
27
What are the pharmacologic interventsions for retained placenta?
IV nitroglycerin or Intraumbilical injection of a solution of oxytocin in saline
28
Uterine fundus collapses into the endometrial cavity
uterine inversion
29
Treatment for uterine inversion
large bore IVs, uterine relaxation, manual correction
30
excessive bleeding that results in signs and symptoms of hypovolemia (tachycardia, tachypnea, delayed capillary refill, orthostatic changes, narrowed pulse pressure)
post partum hemorrhage
31
Treatment of post partum hemorrhage
fundal massage
32
Most frequently used uterotonic drugs to help tighten uterus
oxytocin or hemabate