Day 15 - Ob4 Quiz Flashcards
Mgt breech presentation > 36 wks GA
Offer external cephalic version
Definition of postpartum hemorrhage
Loss of at least 500 mL w/ vaginal; Loss at least 1 L w/ C-section
Tx woman not wish to breastfeed after pregnancy
Ice packs, tight fitting bras, avoidance of nipple stimulation, analgesia; OCPs, bromocriptine
Postpartum female p/w pain and tenderness of breasts, limited to one region, no redness or warmth
Galactocele
When can OCPs be administered in postpartum pts who do not wish to breastfeed
Wait at least 6 wks before OCPs (Risk of DVT)
Within immediate postpartum, pt develops sudden onset hypoxia, cardiogenic shock, DIC
Amniotic fluid emobolism (during labor or immediate postpartum, within 48 hrs of labor)
Pt loses more than 500 cc postpartum of blood & now has anemia, attempts at breastfeeding unsuccessful, as it appears she’s unable to generate any milk
Sheehan’s syndrome (pituitary infarction, absence of prolactin)
Meds used to control postpartum hemorrhage
Uterine massage; Oxytocin; Methergine (ergot), Hemabate (carbaprost tromethamine?, prostaglandin F2alpha); Surgical options
Definition of prolonged latent phase
Labor not progress to active phase after 20 hrs in nulliparous; or after 14 hrs in multiparous
Definition of prolonged active phase
Active phase > 12 hr; Nulliparous not dilating by 1.2 cm per hr, Multiparous pt not dilating by > 1.5 cm per hr
Tx prolonged latent or active phase
3 P’s (passage, passenger, power?) - Augment power; If still not working, C-section
Definition of arrest of descent
Epidural: Multip should not take longer than 2 hr in stage 2, Primip not take longer than 3 hr in stage 2; 1 hr less for ea w/ general (i.e., no epidural)
First steps mgt in fetal hyperstimulation or non-reassuring fetal heart tones
Maternal O2; Remove uterine stimulating (oxytocin or dinoprostone=cervadil); Left lateral decubitus; Increase monitoring (fetal scalp electrode, IUPC)
