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P&P 3 > Ex1 OB 1 Part 2 > Flashcards

Ex1 OB 1 Part 2 Flashcards

1
Q

gravid

A

pregnant

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2
Q

gravidity

A

total # of pregnancies (abnormal or normal)

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3
Q

parity

A

state of having given birth to an infant or infant > 500g+, alive or dead

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4
Q

Abortion

A

expulsion or extraction of placenta + products of conception weighing < 500g

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5
Q

Mom gave birth to triplets. What is her G/P?

A

G1P1

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6
Q

G3P1A1

A

3 pregnancies including the current pregnancy
Previously given birth to 1 infant
Previously experienced loss of embryo or fetus < 500g

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7
Q

After delivery of G3P1A1

A

G3P2A1

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8
Q

Maternal description used by OB

A

GTPAL

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9
Q

GTPAL: G stands for

A

total # pregnancies

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10
Q

GTPAL: T stands for

A

Full term pregnancies (37-40 weeks)

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11
Q

GTPAL: P stands for

A

preterm deliveries (20-36 weeks)

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12
Q

GTPAL: A stands for

A

abortions + miscarriages (before 20 weeks)

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13
Q

GTPAL: L stands for

A

living children

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14
Q

G4,P2,0,1,2

A

This is her 4th pregnancy, she’s had 2 term pregnancies, no preterm, 1 miscarriage and 2 live babies.

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15
Q

human conceptus from fertilization through the 8th week of pregnancy

A

Embryo

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16
Q

human conceptus from the 8th week until delivery

A

fetus

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17
Q

gestational age

A

estimated age of fetus *calculated from 1st day of last (normal) menstrual period (LMP), assuming 28-day cycle

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18
Q

neonate descriptions

A

Clinically viable
Immature infant
Premature infant

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19
Q

Clinically viable neonate

A

gestational age: 23-24w
+
Weight > 600g

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20
Q

Immature infant

A

completed 20-27+6 weeks
+
Weight = 500-1000g

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21
Q

Premature infant

A

Gestation: 28-36+6weeks
+
Weight = 1,000-2,500g

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22
Q

When is an infant considered full term?

A

37 weeks

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23
Q

Preterm infant

A

born prior to the 37th week of gestation (259 days)

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24
Q

mature infant

A

a live-born infant who has 37 weeks of gestation and usually weighs over 2,500 g

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25
Q

post mature infant

A

one who has completed 42 weeks of gestation or more

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26
Q

low birth weight infant

A

any live-born infant weighing 2,500 g or less

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27
Q

small-for-date infant

A

under grown infant who is significantly undersize (< 2 SD) for the period of gestation

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28
Q

oversize infant

A

> 4,000g

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29
Q

excessive size infant

A

macrosomia ( > 4,500g)

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30
Q

delivery

A

mode of expulsion of fetus + placenta

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31
Q

baby dropped also means

A

lightening: settling of fetal head into brim of pelvis

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32
Q

lightening occurs

A

> 2 weeks before labor in first pregnancy

-may not occur in women with previous deliveries until early labor

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33
Q

s/s lightening

A

Flattening of upper abdomen may be noticed, along with decreased heart burn and shortness of breath, but increased pelvic discomfort + frequent urination

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34
Q

irregular, painless uterine contractions which occur w/ slowly increasing frequency during last 4-8weeks

A

braxton-hicks contractions

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35
Q

braxton hicks contractions during early 3rd trimester

A

must be distinguished from true labor

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36
Q

braxton hicks contractions in late 3rd trimester

A

common cause of “false labor”

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37
Q

do cervical changes occur with braxton hicks?

A

no

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38
Q

cervical changes seen around labor

A

cervical softening, effacement, dilation

-occur days-weeks before true onset of labor

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39
Q

cervix is how dilated when labor starts?

A

Often 1-3cm

40
Q

Significant event that occurs prior to labor

A

bloody show

41
Q

bloody show

A
  • full cervical effacement, canal completely obliterated, bloody mucus plug w/in canal released
  • 1week to 1 hour prior to true labor
42
Q

Labor begins when

A

Braxton Hicks contractions increase in:

  • Strength (25-60 mmHg)
  • Coordination
  • Frequency (15-20 min apart)
43
Q

How is labor divided?

A

3 stages

44
Q

First stage of labor

A

interval between onset of labor + full cervical dilation; divided into 2: latent + active phase

45
Q

Second stage of labor

A

interval between full cervical dilation + delivery of infant

46
Q

Third stage of labor

A

period between delivery of infant + delivery of placenta

47
Q

First stage of labor: length of time

A

nulliparous: 8-12h
multiparous: 5-8h

48
Q

Latent Phase of labor

A
  • 1st stage of labor

- Variable duration in which progressive cervical effacement and minor dilation (2-3 cm) occurs

49
Q

Active phase of labor

A

More frequent contractions (3-5 min apart) which last up to 1 minute in duration
Leads to progressive cervical dilation up to 10 cm

50
Q

when does mom feel a desire to bear down?

A

Second stage of labor, with each contraction

51
Q

how is progress of 2nd stage of labor measured?

A

Descent of fetal head in relation to mom’s ischial spines

Stations: -3 to +3

52
Q

Contractions during second stage of labor occur how often + last how long?

A

1.5-2 minutes apart

Last 1-1.5minutes

53
Q

Average length of second stage of labor

A

primigravid women: 30m-3h

multigravid: 5-30m

54
Q

3rd stage of labor usually lasts how long?

A

2-10 minutes on average

up to 30min

55
Q

Why do we tell mom to take slow, deep breaths during delivery?

A

Hypocarbia can cause uterine vasoconstriction –> decreases placental perfusion –> risk to fetus (promotes fetal acidosis)

56
Q

Which time period puts mom at highest risk for cardiomyopathy?

A

Immediately after delivery - CO is maximal (+80% above prelabor values)

57
Q

tocodynamometer

A

transducer that measures uterine contractions/activity

58
Q

Normal fetal heart rate

A

120-160 bpm

59
Q

increased baseline FHR may be due to

A
  • prematurity
  • mild fetal hypoxia
  • chorioamnionitis
  • maternal fever
  • maternally administered drugs
  • hyperthyroidism
60
Q

decreased baseline FHR may be due to

A
  • post term pregnancy
  • fetal heart block
  • fetal asphyxia
61
Q

baseline variability

A

interplay between sympathetic (acceleration) + parasympathetic (deceleration) nervous systems which creates a baseline variability in heart rate (difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing)

62
Q

Baseline variability is measured how

A

beat-to-beat from R wave to R wave

63
Q

Minimal variability

A

< 5 bpm

64
Q

Moderate variability

A

6-25 bpm

65
Q

Marked variability

A

> 25 bpm

66
Q

What is considered normal variability in the fetus?

A

Moderate variability (6-25 bpm)

67
Q

single most important indicator of an adequately oxygenated fetus

A

Variability

68
Q

Prominent sign of fetal asphyxia

A

Sustained decreased baseline variability

69
Q

What is meant by a flat strip?

A

Bad Variability

*may need C/S if other options don’t work

70
Q

Accelerations in FHR

A

-increases of 15 bpm or+

Lasting > 15s

71
Q

FHR accelerations occurring periodically

A

normal oxygenation, related to fetal movement + response to uterine movement

72
Q

Normal fetuses have ____ accelerations

A

15-40 accelerations per hour

73
Q

FHR Accelerations decrease with

A
  • fetal sleep
  • drugs (opioids, magnesium, atropine)
  • fetal hypoxia
74
Q

Loss of variability may be d/t

A

anticholinergic block (atropine) bc fetal tachycardia

75
Q

“wake up the baby”

A

OB RN may rock the mothers abdomen or have her move in bed.

  • press on baby’s head thru cervix w/ finger
  • give mom fluids/bolus
76
Q

nonreassuring patterns

A

absence of both baseline variability + acceleration

-may be s/s fetal compromise

77
Q

Early decelerations

A
  • concomitantly with uterine contractions + provide mirror image on graphic monitoring
  • head compression
  • 20beats or less than FHR baseline
  • does not req. intvn
78
Q

late decelerations

A
  • occur 10-30s after onset of uterine contraction

- resolve 10-30s after contraction has ended

79
Q

late decelerations are caused by

A

decrease in uterine blood flow during contraction which leads to fetal hypoxia
*vigorous efforts should be made to eliminate late decels!

80
Q

late decelerations tx

A
  • correct moms HOTN
  • ensure adequacy of left uterine displacement
  • admin of O2 via face mask to mom
81
Q

if late decels are not able to be corrected, what is next option?

A

emergency C/S

82
Q

prolonged deceleration

A

*very bad.

drop of more than 30bpm, lasts for longer than 2minutes

83
Q

If a prolonged deceleration occurs, what should you expect?

A

If no epidural –> prepare for GETA

84
Q

variable decelerations are associated with

A

umbilical cord compression
or
decreased umbilical blood flow

85
Q

prolonged variable deceleration

A

> 30 minutes

86
Q

Severe variable deceleration

A

decrease of 60 bmp from baseline
OR
any FHR < 70 bmp for > 60s
-may require emergency delivery

87
Q

Category I FHR tracing

A
  • Normal = no management required
  • Baseline FHR 110-160 bmp
  • Moderate baseline variability
  • No late or variable decels
  • Early decels may be present or absent
  • Accelerations may be present or absent
88
Q

Vagal stimulation of baby

A

head compression or stretching of neck during uterine contractions

89
Q

indeterminate

A

all tracings that are not Category I or III

90
Q

Category II FHR tracing

A

“Indeterminate”
Fetal tachycardia, absence of accelerations after stimulation, prolonged decels > 2 min but < 10 min
Not predictive of abnormal fetal acid-base balance
Require continued monitoring + reevaluation

91
Q

Category III FHR Tracing

A

Abnormal and associated with abnormal fetal acid-base balance at the time of observation
Sinusoidal FHR patter, absent variability, recurrent late decels, bradycardia
Require prompt intervention

92
Q

Category III FHR Intvn

A

Intrauterine resuscitation with change in maternal position, discontinuation of labor augmentation, treatment of maternal hypotension, supplemental O2
If FHT does not improve, emergency Cesarean section

93
Q

Cord compression usually seen during ______

A

2nd stage of labor

94
Q

mnemonic for FHR

A

VEAL CHOP

95
Q

VEAL CHOP

A

Variable::cord compression
Early::head compression
Acceleration::Ok
Late::Placental insufficiency

P&P 3 (9 decks)

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