Exam 1 (Pregnancy, Labor, & Birth)

Question 1

Why do we measure fundal height?

Answer 1

• Estimation of gestational age
• Number of centimeters should equate to weeks gestation
  
  • Ex. 28 cm. = 28 weeks ± 2

Question 2

How is obstetrical history obtained?

Answer 2

GP:

• Gravidity: Total number of pregnancies
• Parity: Number of pregnancies greater than or equal 20 weeks, irrespective of outcome

Parity can be expanded to give more information: TPAL

• Term: Born at or after 37 weeks
• Preterm: Born 20-36.6 weeks
• Abortions: Spontaneous or elective (before 20 weeks)
• Living: Current number of living children

Question 3

Kim is currently 32 weeks pregnant and has four living children: North (born at 36 weeks), Saint (born at 38 weeks), Chicago (born at 37 weeks), and Psalm (born at 39 weeks). What is her GPTPAL?

Answer 3

G: 5
P: 4
T: 3
P: 1
A: 0
L: 4

Question 4

Sam has been pregnant 3 times. They had a miscarriage at 8 weeks, a preterm delivery of a live infant girl at 34 weeks, and a set of twins born at 37 weeks. What is their GPTPAL?

Answer 4

G: 3
P: 2
T: 1
P: 1
A: 1
L: 3

Question 5

What is Naegele’s Rule?

Answer 5

• How we estimate due date
• First Day of Last Menstrual Period (LMP) - 3 months + 7 days

Question 6

What does true labor look like?

Answer 6

• progressive cervical change
• contractions felt in back and abdomen
• contractions increase in duration, intensity, and frequency
• bloody show
• ROM (rupture of membranes)

Question 7

What does false labor look like?

Answer 7

• no cervical change
• contractions mostly felt in lower abdomen
• contractions have little to no pattern and do not get stronger
• contractions stop with hydration or activity

Question 8

What is the fetal heart rate baseline?

Answer 8

110-160 beats per minute

Question 9

What are the different kinds of variability?

Answer 9

• absent: looks like a flat line
• minimal: barely any changes (<5 beats)
• moderate: great! (5-25 beats)
• marked: tells you nothing about the fetus (>25 beats)

Question 10

What are early decelerations?

and what are they caused by?

Answer 10

• mirror contractions, benign
• often caused by fetal head compression
• no intervention needed

Question 11

What are variable decelerations?

and what are they caused by?

Answer 11

• sharp, abrupt decrease in heart rate
• often caused by umbilical cord compression
• does not need to be related to contraction
• interventions: position change and amnioinfusion

Question 12

What are late decelerations?

and what are they caused by?

Answer 12

• start after the contraction has peaked, gradual decrease
• can be caused by poor placental perfusion, hypoxia, maternal hypotension, tachysystole (more than 5 contractions in 10 minutes), infection, etc.
• Interventions: Change position, fluid bolus, oxygen, d/c pitocin, notify provider

Question 13

What is Magnesium sulfate used for?

Answer 13

• prevent seizures in patients with preeclampsia
• Can temporarily slow or stop preterm labor
• Neuroprotective for preterm baby