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Paloma's Class > 🤰🏾- Exam 2 > Flashcards

🤰🏾- Exam 2 Flashcards

1
Q

Placenta previa

A

Abnormal implantation of the placenta in the lower uterus at or very near the cervical os

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2
Q

Indications for limited ultrasound scan

A

(Done quickly for a specific reason)

  • determine placental location
  • detect presence or absence of fetal ❤️ rate
  • assess volume of amniotic fluid
  • guide delivery of 2nd twin in a vag birth
  • assist with amniocentesis
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3
Q

Doppler ultrasound blood flow assessment

A

Performed on pregnancies complicated by hypertension or fetal growth restrictions

To identify abnormalities in the diastolic flow

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4
Q

Low vs high levels of MSAFP are associated with what

A

Low levels associated with chromosomal abnormalities
Ex: Down syndrome, trisomy 21

High levels are associated with open NTD and body wall defects
Ex: anencephaly, spina bifida, hydronephrosis

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5
Q

Alpha-Fetoprotein screening

A

Done between 16 and 18 weeks

** maternal weight can misconstrue results **

Screening test , not diagnostic

Done to detect possible open body defects and congenital anomalies

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6
Q

Chorionic villus sampling

A

The villi are fetal tissues

Done between 10 and 12 weeks to diagnose fetal chromosomal, metabolic or DNA abnormalities

Can cause limb reduction defects (LRD)

Give RhoGAM to 🤰🏾that is Rh-negative

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7
Q

Amniocentesis

A

Done at 15 to 20weeks

Can cause foot deformations

May resume normal activities 24hrs after procedure

Aspirate 20mL of amniotic fluid for testing

Give RhoGAM

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8
Q

Amniocentesis in 2nd vs 3rd trimester

A

2nd - done to identify chromosome abnormalities

3rd - done to determine fetal lung maturity and test for fetal hemolytic disease (anemic , jaundice and hydrops fetalis)

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9
Q

Percutaneous umbilical blood sampling

A

Aka cordocentesis

Aspiration of fetal blood from the umbilical cord for prenatal diagnosis and management rH disease, abnormal blood clotting and determination of the acid-base stays of the fetus

can deliver therapeutic drugs/blood trans that can’t be delivered to the fetus in another way

Umbilical VEIN is used because it’s larger

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10
Q

3 goals and types of antepartum fetal surveillance

A

Goals

  1. Determine fetal health or compromise as accurately as possible
  2. Reduce perinatal morbidity and mortality
  3. Guide intervention by the obstetric team

Types: nonstress test, contraction stress and biophysical profile

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11
Q

Non-Stress Test

A

Used to determine reactive/reassuring fetal movement = At least 2 fetal heart accelerations with or without movement occur within a 20min period .

before the NST, the woman should void

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12
Q

Fetal acceleration is classified as

A

An increase of heart rate at least 15 beats lasting at least 15 secs

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13
Q

Preterm acceleration in a NST

A

In a fetus younger than 32wks two accelerations that peak 10 beats and lasts for 10 secs - within a 20min window

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14
Q

What is the concern with FHR accelerations without fetal movement

A

Fetal hypoxemia and acidosis

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15
Q

Uteroplacental insufficiency

A

Inability of placenta to exchange oxygen, carbon dioxide, nutrients and waste products properly between maternal and fetal circulations

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16
Q

CST interpretation: negative, positive, equivocal or unsatisfactory

A

Negative- (reassuring) no late deceleration present

Positive- (abnormal) late decelerations are present

Equivocal- test must be redone

Unsatisfactory- fewer than 3 contractions in 10mins occurred; unable to test

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17
Q

What is used to induced contractions in a contraction stress test (CST)

A

Diluted oxytocin

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18
Q

Oligohydramnios

A

Decreased amniotic fluid

Which suggests prolonged fetal hypoxia

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19
Q

Biophysical profile (BPP)

A

Assess FHR, fetal breathing movements, gross fetal movements, fetal muscle tone and amniotic fluid volume

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20
Q

Gradual hypoxia concept

A

Fetal activity is effected in stages with how long hypoxemia lasts

  • loss of FHR reactivity (occurs first)
  • reduced, then absent, fetal breathing movements
  • reduced, then absent, gross (large) fetal movements
  • reduced fetal tone
  • prolonged hypoxemia: reduced amniotic fluid volume (occurs last)
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21
Q

Absence of fetal tone indicates what

A

Advanced asphyxia and acidosis

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22
Q

BPP score interpretation

A

Less than 4= deliver baby now

6= equivocal

8-10= normal

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23
Q

Maternal assessment of fetal movement

A

Assess the kick counts within a time period

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24
Q

Fetal circulation umbilical vein vs arteries

A

Vein- carries oxygenated blood TOWARD the fetus

Arteries- dexoxygenated blood AWAY from the fetus to the placenta

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25
Q

Adequate fetal oxygenation needs what 5 related factors

A

1 normal maternal blood flow and volume to the placenta

2 normal oxygen saturation in maternal blood

3 adequate exchange of oxygen and carbon dioxide in the placenta

4 an open circulatory path between the placenta and the fetus through vessels in the umbilical cord

5 normal fetal circulatory and oxygen-carrying functions

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26
Q

5 factors of fetal ❤️ rate regulation

A

1 autonomic nervous system

2 baroreceptors

3 chemoreceptors

4 CNS

5 adrenal glands

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27
Q

FHR and parasympathetic vs sympathetic nervous system

A

Sympathetic- increases ❤️ rate through release of epinephrine and norepinephrine

Parasympathetic- reduces ❤️ rate and maintains variability through stimulation of the vagus nerve / exerts greater influence as the fetus matures between 28 and 32wks gestation

fhr in the term fetus is lower than in the preterm fetus

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28
Q

Compromise of fetal oxygenation may occur because of what 5 factors

A

1 maternal cardiopulmonary alterations

2 hypertonic uterine contractions

3 placental disruptions

4 umbilical blood flow interruptions

5 fetal alterations

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29
Q

Doppler transducer

A

Produces a two-part muffled sound that resembles the sound of a galloping 🐴.

Represent closure of the heart valves during systole (mitral / tricuspid) and diastole (aortic / pulmonic)

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30
Q

Tocotransducer

A

Detects changes in abdominal contour to measure uterine activity “assess contractions”

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31
Q

Classification of variability

A

Absent - undetectable

Minimal - undetectable to 5 bpm

Moderate - 6 to 25 bpm

Marked - greater than 25 bpm

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32
Q

Early decelerations

A

Fetal head compression increases ICP causing the vagus nerve to slow the ❤️ rate - not associated with fetal compromise and require no intervention

Mirror contractions

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33
Q

Late decelerations

A

Deficient exchange of oxygen and waste products in the placenta (uteroplacental insufficiency)

Intervention: reposition to Left side, give oxygen, increase fluids, decrease pitocin

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34
Q

Variable decelerations

A

Conditions that reduce flow through the umbilical cord

Interventions: reposition, decrease pitocin, give amnioinfusion

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35
Q

Aminoinfusion

A

Infusion of a sterile isotonic solution into the uterine cavity during labor to reduce umbilical cord compression

May also be done to dilute meconium in amniotic fluid and reduce the risk that the infant will aspirate thick meconium at birth

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36
Q

Contraction frequency

A

Beginning of one contraction to beginning of the next

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37
Q

Contraction duration

A

Beginning to end of each contraction

How long contraction lasts

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38
Q

Cord blood gases and pH

A

Umbilical cord blood analysis is used to asses the infants oxygenation and acid-base balance immediately after birth

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39
Q

What is the physiologic retraction ring

A

The division between the upper and lower segments of the uterus

Upper- contracts actively and during labor becomes thicker

Lower- and cervix contracts passively , during labor both become thinner and are pulled upward

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40
Q

Effacement vs dilation

A

Effacement is thinning and shortening of uterus

Dilation is opening of uterus

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41
Q

During labor which cervix remains thickest a multipara or nullipara

A

Multipara’a cervix remains thicker that the nullipara’s cervix

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42
Q

Increment, acme, decrement

A

3 phases of a contraction:

Increment- period of increasing strength

Acme- aka peak period during which the contraction is most intense

Decrement- period of decreasing intensity

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43
Q

Physiological effects of the birth process:

Maternal response
5 systems

A

Cardiovascular - increase in maternal blood volume, increasing BP decrease ❤️ rate

Respiratory - increased respirations , can lead to respiratory alkalosis

GI - decreased motility can cause nausea and vomiting

Urinary - decreased sensation of a full bladder

Hematopoietic -

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44
Q

Respiratory alkalosis

A

Result of hyperventilation when she exhales too much carbon dioxide

Presentation:
Tingling of hands and feet, numbness and dizziness

Intervention:
Help mom slow her breathing and breathe into a paper bag to restore normal carbon dioxide levels

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45
Q

Physiological effects of the birth process:

Fetal response
3 systems

A

Placental circulation-

Cardiovascular- alterations in ❤️ rate

Pulmonary-

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46
Q

What are the 4 components of the birth process

A

Powers- uterine contractions (1st stage) and pushing efforts (2nd stage)

Passage- maternal pelvis and soft tissues

Passenger- fetus, membranes and placenta

Psyche- psychological response to labor is influenced by anxiety, culture, expectations, life experiences and support

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47
Q

Fetal lie

A

The orientation of the long axis of the fetus to the long axis of the woman

Longitudinal- in 99% of pregnancies parallel to the long axis of woman. Head or feet enter pelvis first

Transverse- long axis of fetus is at right angle to long axis of mom

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48
Q

Fetal attitude

A

The relation of fetal body parts to one another

Flexion- (normal) head flexed toward chest and arms and legs flexed over thorax

Extension- (abnormal) head and right arm are extended

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49
Q

Fetal presentation or presenting part

A

The fetal part that first enters the pelvis:

1 cephalic
2 breech
3 shoulder

cephalic presentation with fetal head flexed most common

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50
Q

4 variations of Cephalic presentation

A

Vertex- or occiput presentation. Most common. Fetal head is fully flexed

Military- head in neutral position. Neither flexed or extended. Occipitofrontal presenting

Brow- fetal head partly extended. Supraoccipitomental presenting

Face- head is extended. Occiput near fetal spine. Submentobregmatic presenting

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51
Q

Which fontanel can be felt in the vertex presentation vs military presentation

A

Vertex- posterior

Military- anterior

52
Q

Breech presentation is more common in term or preterm fetus

A

More common in preterm births and when a fetal abnormality like hydrocephalus prevents the head from entering the pelvis

Abnormalities of maternal uterus and pelvis or with placenta previa

53
Q

3 variations of Breech presentation

A

Frank- most common. Fetal legs are extended across the abdomen towards the shoulders

Full (complete)- reversal of cephalic presentation. Head, knees and hips are flexed but butt is presenting

Footling- occurs when one or both feet are presenting

54
Q

Lightening

A

Descent of the fetus toward the pelvic inlet before labor

55
Q

What are the 7 cardinal movements

A

Descent

Engagement

Flexion

Internal rotation

Extension

External rotation

Expulsion

56
Q

Descent

A

Descent of the fetal presenting part through the true pelvis

57
Q

Engagement

A

The Fetal presenting part as its widest diameter reaches the level of the ischial spines of the mothers pelvis (0 station)

58
Q

Flexion

A

Of the fetal head allows the smallest head diameters to align with the smaller diameters of the midpelvis as the fetus descends

59
Q

Internal rotation

A

Allows the largest fetal head diameters to align with the largest maternal pelvic diameters

60
Q

Extension

A

Of the fetal head as the neck pivots on the inner margin of the symphysis pubis, allows the head to align with the curves of the pelvic outlet

the head is born

61
Q

External rotation

A

Of the fetal head aligns the head with the shoulders during expulsion

62
Q

Expulsion

A

Of the fetal shoulders and fetal body

63
Q

What are the 4 stages of labor

A

Stage 1- cervical effacement and dilation occur longest stage

Stage 2- (expulsion) begins with complete dilation and full effacement and ends with birth of the 👶🏾

Stage 3- (placental) begins with the birth of the baby and ends with the expulsion of the placenta shortest stage, average length 6 mins

Stage 4- physical recovery and bonding may experience chills

64
Q

Schultze mechanism vs Duncan mechanism

A

Schultze- placenta expelled with the SHINNY fetal side presenting first more common

Duncan- ROUGH maternal side presents first

65
Q

Latent phase of the first stage of labor

A

Lasts through the first 3cm of dilation

Lasts 7.3-8.6hrs in nulliparas and 4.1-5.3hrs in multiparas

Contractions every 5mins lasting 30-40secs

66
Q

Active phase of the first stage of labor

A

Cervix dilates from 4 to 7cm , effacement is completed

Fetus descends in the pelvis and internal rotation begins

Contractions are 2-5 mins apart lasting 40-60secs

67
Q

Transition phase of the first stage of labor

A

Cervix dilates from 8 to 10cm

bloody show increases with completion of dilation

Contractions 1.5-2mins apart lasting 60-90secs

Leg tremors, nausea and vomiting are common

68
Q

When should 🤰🏾go to the hospital

A

-contractions:
nullipara 5mins apart for 1 hour
multipara 10mins apart for 1 hour

  • ROM
  • Bleeding/increased bloody show
  • Decreased fetal movement
69
Q

How does a nurse establish a therapeutic relationship with mom and their significant other

A

Make the family feel welcome, determine family expectations about birth, convey confidence, assign a primary nurse, use touch for comfort, respect cultural values

70
Q

Maternal vital signs are assessed to identify signs of

A

Hypertension and infection

A temperature of 38’C (100.4’F) or higher suggests infection

71
Q

What are the signs of impending birth

A

Grunting sounds, bearing down, sitting on one butt cheek and saying “the baby’s coming”

72
Q

Database assessment during admission

A
  • obtain basic info (LMP, Due date, GTPAL, etc)
  • fetal assessment presentation and position assessed using vaginal exam and leopold
  • labor status
  • physical examination

no vag exam if active bleeding or preterm , do speculum exam instead

73
Q

What are the 4 Leopold’s maneuvers

A

1- distinguishes between cephalic or breech presentation

2- determines which side the fetal back is facing

3- determines if presenting part is engaged

4- determines if head is flexed or extended not done if in breech position

74
Q

What does yellow or green amniotic fluid color mean

A

Amniotic fluid should be clear and may contain bits of vernix

Yellow- cloudy, yellow and foul-smelling suggests infection

Green- indicates that the fetus passed meconium before birth

75
Q

Intact / bulging / ruptured membranes

A

Intact- feel slippery , no leakage of amniotic fluid can be detected

Bulging- feel like a slippery, fluid-filled balloon

Ruptured- show drainage of fluid from the vagina

76
Q

What is 0 station

A

When the presenting part is at the ischial spine

Negative numbers- no fetal descent

Positive numbers- head descent through pelvis

77
Q

Conditions associated with fetal compromise

A
  • FHR outside the normal range or loss of variability
  • meconium stained amniotic fluid
  • cloudy, yellowish or foul-smelling amniotic fluid
  • Hypertonic contractions (reduces placental blood flow)
  • maternal hypotension or hypertension
  • maternal fever (100.4’F)
78
Q

What does laboring down mean

A

The technique of delaying pushing until the reflex urge to push occurs

79
Q

What is valsalva maneuver

A

“Purple pushing”

Sustained pushing while holding a breath

80
Q

Nursing interventions to elevate discomfort during birth

A

Comfort measures

Teaching

Encouragement

Giving of self (spend time with patient)

Pharmacologic measures

Caring for the birth partner

Evaluation

81
Q

List examples of comfort measures during child birth the nurse should do

A 
Dim lights 
Mouth care (ice chips)
Adjust temperature 
Damp washcloths 
Maintain dry chux 
Change position 
Assist bladder emptying 
Provide cleanliness
82
Q

Maternal positions during first stage vs second stage

A

First- sitting leaning forward with support, semi sitting, side lying, kneeling leaning forward with support

Second- hands and knees, semi sitting and side lying

83
Q

Back labor

A

When the back of the fetal head puts pressure on the woman’s sacral promontory (occiput posterior position)

Hands-and-knees position enhance the internal rotation mechanism of labor

84
Q

Pushing before stage 1 is complete causes

A

Cervical edema

Block labor

Lacerations

85
Q

Nurse’s responsibilities during birth

A
  • preparation of delivery table
  • perineal cleansing preparation
  • support with final pushing efforts
  • administer medications (oxytocin to contract uterus and control blood loss)
86
Q

Nursing care during the fourth stage of labor

A

Care of the infant- cardiopulmonary , thermoregulatory and identifying the infant

the mother- assess VS q15mins, assess fundus firmness and position, a full bladder interferes with contraction of the uterus and assess lochia

the family unit- first hour after birth ideal for parent and infant attachment

87
Q

Early nipple stimulation from the baby attempting to latch helps what

A

Initiate milk production and contract the uterus

88
Q

What are the three risks associated with amniotomy

A

Prolapse cord

Infection

Abruptio placentae

89
Q

Chorioamnionitis

A

Inflammation of the amniotic sac, usually caused by bacterial and viral infections

90
Q

Hydramnios vs oligohydramnios

A

Hydramnios- excessive volume of amniotic fluid associated with some fetal abnormalities

Oligohydramnios- abnormally small quantity of amniotic fluid maybe associated with placental insufficiency or fetal urinary tract abnormalities

91
Q

What are the criteria for an amniotomy

A

Active labor (4cm)

Term (37wks)

Engaged (0 station)

92
Q

Induction vs augmentation

A

Induction- to cause/initiate labor

Augmentation- stimulate effective contractions after labor has begun

93
Q

Indications for induction of labor

A
  • gestational and chronic hypertension
  • PROM
  • chorioamnionitis
  • postterm (over 42 weeks)
  • intrauterine growth restriction
  • positive contract test
  • isoimmunization (maternal fetal blood incompatibility)
  • fetal death
94
Q

Contraindications of induction of labor

A
  • disproportion between fetal head and maternal pelvis
  • unfavorable fetal presentation (transverse or breech)
  • placenta previa/abruptio placentae
  • multifetal gestation or multiparity (6 or more)
  • prior classical uterine incision
  • active genital herpes
  • prolapse cord
95
Q

Dinoprostone

A

(Prepidil) prostaglandin gel

0.5mg applied to cervix, maximum recommended dose 1.5mg applied to cervix and 2.5mg vaginally

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate)

When to start oxytocin: delay 6-12hrs recommended

Comments: remain still for 15-30mins after application, increases effects of ephedra , use caution in women with asthma/hypertension/glaucoma/Renal, liver or heart disease

96
Q

Vaginal insert dinoprostone

A

Cervidil

10mg in a time release vaginal insert left in place for up to 12hrs. Remove with onset of active labor, ROM, uterine hyperstimulation

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate), remove insert

When to start oxytocin: 30-60mins after removal of insert

97
Q

Misoprostol

A

Cytotec

25mcg of 100mcg tablet vaginally

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate)

When to start oxytocin: atleast 4 hours after last dose

Comments: only approved for peptic ulcers but used for cervical ripening
contraindicated in previous cesarean or other uterine surgery

98
Q

Bishop score

A

Estimates whether the cervix is favorable for induction

Cervical dilation, effacement, fetal station, cervical consistency, position

Vaginal birth more likely to result if score is higher than 8

99
Q

Serial induction of labor

A

May be performed when the cervix is not favorable and she has an indication for induction but same-day birth is not imperative

Postdate pregnancy

100
Q

Version

A

Change fetal presentation

Contraindications: abnormal uterus shape, baby over 4000g, engagement of fetal head, nuchal cord

Risks: fetal hypoxia, abruptio placentae and immediate c-section if compromised

perform NST or BPP, after 37wks, administer tocolytic or RhoGAM if needed

101
Q

Version

A

Change fetal presentation

Contraindications: abnormal uterus shape, baby over 4000g, engagement of fetal head, nuchal cord

Risks: fetal hypoxia, abruptio placentae and immediate c-section if compromised

perform NST or BPP, after 37wks, administer tocolytic or RhoGAM if needed

102
Q

Serial induction of labor

A

May be performed when the cervix is not favorable and she has an indication for induction but same-day birth is not imperative

Postdate pregnancy

103
Q

Bishop score

A

Estimates whether the cervix is favorable for induction

Cervical dilation, effacement, fetal station, cervical consistency, position

Vaginal birth more likely to result if score is higher than 8

104
Q

Misoprostol

A

Cytotec

25mcg of 100mcg tablet vaginally

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate)

When to start oxytocin: atleast 4 hours after last dose

Comments: only approved for peptic ulcers but used for cervical ripening
contraindicated in previous cesarean or other uterine surgery

105
Q

Vaginal insert dinoprostone

A

Cervidil

10mg in a time release vaginal insert left in place for up to 12hrs. Remove with onset of active labor, ROM, uterine hyperstimulation

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate), remove insert

When to start oxytocin: 30-60mins after removal of insert

106
Q

Dinoprostone

A

(Prepidil) prostaglandin gel

0.5mg applied to cervix, maximum recommended dose 1.5mg applied to cervix and 2.5mg vaginally

Actions for HC: side lying, 8-10L oxygen, administer tocolytic (terbutaline of mag sulfate)

When to start oxytocin: delay 6-12hrs recommended

Comments: remain still for 15-30mins after application, increases effects of ephedra , use caution in women with asthma/hypertension/glaucoma/Renal, liver or heart disease

107
Q

Operative vaginal birth

A

Forceps or vacuum extraction

Indications: exhaustion, inability to push effectively, non reassuring FHR patterns, failure of presenting part to rotate and descend

Contraindications: severe fetal compromise, maternal CHF and pulmonary edema, high fetal station and disproportionate fetus size to maternal pelvis

108
Q

Chignon

A

Scalp edema that often forms under the suction cup of a vacuum extractor

109
Q

3 Classifications for operative vaginal delivery

A

Outlet operative vaginal delivery- fetal head is at perineum, with the scalp visible at vaginal opening

Low operative vaginal delivery- fetal head between +2 and +3 (passed ischial spine)

Midpelvis operative vaginal delivery- fetal head between 0 and +2 station

110
Q

Median or midline episiotomy

A

Advantages: minimal blood loss, neat healing with little scarring, less postpartum pain

Disadvantages: an added laceration may extend the median episiotomy into the anal sphincter, limited enlargement of the vaginal opening due to anal sphincter

111
Q

Mediolateral episiotomy

A

Advantages: more enlargement of the vaginal opening (more room for the baby to come out), little risk that the episiotomy will extend to the anus

Disadvantages: more blood loss, increased postpartum pain, more scarring and irregularity in the healed scar, prolonged dyspareunia (painful intercourse)

112
Q

Why is the rate of c-sections increasing

A
  • women having their first baby more like to do c-section
  • first baby induced greater risk for c-section
  • repeat c-sections more common
  • more common in older pregnant woman
  • breech position
  • higher maternal requests
113
Q

Placenta accreta

A

Abnormal adherence of the placenta to the uterine wall, often along the previous incision area

114
Q

Indications and risks of cesarean section

A

Indications- dystocia, cephalopelvic disproportion, hypertension, active genital herpes, previous uterine surgical procedures, prolapsed cord, breech, abruptio placentae

Risks- infection, hemorrhage, UTI, thromboembolism, paralytic ileus, atelectasis

115
Q

Why is Bicitra administered before cesarean section

A

Given to reduce gastric acidity

116
Q

Pfannenstiel skin incision

A

Transverse or “bikini” cut

Advantages: less visibility when healed and the pubic hair grows back, less chance of dehiscence or formation of a hernia

Disadvantages: less visualization of the uterus, can’t be done as quickly (emergency cesarean), can’t easily be extended to give greater operative exposure, re-entry at a subsequent cesarean may require more time

117
Q

McRoberts maneuver

A

To relieve dystocia the woman flexes her thighs sharply against her abdomen , which straightens the pelvic curve somewhat

118
Q

Gynecoid shaped pelvis

A
  • most common
  • round, cylindric shape throughout. Wide pubic arch (90 degrees or greater)
  • prognosis for vaginal birth: good
119
Q

Anthropoid shaped pelvis

A
  • long, narrow oval. Anteroposterior diameter is longer than transverse diameter. Narrow pubic arch
  • prognosis for vaginal birth: more favorable than android or platypelloid pelvic shape. Fetus may be born in occiput posterior position
120
Q

Android shaped pelvis

A
  • heart or triangular-shaped inlet. Narrow diameters throughout. Narrow pubic arch
  • prognosis for vaginal birth: poor
121
Q

Platypelloid shaped pelvis

A
  • flattened wide, short oval. Transverse diameter wide, but anteroposterior diameter short. Wide pubic arch
  • prognosis for vaginal birth: poor
  • not ideal for vaginal delivery= cesarean
122
Q

Precipitate labor vs precipitate birth

A

Labor- birth occurs within 3 hours of its onset

Birth- when a trained attendant is not present to assist

123
Q

Medication used to accelerate fetal lung maturity

A

Betamethasone (celestone) - 12mg IM. Corticosteroid used to stimulate surfactant production BEFORE delivery.

Dexamethosone - 6mg IM q12h x 4 doses

124
Q

Fetal fibronectin

A

A protein present in fetal tissue that correlates with presence of onset of labor

*positive fFN mid pregnancy could mean maternal or fetal infection

125
Q

Prolapsed cord

A

Occult prolapse- cord compressed between fetus and pelvis and can’t be seen or felt during vaginal exam

Cord prolapsed infront of fetal head

Complete cord prolapse- cord can be seen protruding from the vagina

Interventions: reposition, give oxygen, don’t touch cord, keep presenting part elevated

126
Q

First trimester ultrasound

A

Done at 5-6 weeks

Transvaginal

Done to confirm pregnancy and measure gestation with CRL (crown-rump length)

Paloma's Class (10 decks)

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