Exam 2 Study Guide & Tutor Notes Flashcards
Intrauterine Growth Restriction
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Limited nutrients from the placenta to the baby
- can lead to low birthweight – < 2500 grams (5.5 lbs)
Signs & Symptoms of Preterm Labor
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- Vaginal discharge (change / increase)
- Pelvic pressure
- Mild abdominal cramps
- Constant dull back pain
- Regular contractions / ruptured membrane
What is Chorioamnionitis?
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Bacterail infection of the amniotic cavity
Tx: IV broad spectrum antibiotics & deliver baby
Signs & Symptoms of Chorioamnionitis
- Fever
- Tachycardia
- Uterine tenderness
- Foul odor amniotic fluid
What is Group Beta Strep (GBS)?
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Leading cause of perinatal infections including bacteremia, endometritis, chorioamnionitis & UTIs
* Vaginal-rectal culture is usually done between 35-37 weeks
- TX: IAP antibiotics (intrapartum antibiotic prophylaxis) to decrease risk of chorioamniotitis
- Effect on Newborn: can cause focal or systemic disease – severe respiratory distress, pneumonia, shock,& meningitis (less often to develop meningitis); osteomyelitis & septic arthritis
How can Group Beta Strep (GBS) effect a newborn?
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Can lead to severe respiratory distress, pneumonia, shock, & in rare cases meningitis
What can Group Beta Strep cause? What is the treatment? What impact does it have on the newborn?
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Can cause infections including chorioamnionitis & UTIs
- Tx = IAP (intrapartum antibiotic prophylaxis)
- Newborn Impact: severe respiratory distress, pneumonia, shock, & in rare cases meningitis
What is considered Preterm birth?
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Birth between 20 - 36 6/7 weeks
- Very Preterm – < 32 weeks
- Moderately Preterm – 32-34 weeks
- Late Preterm – 34 - 36 6/7 weeks
CAUSES:
* infection (UTIs)
* congenital structural abnormalities of the uterus
* placental causes
* maternal & fetal stress
* uterine overdistention
* allergic reaction
* decreased progesterone
* periodontal disease
What is considered Posterm Labor?
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birth at > 42 weeks (< 0.5% of mothers)
- increased maternal morbidity
- dysfunctional labor
- abnormal growth
- shoulder dystocia
- meconium stained fluid
What is external cephalic version (ECV)?
Attempt to turn the fetus from breech or shoulder presentation for birth
Amniotomy
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Artificial Rupture of Membranes (AROM)
- when the amniotic sac is ruptured with a hook
do NOT rupture membranes until baby is ≥ -3 station (-3, -2, -1, 0)
Indications for Forceps-Assisted or Vacuum-Assisted Birth
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Forceps or Vacuum may be used in…
*
- 2nd stage of labor (10 cm dilation & 100% effaced)
- HTN or cardiovascular disease
- Mom is exhausted
Must Be / Have:
* full dilation
* empty bladder
* baby’s head must be down
* ≥ 34 weeks
* ruptured membranes
What is Uterine Atony?
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failure of the uterus to contract firmly (down to its pre-pregnancy size) (hypotonia = low muscle tone of the uterus)
- most common cause of postpartum hemorrhage
Postpartum Hemorrhage
* Early PPH
* Late PPH
* Medications
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Cumulative blood loss ≥ 1000 mL or s/s of hypovolemia with in 24 hours after birth
- Early (within 24 hours of birth) – atony, bladder distention, trauma
- Late (> 24 hours or < 6 weeks) – infection, subinvolution, retained placenta, or coagulation defects
- Medications = Methergine or Hemabate (also IV oxytocin)
Define Postpartum Hemorrhage
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Cumulative blood loss ≥ 1000 mL or s/s of hypovolemia within 24 hours after birth
