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EMRG1305 > General Obstetrics > Flashcards

General Obstetrics Flashcards

1
Q

What is a full term Pregnancy?

A

37-42wks

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2
Q

What are the general child-bearing years?

A

14-50 years of age

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3
Q

When is a pregnancy considered viable, and what is done after this point?

A

20 weeks, every effort to resuscitate must be made

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4
Q

What are the 3 stages of Pregnancy?

A

Germinal, embryonic, fetal

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5
Q

When is the germinal stage?

A

0-2 weeks

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6
Q

When is the embryonic stage?

A

3-8 weeks

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7
Q

When is the fetal stage?

A

9 weeks to birth

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8
Q

What are the normal Circulatory changes for a pregnant woman?

A

^ blood volume (5-6 total volume)
Cardiac Output ^by 40-50%
HR increases by 10-20 bpm
SV ^ 30%
Intravascular volume ^45%
Systolic BP - minimal change
Diastolic - 20% decrease mid pregnancy

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9
Q

How does resp. system change suring pregnancy?

A

30-40% increase o2 consumption
Resp rate ^ slightly
30-35% ^ tidal volume
25% decrease residual capacity

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10
Q

What is the fundus?

A

Top part of the uterus

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11
Q

Where is the fundus at 20wks?

A

at the umbilicus

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12
Q

How can fundal height be used to predict gestational age?

A

Umbilicus is 20wks, 1 cm above is another week

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13
Q

What are the normal gastrointestinal changes in pregnant women?

A

Elevated progesterone - causes nausea and vomit (first6-14wks)
constipation, heartburn

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14
Q

What is the metabolism like in early pregnancy?

A

Anabolic state, increase maternal fat stores, small ^ insulin sensitivity. Nutrients stored to meet demands of mother and fetus

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15
Q

What is metabolism like in late pregnancy?

A

Catabolic state, decreased insulin sensitivity, ^ maternal glucose/free fatty acid, fetal growth

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16
Q

What does gravida mean?

A

How many times pregnant? Includes miscarriages/abortions

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17
Q

What does Para mean?

A

Number of pregnancies a woman carried past 28 weeks (dead or living, current not counted, multiples counted as 1)

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18
Q

What is an Amniotic Sac?

A

Fluid filled, bag like membrane where the fetus grows

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19
Q

What is an abortion

A

Expulsion of the fetus, for any cause before 20 wks

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20
Q

What does primipara (primip) mean?

A

First time pregnancy/labour

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21
Q

What is a multipara (multip)?

A

Pt has had 2 or more deliveries

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22
Q

What is a pt who is pregnant for the 3 time, with no children at home described?

A

G3P0

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23
Q

What are the two notable factors of contractions?

A

Frequency (interval between), duration (of contraction)

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24
Q

What are Braxton hicks contractions?

A

False labour pains, 2/3 trimester, body’s way of preparing.
Not in regular pattern, and go away
uncomfortable, but don’t get worse

25
Q

What does the first stage of labor involve?

A

Uterine contractions that increase in strength, length and frequency. fetus descends, cervix softens, shortens, thins and dilates

26
Q

How is the first stage of labour broken down?

A

Early and Active labour

27
Q

What are the characteristics of early labour?

A

Mild and irregular contractions (20-30secs long), bloody show, SROM may occur

28
Q

How may the patient present in early labour?

A

Walking and talking through mild, irregular, short contractions

29
Q

What characterizes active labour?

A

Regular, continuous, strong contractions (3-4 mins, lasting 45-60 seconds), progressive dilation, bright red bloody show

30
Q

How might the patient present during active labour?

A

Difficulty walking and talking through contractions, may be distressed. Vomit/shaking overwhelming emotions possible

31
Q

When does stage 2 of labour start and end?

A

Starts when pt is fully dilated (10cm), and feels the urge to push, ends once baby is born.

32
Q

What do contractions look like in Stage 2?

A

less than 2 mins apart, lasting 60-90 seconds, strong.

33
Q

What characterizes Stage 2 of labour?

A

The uterus will rise up and change shape
Urge to push occurs when the presenting part reaches the pelvic floor
Pt is actively bearing down
Bloody show, stool, amniotic fluid drainage
Pain and perineal pressure with distention
Bulging perineum until presenting part is visible

34
Q

How is imminent birth explained as per ALS for Primips?

A

presenting part is visible during and between contractions,
maternal urge to push or bear down,
contractions are less than two (2) minutes apart

35
Q

How is imminent birth explained as per ALS for Multips?

A

contractions five minutes apart or less and any other signs of second stage labor present.

36
Q

When does stage 3 start and finish?

A

Starts from the birth of baby till delivery of placenta?

37
Q

What are paramedic observations of Stage 3?

A

Lengthening of the cord.
Sudden gush or trickle of blood
Uterine Contraction

38
Q

What does CCT stand for in delivery?

A

Controlled Cord Traction

39
Q

What is an Indication that the placenta is being delivered?

A

Gush of blood, lengthening of cord, contractions

39
Q

What is done with a placenta after it is delivered?

A

Inspect for wholeness, place in plastic bag (mark mother name and time), transport with patients

40
Q

Why is placental delivery considered high risk?

A

Increased risk of bleeding and post-partum hemorrhage

41
Q

In an ideal situation, how would you set up the delivery station?

A

Call for additional crew. Open OBS Kit, Pt on firm surface, prepare neonate resus station, prepare towels and blankets

42
Q

What happens if midwife is on scene?

A

Let them take over - assist them where they ask

43
Q

What are the 7 phases of a normal birth?

A

Engagement, Flexion, Internal Rotation, Extension, Restitution, External Rotation, Expulsion

44
Q

What is Restitution?

A

When baby’s (delivered) head turns to side

45
Q

How is external rotation of baby different from internal and why is it important?

A

External happens once the head is delivered, it allows for the shoulder to deliver

46
Q

Where should the umbilical cord be cut?

A

at approx. 15 cm and 7 cm

47
Q

What must be done prior to cutting the umbilical cord?

A

It must be clamped

48
Q

What is delayed cord clamping?

A

Delaying clamping the cord until pulsations stop (about 2 minutes)

49
Q

What is the benefit of delayed cord clamping?

A

Increase blood flow, and decrease probability of anemia

50
Q

What does APGAR stand for?

A

Appearance, pulse, grimace, activity, respirations

51
Q

What is the APGAR criteria at 0

A

Pale and blue, no pulse, no response, limp, no respirations

52
Q

What is APGAR criteria at 1

A

Body pink with blue limbs, HR<100, grimace, weak activity, slow/irregular respirations

53
Q

What is APGAR criteria at 2

A

pink, pulse>100, coughing and crying, strong activity, good resp

54
Q

What are the basics of oxytocin?

A

promotes uterine contraction, fast onset, duration 2-3hrs, minimal side effects

55
Q

What is Vertex Presentation?

A

head first, face toward back of mom. majority of births

56
Q

What are some indications that the maternal pt may be having twins?

A

Smaller than anticipated, fundal height stays high, additional fetal parts palpated through abdomen

57
Q
A

EMRG1305 (2 decks)

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