Gestational Abnormalities

Question 1

placenta abruptio

Answer 1

premature seperation of the placenta from the uterine wall

Question 2

types of placenta abruptio

Answer 2

*marginal
*central (no bleeding)
*complete (fetal mortality 100%)

Question 3

manifestations of placenta abruptio

Answer 3

uterine tenderness
board-like abdomen
increased uterine rest tone
fetal distress
vaginal bleeding (not always)
hypovolemia

Question 4

placenta abruptio management

Answer 4

assess for fetal distress
manage hypovolemia (IV fluids/blood)
c-section

Question 5

placenta previa

Answer 5

implants over the cervix

Question 6

types of placenta previa

Answer 6

*low lying (possible vaginal delivery)
*partial (need c section)
*complete (need c section)

Question 7

manifestations of placenta previa

Answer 7

bright red bleeding
painless bleeding
soft uterine body

Question 8

management of placenta previa

Answer 8

fetal monitoring
NO vaginal exams
c section (term)
type/cross (blood typing)
IV access

conservative management (bedrest, pelvic rest)

Question 9

induction

Answer 9

start labor, ripen cervix
*cervidil/prepidil
*oxytocin/pitocin
*cytotec

Question 10

augmentation

Answer 10

enchances labor
artificial ROM
*oxytocin/pitocin

Question 11

pitocin hyperstimulation

Answer 11

increased amplitude (over 90mm/Hg)
increased frequency
FHR irregularity
increased pain
increased duration (longer than 90 secs)
increased tone between contractions

Question 12

hypotonic labor pattern manifestations

Answer 12

irregular contractions
low amplitude
slow dilation or arrest of dilation

Question 13

hypotonic labor pattern interventions

Answer 13

give meds (oxytocin)
augumentation (stimulate contractions)
monitor fetal HR

Question 14

hypertonic labor pattern manifestations

Answer 14

ineffective contractions
arrest / slow dilation

Question 15

hypertonic labor pattern manifestations

Answer 15

pain management
artificial ROM
monitor fetal HR closely

Question 16

shoulder dystocia

Answer 16

fetal anterior shoulder impacts against maternal symphysis after delivery of head

cord can be compressed

Question 17

shoulder dystocia management

Answer 17

McRoberts maneuver
-maternal legs hyperflexed onto the abdomen
-suprapubic pressure

*general anesthesia

Question 18

umbilical cord prolapse

Answer 18

cord compressed between fetal head and maternal pelvis
umbilical cord precedes the presenting part

Question 19

umbilical cord prolapse management

Answer 19

relieve compression
protect exposed cord
c section birth

Question 20

cephalopelvic disproprtion (CPD)

Answer 20

**size discrepancy due to
fetal head or maternal pelvis

**related to
large fetal head
abnormal shaped or small pelvis
fetal position

Question 21

cephalopelvic disproportion (CPD) management

Answer 21

trial of labor
maternal positon changes
prepare for c section