Gynecology & Pregnancy Emergency Terminology Flashcards
dysmenorrhea
pain during menstruation
- caused by muscular contractions of the myometrium, infection, inflammation
- presence of IUD
what does IUD stand for?
intrauterine device
IUD
“a contraceptive device fitted inside the uterus and physically preventing the implantation of fertilized ova”
signs of dysmenorrhea
- headache
- faintness, dizziness, nausea
- diarrhea
- backache
- leg pain
mittelschmerz
pain in the right or left lower abdominal quadrant during normal mid-cycle of menstrual period
- pay be due to follicular rupture and bleeding from ovary during menstrual cycle
gravida
number of times a women has been pregnant (including current)
para
number of live birth (infants born after 20 weeks’ gestation)
gestation
“the period of time between conception and birth”
antepartum
the maternal period before delivery
intrapartum
the maternal period during delivery
postpartum
the maternal period after delivery
term
a pregnancy that has reached 40 weeks gestation
first stage of labor
begins with contractions and ends when the cervix is fully dilated (10 cm)
second stage of labor
measured from full dilation to delivery of the newborn
third stage of labor
begins with delivery of the baby and ends with placental delivery
precipitous birth
onset of labor to birth is less than 3 hours
onset
“the first appearance of the signs of an illness”
ectopic pregnancy
pregnancy that develops outside of the uterus (fallopian tube or ovary)
- typically found at 8-12 weeks’ gestation
signs of ectopic pregnancy
- vaginal bleeding
- crampy abdominal pain
- spotting
- rigid, stiff, board-like abdomen
- after rupture, severe abdominal pain, vaginal spotting, internal hemorrhage, sepsis, and shock
spotting
“any bleeding from the vagina that is not due to the monthly menstrual cycle”
sepsis
“an extreme immune response to infection that can lead to tissue damage, organ failure, or death if not treated right away”
management of ectopic pregnancy
- rapid transport
- contact ALS
placenta previa
- strongly associated with number of previous C-sections and deliveries
- most common cause of pre-term bleeding
signs of placenta previa
third-trimester pain (aching)
- painless
- bright red bleeding
C-section
“surgical procedure that involves cutting into the mother’s abdomen and uterus to deliver the baby”
abruptio placenta
“the early separation of placenta from the lining of the uterus before the completion of the second stage of labor”
signs of abruptio placenta
third-trimester pain (stabbing)
- painful
- dark red bleeding
- localized uterine tenderness
uterine
relating to the uterus
preeclampsia
“serious pregnancy complication that involves high bp and other signs of organ damage that occur after 20 weeks of pregnancy”
signs of preeclampsia
- proteinuria (protein/blood in urine)
- low platelets
- impaired liver function
- renal insufficiency
- pulmonary edema
- visual or cerebral disturbances
- severe hypertension: systolic > 160; diastolic > 110
management of preeclampsia
- oxygen
- calm transport
what does PRN stand for?
pro re nata (“as needed”)
eclampsia
preeclampsia + seizure
signs of eclampsia
- tonic-clinic activity
- labor can begin suddenly/progress rapidly
management of eclampsia
- left lateral recumbent positioning
- oxygen
- contact ALS
recumbent
“the body’s position when it is lying horizontally”
postpartum hemorrhage
500mL of blood loss after delivery
- occurs within first 24 hours
obstetric
“a branch that deals with childbirth and with the care of women before, during, and after childbirth”
management of postpartum hemorrhage
- fundal massage
- encourage newborn breastfeeding
- contact ALS
fundal
“the part of a hollow organ that is across from, or farthest away from, the organ’s opening”
management of trauma during prenancy
- ABC’s first
- aggressive resuscitation
notes
- never transport pregnant patient flat on back after first trimester
supine hypotensive syndrome*
- transport on left side
- if spinally immobilized, …
imminent delivery
- regular contractions, 45-60 seconds in length, at 1-2 minute intervals
- mother has sensation of bowel movement
- crowning occurs
- mother believes delivery is imminent
if contractions are greater than 5 minutes apart,
transport
crowning
“sign of impending birth that occurs during the second stage of labor when the baby’s head becomes visible in the vaginal opening and is firmly rimmed by the vaginal wall”
contractions
“when the muscles of your uterus get tight and then relax”
APGAR Score*
“standardized test used to assess a newborn’s health immediately after birth”
- assign score at 1 and 5 minutes after birth
APGAR score of 10
best possible condition (unlikely in prehospital setting)
APGAR score of 7-9
generally normal
APGAR score of 4-6
moderately depressed
APGAR score of 0-3
severely depressed
APGAR score of < 6
likely resuscitation
shoulder dystocia
fetal shoulders are wedged against symphysis pubis, blocking shoulder delivery
symphysis pubis
“join that connects the left and right pelvic bones, forming a line down the pelvis”
management of shoulder dystocia
- position patient in McRobert’s Maneuver
- apply gentle pressure to suprapubic area
- rapid transport
suprapubic area
“region of the abdomen located below the umbilical region”
cephalopelvic disproportion
newborn’s head is too large to pass through birth canal
McRobert’s Maneuver
“sharply flexing mother’s legs towards her abdomen”
management of cephalopelvic disproportion
- oxygen administration
- rapid transport
breech presentation
largest part of fetus (head) is delivered last
- do not push
management of breech presentation
- rapid transport
- call for assistance
- oxygen administration
umbilical cord prolapse*
cord passes through the cervix at same time or in advance of fetus
- cord is compressed against fetus (diminishes fetal oxygenation from placenta)
cervix
“lower, narrow end of the uterus (womb) that connects the uterus to the vagina
(birth canal)”
placenta
“organ that forms in the womb, also called the uterus, during pregnancy”
- provides oxygen and nutrients to a developing baby
management of umbilical cord prolapse
assess for cord pulsation
- if pulsating, wrap with moist sterile dressing and then dry dressing to maintain temp, continue to assess for pulse
- if not pulsating, insert two gloved fingers into vagina and attempt to move baby off of cord, may also place mom in knee chest position; continue methods until cord begins pulsating and follow directions above
nuchal cord
cord is wrapped around fetus’ neck during delivery
management of nuchal cord
try to remove the cord from the fetus’ neck during delivery
- if unable, clamp in two places and cut immediately
delivery process
- crowning occurs (apply gentle counter pressure to fetus’ head to prevent explosive delivery)
- observe for nuchal cord with delivery of head
- grab head with hands over ears to support head as it rotates for shoulder presentation
- once shoulders deliver, rest of baby delivers very quickly (use dry towel to grasp/support)
- suction airway (mouth then nose) only if meconium staining is present along with signs of respiratory distress or coarse gurgling
- dry newborn (record sex and time of brith)
meconium staining
when meconium (stool) enters the amniotic fluid
- gives fluid greenish, brownish color
cutting umbilical cord
- cord should have stopped pulsating
- clamp cord (if baby does not need resuscitation, allow for 30 seconds to 1 minute after delivery to clamp/cut)
- clamp 4-6’’ away from the newborn (in two places)
- cut between the clamps (do not take the clamps off
conception
“the beginning of pregnancy, marked by fertilization of an egg by a sperm”
uterus
“a hollow, muscular organ in the female pelvis that develops and nourishes a fetus”
fallopian tube
“one of two long, slender tubes that connect the ovaries to the uterus”
