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Critical Care > High Risk Obstetrical Emergencies > Flashcards

High Risk Obstetrical Emergencies Flashcards

1
Q

What is the mauriceau maneuver?

A

A method of delivering the head in an assisted vaginal breech delivery in which the infant body is supported by the right forearm while traction is made upon the shoulders by the left hand. Head is maintained in a flexed position by placing the index and middle finger of the maxillary prominence on either side of the nose.

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2
Q

Which type of breech presents with buttocks flexed at the hip and extended at the knees?

A

Frank Breech
65-70% of breechs

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3
Q

Which type of breech presents with hips and knees flexed so that the baby is sitting cross legged with feet beside the buttocks?

A

Complete Breech

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4
Q

Which type of breech presents with one or both feet come first with the buttocks at a higher position.

A

Footling Breech

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5
Q

Which type of breech presents with one or both legs extended at the hips and flexed at the knees?

A

Kneeling

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6
Q

What is a hypertonic Uterus?

A

Hyperstimulated.
An overdose of oxytocin may cuase this type of uterine activity

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7
Q

V C
E H
A O
L P

A

Variable Cord compression
Early Head compresion
Accelerated Okay
Late Placenta

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8
Q

What is the first stage of labor?

A

Onset of labor and ends when the cervix is 100% effaced and completeley dilated to 10cM 12-17 hrs

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9
Q

What is the second stage of labor?

A

When cervix is completely effaced and dilated and ends with birth. 1-2 hours

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10
Q

What is the third stage of labor?

A

Begins with birth and ends at delivery of placenta. 15-20 minutes

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11
Q

What is the fourth stage of labor?

A

Delivery of placenta and ends after 1-2 hours after delivery

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12
Q

Fetus of preelcamptic mother during labor will comonly experence

A

Late Decelerations

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13
Q

Normal Magnesuim level is

A

1.5-2.5

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14
Q

Theraputic serum magnesium to prevent seizures in OB

A

4-8mEq/L

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15
Q

What are the main assessment fingings in pregnacy induced hypertension (PIH)

A

Hypertension, Edema, proteinuria

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16
Q

Fesus’s variability is

A

expected to increase during active labor, normal 10-15 beats per minute and the best indicator of fetal viability

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17
Q

What is minimal variability

A

<5

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18
Q

What is moderate variability

A

6-25

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19
Q

What is Marked variability

A

> 25

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20
Q

Causes of Sinusoidal pattern on EFM

A

Fetal hypovolemia, accidental tap of the umbilical cord during amniocentesis, placetal abruption

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21
Q

What does HELLP stand for?

A

Hemolysis, Elevated Liver enzymes and Low Platlets
complication of severe preeclampsia, life threatening
Platelet count lower than 100,000 is characteristic of HELLP
High biliruben, lower platelet and red blood cell fragment and irregularly shaped red blood cells

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22
Q

When do you give methergine?

A

0.2mg administered IM or IV is recommended to prevent or control bleeding following birth.

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23
Q

What side effects can be seen after magnesium sulfate administrion

A

Flushing of skin, diaphoresis, nausea, vomiting and drowsiness. A decrease in FHR variability may be observed.

24
Q

What is given to prevent hemolytic disease of newborn

A

Rho(D)

25
Q

Frequency of contractions is defined as

A

begnning of one contraction to the begnning of another

26
Q

The Duration of contractions is defined as

A

beginning of one contraction to the end

27
Q

How do you measure fundal height

A

From top of bupic bone to top of the uterus

28
Q

Fundal height just above the umbilicus is how many weeks

A

20-24 Weeks

29
Q

Where do most ectopic pregnancies occur

A

Fallopian tubes

30
Q

What medications can decrease or stop uterine activity

A

Terbutaline, mag, nsaid’s

31
Q

What med can help decrease the chance an infant will have respiratory distress syndrome

A

Betamethasone (Celestone)

32
Q

A small amount of fluid is spread on a sline and allowed to dry, a frond crystallization pattern of dried amnionitic flud will be seen under microscopic exam, what is this called

A

Postivie Ferning

33
Q

Nitrazine paper will turn what color in presence of amniotic fluid

A

Blue

34
Q

What are contraindications for Magnesium sulfate administration

A

Myasthenia gravis and renal failure

35
Q

What is Macrosomia

A

Newborns with excessive birth weight

36
Q

When can Uterine inversion occur

A

excessive cord traction, fundal pressure, uterine atony
rate mecial emergency where uterus turns inside out and protrudes into the vagina.
treatment is immediate manual reduction by pushing up on the fundus is returned to its normal position

37
Q

What is the most common cause of preterm labor

A

Infection

38
Q

Define Placental abruption

A

premature detachment of a normally implanted placenta from uterine wall

39
Q

Diasotlic BP goal when managing pregnancy induced hypertension is

A

90-100

40
Q

What method should be used to monitor an OB patient with suspected concealed bleeding

A

marking and determining fundal height frequently

41
Q

EFM strip is V-shaped or W-shaped and what does it indicate

A

Variable deceleration
Cord compression

42
Q

Normal FHR

A

110-160

43
Q

Fetal Bradycardia

A

<100 bpm

44
Q

Fetal tachycardia

A

> 160

45
Q

What is the most common cause of postpartum hemorrhage

A

uterine atony
Loss of tone in the uterine musculature
75-80% of postpartum hemorrhage is due to uterine atony

46
Q

Leopolds Maneuver is

A

Common and systematic way to determine the position of a fetus inside the uterus.

47
Q

Physiologic changes to mother during pregnancy

A

Increase blood volume
increase CO
increased minute ventilation
ABG cahnges to compensated rep alkalosis

48
Q

Preterm labor patient is identified as

A

24-36 weeks

49
Q

What medication should the pre term labor mother recieve

A

Tocolytic agent, Terbutaline 0.25 mg or Mag 4G infuse

50
Q

What presents with fetal parts palpated inthe abdomen

A

Uteine rupture, likley caused by trauma

51
Q

Pregnancy HTN meds

A

Mag 4g in 100ml over 20 min
Labetolol 10 mg SIVP with stacked dosing (10,20,40)
Hydralazine (alpresoline)
Nifedipine (procardia) CCB that targets the arteries

52
Q

Magnesium toxicity presents with what and what is given to reverse the effects

A

reduced DTR, CNS depression, Hypotension,
Give galcium as a reversal agent

53
Q

A EFM where heart rate deceleration occurs completly after the contaction is complete

A

Late Decel

54
Q

A EFM where heart rate deceleration occurs at the same time as contaction

A

Early Decel

55
Q

A EFM where heart rate deceleration occurs in a V shape or sharp decline

A

Variable decel

56
Q

A EFM where heart rate acceleration occurs with contraction

A

Normal

57
Q

What do you do if the OB patient develops uterine tetany

A

discontinue infusion

Critical Care (13 decks)

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