Intrapartum Flashcards
What is a nitrazine test used for?
To confirm ROM
What is the greatest risk factor for third- or fourth-degree lacerations during vaginal delivery?
medial episiotomy
What is the best way to minimize the risk of extensive damage to the perineum?
avoidance of episiotomy
How is prolonged latent phase defined?
> 20 hrs for nulliparas
>14 hours for multiparas
What is amniotomy?
artificial rupture of membranes
What are risks for cord prolapse?
rupture of amniotic membranes, polyhydramnios, small fetus, backup transverse lie
What is McRoberts maneuver used for?
In case of shoulder dystocia
What is the “turtle sign” and when is it seen?
retraction of the fetal head seen when the anterior shoulder catches, shoulder dystocia
What are risk factors for placental abruption?
smoking, cocaine use, chronic HTN, trauma, prolonged premature rupture of membranes, hx of prior abruptions
What are common presenting signs of placental abruption?
abdominal pain, bleeding, uterine hypertonus, fetal distress
What are prostaglandin E1 and E2 used for?
Increase the rate of contractions
What is the appropriate management of a suspected intra-amniotic infection?
Delivery
Magnesium sulfate is contraindicated in what patient population?
myasthenia gravis
What is the first sign of magnesium toxicity?
diminished/absent DTR
What is associated with betamethasone treatment between 24 and 34 weeks?
increase pulm maturity, decrease intracerebral hemorrhage, decrease necrotizing enterocolitis
What is the strength of fetal fibronectin?
negative predictive value 99.2%
What is the mechanism of action of magnesium sulfate?
completes with calcium for entry into cells
When are prostaglandins contraindincated during labor?
For pts with h/o previous cesarean delivery
When is fetal heart rate considered “tachycardia”?
> 160
What maternal conditions lead to fetal tachycardia?
chorioamniotnitis and maternal fever
How is a variable deceleration characterized?
sharp decrease in heart rate with a slow /variable rise back to baseline
What is the objective of the left lateral position?
increases perfusion to the uterus, treat fetal hypoperfusion
What is a complication of oxytocin use intrapartum?
insufficient uterine relaxation between contractions –> placental spiral artery constriction, decrease in placental blood flow, fetal hypoxia
Define the stages of labor:
stage 1 - latent 0-6 cm dilation; active 6-10 cm dilation
stage 2 - 10 cm to delivery of baby
stage 3 - delivery of baby to placenta
