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Women's Health Clin med > L & D > Flashcards

L & D Flashcards

1
Q

What is labor

A

Painful, repetitive uterine contractions causing cervical effacement and dilation

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2
Q

What properties make up ‘true labor’

A

Regular contractions
interval decreases
walking makes worse
abdomen / back pain
mild sedation has no effect

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3
Q

What properties make up ‘false labor’

A

irregular contractions
interval remains the same
walking helps
abdominal cramping
mild sedation helps

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4
Q

If group B strep is present and the mom is not allergic, how do you treat them

A

pen G for at least 2 doses 4hrs apart until delivery

*IV cefazolin if allergic

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5
Q

How do you assess fetal wellbeing

A

Fetal heart rate
presentation/position/attitude
Size

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6
Q

What is the goal of fetal wellbeing assessments during labor

A

to maintain optimal oxygenation to the brain

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7
Q

How do you monitor the fetus during labor

A

external and internal methods

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8
Q

What is an internal method of monitoring the fetus

A

fetal scalp electrode

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9
Q

What is an external method of monitoring the fetus

A

Intermitten auscultation
continuous electronic monitoring

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10
Q

What is the purpose of electronic fetal monitoring

A

to continuously record heartbeat of fetus and contractions of the uterus through labor

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11
Q

how is an internal electric fetal monitoring preformed

A

an intrauterine pressure catheter

less effected by birthing person/fetal movement

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12
Q

What is the upper tracing on the fetal monitoring screen

A

Fetal heart rate

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13
Q

What is the lower tracing on fetal monitoring

A

contractions

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14
Q

What does the fetal heart rate tell us

A

Whether or not its safe to continue labor if no other problems are present

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15
Q

What things may effect the fetal heart rate during labor

A

Fetal conditions
tests done during labor
birthing person condition
medication in labor
uterine contractions
pushing
*doesnt mean something is wrong

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16
Q

What are the 5 components of fetal heart rate tracing

A

baseline
variability
accelerations
deceleration
changes/trends over time

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17
Q

What is a normal fetal heart rate

A

110-160 bpm

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18
Q

What is a moderate beat to beat variability

A

amplitude of 6-25 over a 10-20 minute period

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19
Q

What is beat to beat variability a measure of

A

fetal pH

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20
Q

What are early decelerations associated with

A

head compression

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21
Q

What are variable decelerations associated with

A

cord compression

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22
Q

What are accelerations associated with

A

oxygenation

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23
Q

What are late decelerations associated with

A

placental insufficiency

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24
Q

What is the most common form of deceleration

A

Variable (cord compression)

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25
Q

What do the presence of accelerations predict

A

Absence of metabolic anemia at the time of observation

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26
Q

How are uterine contractions measured

A

the number of contraction occurring in 10 minutes, averaged over 30 minutes

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27
Q

What is tachysystole contractions

A

> 5 contractions in 10 minutes over 30 minutes

28
Q

What is normal uterine activity

A

<5 contractions in 10 minutes averaged over 30

29
Q

How is contraction strength measured

A

by Montevideo units
*the sum of intensity of each contraction in 10 minutes

30
Q

What indicated accurate uterine activity

A

a contraction pattern that generates >200MVUs

31
Q

What are the 3 Ps of labor

A

passenger
power
passage

32
Q

What is felt on the first Leopold maneuver

A

Determines shape and consistency of the fundus and if fetal part is head or butt

33
Q

What are the descriptors used to describe the passenger

A

Lie (how are they in relation to mom)
Presenting part (Breech, shoulder, etc)
position
attitude (How high in the birth canal)

34
Q

What is the second Leopold maneuver

A

Determines where the back is

35
Q

What is the third Leopold maneuver used for

A

identifies presenting part and its mobility

36
Q

What is the fourth Leopold maneuver

A

Determines fetal attitude and degree of extension into pelvis

37
Q

What determines the babies position

A

Where the back is on mom

38
Q

What is the normal presenting part in delivery

A

Facing backwards, head first

39
Q

What is the cord presentation

A

umbilical cord falls between present part and crevice with or without membrane rupture

40
Q

What is a cord prolapse

A

umbilical cord falls through cervic next to or before presenting part WITH membrane rupture

*STAT C-section

41
Q

What are the 3 configurations of breech presentations

A

Frank
complete
footling

42
Q

What are some risk factors for breech presentations

A

Gestational age before term
hydramnios
multiple fetuses
hydrocephaly
pelvic tumor
uterine anomalies
placenta previa

43
Q

what is placenta previa

A

When the placenta is low in the uterus and blocks some of the cervical opening

44
Q

What is fetal station

A

Station refers to how far down fetal head is in pelvis

45
Q

What is considered the ‘zero station’

A

Geometric plane that extends through ischial spine up to the pubic bone (mid-pelvis)

46
Q

What is placenta accreta

A

When the placenta grows too deeply into the uterine wall and cannot be separated

47
Q

What properties make up a GOOD contraction

A

covers entire uterus
all parts reach peak at same time
intrauterine pressure 55-60
frequency every 2-4min
Complete relaxation between

48
Q

What is cervical effacement

A

Thinning of cervix

49
Q

What is cervical dilation

A

Enlargement of cervical opening

50
Q

When does effacement occur in first time births

A

before dilation

51
Q

When does effacement occur in experienced mothers

A

After dilation

52
Q

What is Bishops score used for

A

Determine favorability / ripening of cervix in vaginal examination

53
Q

What does it mean is the Bishop score is <6

A

Cervical ripening is needed before labor induction

54
Q

How can you ‘ripen’ the cervix

A

Balloon
Osmotic
amniotomy
prostaglandins

55
Q

What is cervical ripening

A

collagen chains fracture, more hydrophilic glycosaminoglycans, increased H2O

56
Q

What occurs in the first stage of labor

A

From beginning of labor until full cervical dilation

57
Q

What occurs in stage 2 of labor

A

From full dilation ends with delivery of baby

58
Q

What occurs in stage 3 of labor

A

from delivery of baby ends with delivery of placenta and membranes

59
Q

What is the 4th stage of labor

A

Recovery period after delivery of placenta uterus contracts and regains

60
Q

What occurs in the prodrome of labor

A

Passing mucous plug
lightening (dropping into pelvis)
Cervical ripening

61
Q

What are the cardinal movements of labor

A

Engagement
Descent
Flexion
Internal rotation
extension
external rotation
expulsion

62
Q

What are the signs of the third stage of labor

A

Gush of blood
cord appears to lengthen
uterus is globular
uterus rises anteriorly

63
Q

What are the 2 methods for managing the 3rd stage of labor

A

Active: admin oxytocin, apply fundal pressure, controlled umbilical traction

Expectant: Spontaneous placenta expulsion

64
Q

What is uterine involution

A

Fundus is about the size of a grapefruit immediately

rises to umbilicus for about 12 hours

drops 1cm each day for 10 days until back in pelvis

65
Q

When do mothers have their post partum visit

A

Between 21 and 56 days post delivery

66
Q

What conditions require Cesarean section or expedited delivery

A

Fetal distress
birthing person distress
arrest of dilation
arrest of descent
placenta previa
malpresentation

Women's Health Clin med (13 decks)

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