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Repro > Labor and Delivery (Young) > Flashcards

Labor and Delivery (Young) Flashcards

1
Q

a term pregnancy is 40 weeks from …

A

last menstrual period

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2
Q

viability is at ___ weeks

A

24 weeks

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3
Q

pre term is at ___ weeks

A

37 weeks

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4
Q

early term is at ___ weeks

A

37, 38

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5
Q

term is at ___ weeks

A

39, 40

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6
Q

post term is at ___ weeks

A

42

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7
Q

goal of initial visit when pregnant?

A

screen, ID high risk factors, and anticipate problems

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8
Q

what age is considered advanced or at high risk

A

35

*but really its 37

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9
Q

What is monitored as the pregnancy progreses

A

diabetes, anemia, STD, weight gain, BP, GBS,

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10
Q

how much weight should a women gain for a healthy pregnancy?

A

25-30 lbs (+5 for each additional fetus)

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11
Q

is a form of malnutrition

A

obestiy

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12
Q

What are the 9 essential aa? Where do we get them?

A

histidine, isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, thyrosine, threonine, tryptophan, valine

meat, fish, soy

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13
Q

What are the 3 types of HTN in pregnancy?

A

pre-existing
gestational
pre-eclampsia

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14
Q

HTN med that should never be taken while preggers? why?

A

ACEi bc it causes malformation of organs during the first trimester

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15
Q

2 characteristic findings in pre-eclampsia

A

htn and proteinuria (nephrotic syndrome)

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16
Q

pre-eclampsia is only seen ____ weeks

A

after 20 weeks

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17
Q

why “pre-“ eclampsia

A

eclampsia means convulsions so it is the syndrome before it gets to that point

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18
Q

what is the Rh factor?

A

rhesus D Ag

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19
Q

what is the significance of Rh factor and prenancy?

A

mom is Rh- and baby is Rh+ –> mom makes Ab to the fetal Ag –> mom become sensitized – > mom gets pregant with 2nd Rh+ babt –> she “rejects” pregnancy

20
Q

how is Rh factor “treated”

A

give mom rhogam shot… this is IgGs that coat fetal RBCs so that mom cannot see the Ag. given prior to birth (have 72 hrs where it is affected) when the blood can mix

21
Q

if you get gestational diabetes, do you have an increased risk to get DM later in life?

A

yes (40-50% do)

22
Q

is gestation diabetes like type I or II DM

A

type II = insulin independent

23
Q

what is the most important risk factor for gestational diabetes

A

obesity

24
Q

the alpha structure of hCG is very similar to the alpha structure of …

A

TSH and insulin

25
Q

when are the fetal organs surveyed for anatomic abnormalities

A

18-20 weeks (this is when they are big enough to see on ultrasound, even though they were developed at 12 weeks)

26
Q

what are the 3 things ultrasounds can give you info on

A

structure (where and how many)
blood flow
amniotic fluid volume

27
Q

what is the range for baseline fetal HR

A

110-160 BPM

28
Q

what is viability?

A

ability to live outside the uterus

29
Q

What is preterm vs pre-mature

A

an birth/delivery is pre-term and baby is pre-mature

30
Q

what 3 things signal the onset of labor

A

contractions, bleeding, and rupture of membranes

31
Q

what is the % of normal pregnancies?

A

75%

32
Q

what are the major complications of pregnancy

A

infection, preterm labor, pre-eclampsia, prior C.S, not vertex

33
Q

what are the phases of labor

A

latent = <4 cm dilated
active (1st) = 4-10 cm dilated
pushing (2nd)
delivery of placents (3rd)

**also can throw in transitional at 7-8 cm dilated

34
Q

what is the definition of labor

A

regular, phasic contractions sufficient to cause progressive dilation of the cervix

35
Q

why are uterine contractions phasic?

A

fetus is perfused during the uterine diastole

36
Q

what is the duration of each phase of labor?

A

latent has no limits
active: friedman curve (1-2cm/hr)
pushing: 3 hr or 2 hr
placental delivery: 1 hr

37
Q

what are the 7 cardinal movements for delivery

A 
engagement
descent 
flexion
internal rotation
extension 
restitution (external rotation)
expulsion
38
Q

how to determin if the placenta was delivered correctly

A

is it intact
are there 3 vessels
is there bleeding

39
Q

what can be lacerated during birth?

A

cervix, vaginal wall, perineum, vulva

40
Q

what are the degress of perineum lacerations

A

1st: skin only
2nd: defect in underlying tissue but NOT thru anal sphincter
3rd: into or through the sphincter
4th: defect of rectum

41
Q

What are the 2 toold for assisted vaginal delivery

A

forceps and vacuum

42
Q

term used for managin pre-term labor (it stops preterm labor)

A

tocolytic

43
Q

what is the C/S rate in the US

A

30-35%

44
Q

What are the complications for a vaginal birth after C/S

A 
ruptured uterus (scar is weaker)
repeat C/S
45
Q

can you have a vaginal birth after C/S

A

yes

46
Q

what are the risks assc with a C/S

A

bleeding, infections, intra-abd scarring, uterine rupture, placenta accreata (next pregnancy)

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