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OBGYN > Labor & Delivery > Flashcards

Labor & Delivery Flashcards

1
Q

Maternal contraindications to use of prostaglandins

A

asthma, glaucoma

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2
Q

Obstetric contraindications to use of prostaglandins

A

multiple prior C/S, nonreassuring fetal testing

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3
Q

Montevideo unit

A

average of the variation of the intrauterine pressure from baseline x # of contractions in a 10-minute period

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4
Q

Common indications for primary C/S

A
  • labor dystocia
  • nonreassuring FHR
  • fetal malpresentation
  • multiple gestation
  • suspected fetal macrosomia
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5
Q

active phase arrest

A

absence of cervical change for 2+ hours in the presence of adequate uterine contractions and cervical dilation of 4+cm

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6
Q

Signs of uterine rupture

A
  • abdominal pain
  • FHR decelerations or bradycardia
  • sudden decrease of pressure on IUPC
  • maternal sensation of a “pop”
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7
Q

Complications of epidural

A

-maternal hypotension secondary to decreased SVR –> decreased placental perfusion –> fetal bradycardia

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8
Q

Risks of general anesthesia

A
  • maternal aspiration

- hypoxia to mom and fetus during induction

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9
Q

What is the difference between an epidural and a spinal?

A

Spinal is given in a one-time dose directly into the spinal canal leading to more rapid onset of anesthesia (used more in C/S)

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10
Q

What is the cause of demise in placental abruption?

A

hypoxia resulting from decreased placental surface area and maternal hemorrhage

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11
Q

Presentation of fetal vessel rupture

A

vaginal bleeding w/ sinusoidal variation of FHR indicative of anemia

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12
Q

How is hydration a helpful tocolytic?

A

dehydrated pt –> increased ADH –> binds oxytocin receptors (bc ADH is similar shape to oxytocin) –> contractions

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13
Q

How do beta-mimetics work as tocolytics?

A

increase level of cAMP –> Ca2+ sequestered into SR –> decreases contractions

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14
Q

Ritodrine and terbutaline are…

A

beta-mimetics

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15
Q

How do prostaglandin inhibitors work as tocolytics?

A
  • prostaglandins increase intracellular levels of Ca2+

- indomethacin (NSAID that blocks the enzyme COX and decreases level of prostaglandin) is used as a tocolytic

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16
Q

What are the 4 types of pelvis?

A
  • Gynecoid
  • Android
  • Anthropoid
  • Platypelloid (more likely to have persistent OT position and lead to transverse arrest of labor)
17
Q

3 etiologies of prolonged FHR decelerations

A
  • preuterine: maternal hypotension, hypoxia
  • uteroplacental: abruption, infarct, hemorrhaging previa
  • postplacental: cord prolapse, compression, rupture of fetal vessel
18
Q

What is the Rubin maneuver and what is it used for?

A
  • used to deliver infant w/ shoulder dystocia
  • place pressure on accessible shoulder to push it toward anterior chest wall of fetus to decrease bisacromial diameter and free impacted shoulder
19
Q

What is Wood’s corkscrew maneuver and what is it used for?

A
  • used to deliver infant w/ shoulder dystocia

- apply pressure behind posterior shoulder to rotate infant and dislodge anterior shoulder

20
Q

An insult leading to growth restriction prior to 20 weeks results in (symmetric/asymmetric) hyperplasia whereas an insult leading to growth restriction after 20 weeks results in (symmetric/asymmetric) hypertrophy

A
  • prior to 20 weeks: symmetric

- after 20 weeks: asymmetric

21
Q

What causes variable decels?

A

cord compression (likely from oligo)

22
Q

How do you treat GBS in a woman who is allergic to penicillin?

A

cefazolin, clinda, vanc

23
Q

What is the first step in management of recurrent variables?

A

maternal repositioning –> amnioinfusion

24
Q

What is the optimal mode of delivery for twins when Twin A is breech and Twin B is vertex?

A

C-section

25
Q

Management of PTL between 34 and 37wk includes…

A

betamethasone, Pcn if GBS+ or unknown

26
Q

Management of PTL between 32 and 34wk includes…

A

betamethasone, tocolytics, Pcn if GBS+ or unknown

27
Q

Management of PTL <32wk includes…

A

betamethasone, tocolytics, mag sulfate, Pcn if GBS+ or unknown

28
Q

Retraction of the head, or “turtle sign,” is indicative of…

A

shoulder dystocia

29
Q

_________ and _________ given to patients with PPROM can prolong the latency period by 5-7 days

A

ampicillin, erythromycin

30
Q

Can false+ nitrazine tests occur?

A

yes - blood or semen can cause false+

31
Q

How does magnesium sulfate work?

A

competes with Ca2+ for entry into cells

32
Q

Antibiotic therapy with _________ and ________ given to women with PPROM prolongs latency by 5-7 days

A

ampicillin, erythromycin

33
Q

What antibiotics are given when chorioamnionitis is suspected?

A

clindamycin, gentamycin

34
Q

Hyponatremia, hypotension, and tachysystole are signs of ___________ toxicity

A

oxytocin

OBGYN (5 decks)

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