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* * * 1. NCE: MEDT, ANPH, PATH 1&2 > Late Pregnancy and Delivery > Flashcards

Late Pregnancy and Delivery Flashcards

1
Q

Premature detachment of a normally positioned placenta during pregnancy

A

abruptio placentae

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2
Q

Placenta covering the opening of the cervix

A

placenta previa

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3
Q

What are 2 types of placenta previa?

A
  1. partial 2. complete or central
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4
Q

Type of placenta previa where majority of the placenta is away from the opening

A

partial previa

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5
Q

Type of placenta previa where the more central portion of the placenta covers the opening

A

complete or central previa

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6
Q

Low implantation of the ____ in the uterine cavity causes placenta previa

A

blastocyst

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7
Q

Is vaginal delivery allowed when there is placenta previa present?

A

no

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8
Q

T or F. Immediate C-section is warranted when there is a massive hemorrhage in placenta previa

A

T

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9
Q

Contractions leading to cervical change before 37 weeks of pregnancy

A

premature labor

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10
Q

What IM injections are given to mother in premature labor to reduce complications?

A

betamethasone

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11
Q

What IM injections reduce incidence of premature birth by 30%?

A

progesterone

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12
Q

Spontaneous break in the amniotic sac before onset of regular uterine contractions

A

premature rupture of membranes (PROM)

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13
Q

When the infant is full term, the period between membrane rupture and the onset of labor is ____

A

brief

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14
Q

When infant is pre-term, the period between membrane rupture and onset of labor is ____, which increases risk of fetal death

A

prolonged

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15
Q

A cause for PROM is increased intrauterine tension due to ____ or ____

A

hydramnios or multiple pregnancies

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16
Q

PROM in pre-term pregnancy (28 to 34 weeks) is treated with hospitalization and ____ if there is evidence of infection

A

induction of labor

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17
Q

PROM in term pregnancy when vaginal delivery isn’t achieved within 24 hours following prom, induction of labor with ____ is usually done

A

oxytocin

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18
Q

Pregnancy that persists for 41 weeks or more

A

prolonged post-term pregnancy

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19
Q

T or F. Prolonged pregnancies are not induced because dates may be wrong, inducing comes at a higher risk, hard on mom and baby

A

T

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20
Q

What are the 3 phases of the first stage of labor?

A
  1. early labor (0-4cm)2. active labor (4-8cm)3. hard labor or transition (8-10cm)
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21
Q

Which stage of labor is the longest?

A

first

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22
Q

Stage of labor that begins at full cervic dilation (10cm) and baby’s head has begun to press into the birth canal

A

second stage of labor

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23
Q

Stage two ends with the ____

A

birth of the baby

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24
Q

Stage of labor where the uterus rests for 15 minutes, placenta detaches from the uterine wall, and is delivered by expulsion by the birth canal

A

third stage of labor

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25
Q

The third stage is managed by administering ____ and ____ which when given at time of birth, can reduce severe bleeding

A

oxytocin and ergonovine

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26
Q

Lie

A

position of baby in relation to mom

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27
Q

Lie: fetus is lying lengthwise (vertically) in the uterus

A

longitudinal fetal lie

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28
Q

Lie: fetus is lying crosswise or horizontally in the uterus

A

transverse fetal lie

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29
Q

T or F. Caesarean is always performed when fetus is at a transverse lie

A

T

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30
Q

Lie: maternal axes cross at a 45 degree angle, forming an unstable lie that’ll always become either longitudinal or transverse during the course of labor

A

oblique fetal lie

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31
Q

direction of baby in relation to mom’s pelvis

A

position

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32
Q

part of baby that passes through the pelvis first

A

presentation

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33
Q

Presentation: back part of skull (occiput) is the point of direction

A

vertex presentation

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34
Q

Presentation: chin is the point of direction

A

face presentation

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35
Q

Presentation: brow is the point of direction

A

brow presentation

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36
Q

Presentation: sacrum is the point of direction and the feet are crossed and the thighs are flexed on the abdomen

A

complete breech presentation

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37
Q

__% of breech babies are delivered by cesarean section

A

85%

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38
Q

Presentation: thighs flexed on the abdomen, legs upon the thighs and one or both feet may be lowermost

A

incomplete (footling) breech presentation

39
Q

Presentation: thighs flexed; legs extended over the anterior surfaces of the body

A

frank breech presentation

40
Q

Presentation: prolapsed limb is alongside the presenting part

A

compound presentation

41
Q

Where the fetal head is delivered but one of the shoulders gets stuck behind the pelvic bone, if not managed appropriately, could lead to the fetus suffering serious trauma from the delivery

A

shoulder dystocia

42
Q

How is shoulder dystocia treated?

A
  1. McRoberts maneuver2. Wood screw maneuver
43
Q

Extremely rapid labor and delivery, which may occur without professional assistance (labor of less than three hours)

A

precipitate labor

44
Q

Term used when fetus is believed to be in jeopardy, most often due to decrease oxygen flow.

A

fetal distress

45
Q

Condition of a very large fetus; serious dystocia may arise when large head attempts to pass through a normal pelvis.

A

fetal macrosomia

46
Q

Excessive accumulation of cerebrospinal fluid in ventricles of the brain with consequent enlargement of the cranium.

A

fetal hydrocephalus

47
Q

Normal circumference: 32-38cm. Hydrocephalic babies: ___ cm

48
Q

Result of greatly distended urinary bladder, ascites, or enlargement of kidney or liver; spontaneous delivery may be impossible due to large amount of fetal swelling.

A

large fetal abdomen

49
Q

“Siamese twins” May be diagnosed antenatally, but not always identified until difficulty at delivery

A

conjoined twins

50
Q

Umbilical cord can wrap around baby’s neck during pregnancy and cut off fetal blood supply; knot is deadly

A

umbilical cord entanglement

51
Q

Umbilical cord slipping through the cervix and into the vaginal canal before arrival of the fetus

A

prolapsed umbilical cord

52
Q

Prolapsed umbilical cord is due to _____ before the descent.

A

amniotic membrane rupture

53
Q

Condition in which a newborn does not breathe spontaneously.

A

asphyxia neonatorum or perinatal asphyxia

54
Q

Dark green material in intestine of a full-term infant, often called the first stool of the newborn

55
Q

Newborn inhales (aspirates) a mixture of meconium and amniotic fluid, which can partially or completely block the baby’s airways.

A

meconium aspiration

56
Q

Excess of amniotic fluid. Associated with maternal disorders such as eclampsia and DM.

A

polyhydramnios

57
Q

Placenta that has not been expelled within 30 mins after delivery of baby

A

retained placenta

58
Q

Spontaneous traumatic rupture of the uterus. If fetus is alive at time of rupture, only chance of survival is immediate delivery.

A

ruptured uterus

59
Q

Inverted uterus occurs during the delivery of placenta due to _____ on umbilical cord when placenta is firmly attached to uterine wall

A

excessive traction

60
Q

Perineal lacerations are classified as:

A

1st, 2nd, 3rd, or 4th degree

61
Q

Major cause in the majority of maternal deaths: excessive bleeding from the placental implantation site and/or trauma to the genital tract and adjacent structures.

A

maternal hemorrhage

62
Q

Loss of more than 500ml in vaginal delivery, or more than 1000ml in cesarean

A

Postpartum hemorrhage defined as

63
Q

Amniotic fluid travelling into the bloodstream of the mother through the highly vascular uterine wall due to the pressure generated during labor and delivery; affects lungs and kidneys

A

amniotic fluid embolism

64
Q

Delivered through a device similar to a suction cup, where vacuum is placed on head of fetus and traction is applied; lower risk and less postpartum pain for mother than forceps.

A

vacuum assisted delivery

65
Q

Forceps application is classified according to the position of the fetal head when forceps are applied

A

forceps delivery

66
Q

Performed in stage 2 of labor in order to substitute a straight surgical incision in place of a possible laceration of the perineum.

A

episiotomy

67
Q

Removal of baby from the uterus through an incision in the abdominal wall and uterus.

A

Cesarean section

68
Q

What are the 3 types of c-section?

A
  1. low segment2. classical3. intraperitoneal or extraperitoneal cesarean
69
Q

Type of cesarean: transverse incision in lower segment of uterus

A

low segment

70
Q

Type of cesarean: Vertical incision into the wall of the body of the uterus

71
Q

Type of cesarean: Tissue around urinary bladder dissected providing access to lower uterine segment without entering peritoneal cavity

A

intraperitoneal or extraperitoneal

72
Q

Procedure involving the removal of uterus immediately following cesarean

A

cesarean hysterectomy

73
Q

Another name for cesarean hysterectomy

A

porro operation

74
Q

Usual forms: support persons (birth coaches, doulas), behavioral modifications and breathing, hypnotherapy, massages and showers to manage pain

A

psychoprophylaxis

75
Q

Often used if mother has very short time before the second stage as estimated by nature of contraction and dilation of cervix

A

inhaled agents and injections

76
Q

Preferred method of analgesia because it is extremely effective

A

epidural infusion

77
Q

Allow pain relief without ability of patients to push during second stage of labor

A

continuous options

78
Q

Anesthesia used for c-section and non-emergency (planned) cases where pt does not have an epidural, and is the preferred method of anesthesia because of reduced mortality and morbidity.

A

spinal anesthesia

79
Q

Death after 20 weeks gestational age and/or a fetus weighing >500g

A

intrauterine death or stillbirth

80
Q

___ weeks is the difference between a spontaneous abortion and intrauterine death.

81
Q

Intrauterine death is linked to what?

A
  1. eclampsia2. preexisting type 1/2 DM3. APLA syndrome
82
Q

Half of intrauterine deaths are unknown. T or F

83
Q

Body does not produce adequate amounts of insulin to deal with increased demand during pregnancy.

A

gestational diabetes

84
Q

Serious disease of pregnancy characterized by HTN and proteinuria

A

pre-eclampsia or toxemia

85
Q

Pre-eclampsia is most common in the ___ trimester but can occur anytime after __ weeks

86
Q

When a seizure occurs in a pt with preeclampsia Not all pt with preeclampsia will have this

87
Q

What is given to reduce the possibility of a seizure?

A

magnesium sulfate

88
Q

Inflammation of birth canal during the puerperium. Common cause of childbirth related deaths.

89
Q

What is the cause for pregnancy ifnections?

A
  1. normal vaginal flora that become overgrown
90
Q

When are infections diagnosed?

A

Fever for 48 hours after delivery with elevation of WBC count and erythrocyte sedimentation rate

91
Q

All breast-feeding mothers experience some degree of this (more severe in primiparas) a few days after giving birth

A

breast engorgement

92
Q

Sudden drop of estrogen and progesterone after childbirth triggering deep, ongoing depression that begins in postpartum period.

A

postpartum depression

93
Q

True postpartum depression persists up to ___ months or longer, and can become chronic depression.

* * * 1. NCE: MEDT, ANPH, PATH 1&2 (28 decks)

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