Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Lecture 1 - Complications of Labor > Flashcards

Lecture 1 - Complications of Labor Flashcards

1
Q

How many weeks pregnancy does “Term” refer to?

A

37-42 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does Preterm labor mean?

A

regular contractions occurring at least every 10min resulting in cervical change prior to 37 wks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Under what weight is condsidered Low Birth Weight (LBW)?

A

Any infant < 2500g at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Under what weight is considered Very Low Birth Wt (VLBW)?

A

< 1500g

**At 29 wks gestation, >90% of expected fetal weight is < 1500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the survival rate for infants born at:
< 24wks?
>30wks?
>34wks?

A

24 wks ~10%
30 wks >90%
34 wks > 98%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Survival of an infant can increase by _____% each day between 25-26 wks

A

5% per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

__________ __________ __________ will affect almost all infants < 27wks gestational age.

A

Resp Distress Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Besides resp distress syndrome, what are some other problems that affect premature infants?

A

sepsis, Nec enterocolitis, Intracranial hemorrhage, Ischemic cerebral damage, immature metabolism (prolong Rx effects), hypoglycemia, hyperbilirubinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some causes of preterm Labor?

A

Group B strep
Neisseria Gonorrhea
Bacterial Vaginosis
***antibiotics can prevent preterm labor with some success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Will having a preterm baby delivered C-section prevent intracranial hemorrhage?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Will use of forceps for vaginal delivery increase the chances of intracranial hemorrhage in a preterm infant?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

For a preterm infant that is breech, what delivery method is prefered, C-section or vaginal birth?

A

C-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can an epidural help prevent in PTL?

A

Avoid preciptous delivery
Decrease risk of ICH
Avoid maternal pushing agains an incomplete cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some indications for Tocolytic Therapy?

A

Gestation age 20-34 wks
EFW < 2500g
Absence of fetal distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does Tocolytic therapy reduce morbidity if used long-term?

A

No, but it does permit corticosteroid treatment to aid fetal lung development if used for 48hrs or less or allow for transfer to a facility with a NICU.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tocolytic therapy - problem with using Ethanol?

A

causes intoxication, LOC, aspiration

**no longer used because there’s better drugs out there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tocolytic therapy - problem using methylxanthines (aminophylline, phosphodiesterase)?

A

Narrow therapeutic margin and frequent toxic side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tocolytic therapy - Calcium channel blockers - side effects?

A

Hypotension, tachycardia, dizzy, palpitation
facial flushing
vasodilation, peripheral edema
Myocardial depression, conduction defects
Hepatic dysfunction
Postpartum hemorrhage
Fetal side effects
Decreased UBF –> fetal hypoxemia and fetal acidosis

19
Q

Calcium channel blockers - major concern?

A

pt more prone to cardiac depressant effects of volatile agents
- increase risk of postpartum hemorrhage due to uterine atony refractory to oxytocin and prostaglandin F-a2

20
Q

Tocolytic therapy - how does Indomethacin or Sulindac effect labor?

A

decreases cyclooxygenase –> decrease prostaglandin

21
Q

Maternal side effects of indomethacin or sulindac?

A

Nausea
Heartburn
Transient dec. platelet aggregation –> bleeding
Primary pulmonary HTN

22
Q

What are some side effects to the fetus from using indomethacin or sulindac?

A

Crosses placenta
Premature closure of ductusarteriosus
Persistent fetal circulation
Renal impairment, transient oliguria

23
Q

Tocolytic Therapy - using Magnesium will have what affect on muscle relaxants? MAC?

A

Patient is more sensitive to both depolarizing and nondepolarizing muscle relaxants.
- MAC is decreased

24
Q

What is the normal range of Mag during treatment?

A

4-7 mg/100ml

25
Q

At what range would you expect loss of deep tendon reflexes when using Mag?

A

8-10

26
Q

When using Mag, At what range would you expect respiratory depressing, cardiac conduction defects?

A

10-15

27
Q

What are the cardiac conduction defects you would expect when Mag levels are high?

A

wide QRS and lengthened PR interval

28
Q

When the Mag level reaches 20 or more, what would you expect?

A

Cardiac arrest

29
Q

What is the treatment of Mag overdose?

A

Calcium gluconate or CaCl

30
Q

Tocolytic therapy - when using Terbutaline or Ritodrine (Beta agonists) what side effects are common?

A

N/V
Anxiety, restlessness
Hyperglycemia, hyperinsulinemia, hypokalemia, acidosis
Tachycardia, arrhythmias, dec peripheral VR, Edema
PULMONARY EDEMA (1-5%)

31
Q

Fetal mortality risk is ____ to _____ times greater for twins vs single births

A

5-6

32
Q

mother carrying multiple babies is at no different risk of hemorrhage than single gestation mothers?

A

UNTRUE - please place a large bore IV in multiple gestation mothers

33
Q

What is a great drug for uterine relaxation during c-section for multiple gestation?

A

Nitroglycerin 100mcg initial repeated to dose of 500mcg max

34
Q

What LA is preferred for use in mulitple gestation epidural?

A

2-chloroprocaine 3% preferred due to rapid onset

35
Q

Signs and symptoms of Uterine Rupture

A
  • Sudden abdominal pain despite functioning epidural
  • Vaginal bleeding
  • Hypotension
  • Cessation of labor
  • Fetal distress – most reliable sign
36
Q

what are some risk factors associated with uterine rupture?

A 
Previous uterine surgery
Trauma
Multiparity
Uterine anomaly
Oxytocin
Placenta percreta
Tumors
Macrosomia
Malposition
37
Q

What is an absolute indication for having a c-section?

A

Transverse Lie

38
Q

What does “presentation” refer to?

A

most dependent or presenting part of the infant

39
Q

What does “Lie” refer to?

A

Long axis of infant (longitudinal vs transverse)

**most common is longitudinal (vertex or breech)

40
Q

What position will have the greatest chance of uncomplicated spontaneous delivery?

A

Vertex position, flexed c-spine with chin to chest, Occiput anterior (face down)

41
Q

What is the main cause of fetal demise?

A

cord accidents

42
Q

What age is considered postmaturity?

A

42 wks

43
Q

What are some complications of postmaturity?

A

decreased placental blood flow
umbilical cord compression
meconium staining
macrosomia, shoulder dystocia

44
Q

What are some typical umbilical cord accidents?

A 
prolapsed umbilical cord
monoamniotic twins
umbilical cord length (72cm)
Cord entanglement (nuchal cord)
Torsion

Obstetrics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions