Maternity Flashcards
Gynaecology definition
branch of medicine which deals with the functions and diseases specific to the reproductive system including breasts
Obstetrics definition
the health science that deals with pregnancy, childbirth and the postpartum period which includes care of the newborn.
What does the female genitalia consist of?
Ovaries, fallopian tubes, uterus, cervix vagina, vulva, labia majora and labia minora.
how many stages are there of the menstrual cycle?
menstrual phase, proliferation phase, secretory phase.
What is placenta abruption
when the placenta detaches from the uterine wall
What are the 2 types of placenta abruption
when the placenta doesn’t completely detach
complete total abruption of the placenta
what is placenta previa
when the placenta has implanted over or close to the cervix
what are the 3 types of placenta previa
complete, partial and marginal
what is pregnancy produced hypertension
raised blood pressure, absence or proteinuria
what is pre-eclampsia
development of hypotension with proteinuria 140/90
what is severe pre-eclampsia
160/110
how many stages of labour are there
3
what does primigravid mean
pregnant for the first time
what does multigravida mean
been pregnant multiple times
how many cm’s does the Cervix dilate to
10cm
what is a rupture of membranes
waters breaking
what is a meconium
early stool passes by the baby
how many umbilical cord clamps are in the maternity pack
4
what is the percentage of survival for a baby born at 23 weeks
17%
what is a normal Apgar score
7-9
what is an Apgar score
how to assess a newborn
How many cm should the first clamp be placed on the umbilical cord
15cm (6 inches)
how many cm away should the second clamp be placed
3-4cm away
are there nerves in the cord
no
how many veins does the cord have
1
how many arteries does the cord have
2
what does the vein in the cord deliver
oxygen
what do the arteries do
carries deoxygenated blood and waste from the baby to placenta
what is vernix
white cheese like substance coating the baby
1st stage of labour
dilation and effacement of the cervix, rupture of the membrane and loss of mucous plug
2nd stage of labour
urge to push and bear down, change in patients behaviour, crowning
3rd stage of labour
delivery of the placenta
what does BBBA stand for
born before arrival
what is full term
37+ weeks
What is preterm
Before 37 weeks
What problems do preterm babies have?
Feeding problems, less body fat, less tone, excessive lanugo (hairs/fur)
How many mls of blood is a postpartum hemorrhage?
500mls
A retained placenta is how many minutes?
30 mins
How many trimesters are there?
3
(First 1-12 weeks)
(2nd 13 to 23+6)
(3rd 24 weeks+)
What does EDD mean?
Estimate date of delivery
What does cephalic mean?
Baby is head down
What does gravida mean?
The number of confirmed pregnancies in the body
What does parity mean?
The number of times the woman has given birth (born or stillborn)
Embryo
Before 12 weeks
Foetus
After 12 weeks
What is the uterus
Hollow pear-shaped organ
How many layers does the uterus have?
3
Endometrium
Myometrium
Perimetrium
How long does the uterus stay in the pelvis
12 weeks
At what week does the uterus reach the umbilical region
20 weeks
At what week does the uterus meet the costat margin
34-36 weeks
In which trimester is the uterus thinned walled
3rd trimester
When does the placenta develop
14 days after ovulation
What is the normal cord length
30-60cm
What length is known as a short cord
40cm and below
The intercostal angle will increase from 68 degrees to
103 degrees
What is the tidal volume for a pregnant woman
700 mls
At what percentage does the blood volume increase by
48-50%
What is the normal blood loss when giving birth
300-500 mls
What is the amount of blood loss during c section
750-1000mls
At how many weeks does the plasma stop increasing
34 weeks
What percentage can a pregnant patient lose before developing hypotension
35%
What is eclampsia
Pre-eclampsia with the development of convulsions
What is umbilical cord prolapses
The cord presenting out of the vagina
What is postpartum hemorrhage
Heavy bleeding after birth
What is the primary PPH (postpartum hemorrhage)
Within the first 24 hours after giving birth
What is secondary PPH
24 hours up to 3 months
What is moderate blood loss
1000-1500mls
What is severe blood loss
1500mls
What are the 4t’s of PPH
Tone, trauma, tissue, thrombin
How many estimated hours is a primigravid
12-14 hours
How many estimated hours is a multigravid
6-10 hours
What is the order of decent
- Engagement
- Descent
- Flexion
- Internal rotation
- Extension
- External rotation
- Expulsion
Preterm survival rates
23 weeks 17%
24 weeks 39%
25 weeks 50%
26 weeks 80%
What will a reduction of body temperature do to a newborns glucose levels
Reduce them
How long does it take for a pulsating cord to drop
10-20 minutes
What hormone is controlled through the feedback system
Oxytocin
What level will the diaphragm likely rise to
4tv
Stroke volume will increase raising cardiac output by
64-71%
How much blood can a pregnant woman lose before hypotension
35%
What id gestation
How many weeks pregnant
Where will psychological changes happen, and what are the additional changes that will happen
Cardiovascular system
Respiratory system
Gastro-intestinal system
Endocrine system
Muskoskeletal system
Uterus
Additional changes:
Amniotic fluid
Placenta
Umbilical cord
Airways may be complicated by these changes are likely to have
Short obese neck
Engorged breast tissue
Full detention, reduced calcium-vomiting damage, teeth maybe brittle
What is the percentage of blood loss that can cause foetus distress
10-20%
Whatnis the size of the placenta when the baby is born
8-9 inches wide and thick
What are the functions of the placenta
Respiratory gas exchange
Transportation of nutrients
Excretion of waste
Transfer of heat
Hormone production
Formation of a barrier
What is the foramen ovale
A hole that exists between the left and right atria
What is ducts ateriosus
The blood vessels that connects the aorta to the pulmonary artery
What are the three hormones involved during labour
Melatonin, oxytocin, adrenaline
Red flags during labour
Meconium present in the ruptured membrane
Malpresentation-cord prolapse
History of trauma with reduced foetal movement
Eclamptic seizures
Unconscious mother
Severe pre-eclampsia
Red flags after birth
Meconium present
A retained placenta
A blood loss of more than 500mls
How many months must a pregnant patient be to do a manual uterine displacement
20 weeks
Estimation of blood loss
Inco pad 300-500mls
Maternity sanitary pad 50mls
Branded sanitary pad 30mls
What is nuchal cord
A cord that is wrapped around the baby’s neck
What is moulding
The irregular shape of the baby’s head
When are miscarriages most common
Up to 12 weeks
Risk factors of miscarriage
Previous history of miscarriages
Previous identified potential miscarriage at scan
Smoker
Obesity
Alcohol/drug abuse
Signs and symptoms of miscarriage
Pain
Bleeding
Signs of pregnancy subsiding
What are ectopic pregnancies
A fertilised egg implanted outside of thr womb
What is ruptured ectopic pregnancy
When the egg grown in the fallopian tube causing it to rupture
Signs and symptoms of an ectopic pregnancy
Lower abdominal pain
Uterine bleed
May start on the one side in the lower abdomen
Pain in the tip of the shoulder
Risk factors of ectopic pregnancy
An intra-uterine contraceptive device
Previous ectopic pregnancy
Smoking
Increased maternal age
IVF
Sterilisation or reversal
Pelvis inflammatory disease
Chlamydia
What is postpartum
The time after having a baby
What is antepartum
The time period before childbirth
What is FGM
Female genital mutilation
How many types of FGM are there
Stage 1 - clitoridectomy partial or full removal of clitoris
Stage 2 - excision partial or full removal of the clitoris and the labia minora with or without excision of the labia major
Stage 3 - infibulation narrowing of the vaginally opening through the creation of a covering seal, the seal is formed by cutting and repositioning the inner and outer labia, with or without removal of the clitoris
Stage 4 - other all harmful procedures to the female genital area for non-medical reasons
How many types of abortions are there
2
Medical abortion - the pill, induces miscarriage, 24-48 hours apart, two tablets needed
Surgical abortion- minor procedure to remove the pregnancy - can terminate up to the 24th weekmof pregnancy
What is menorrhagia
Heavy menstrual bleeding, considered 60-80mls
What is uterine prolapse
The muscles and ligaments of the pelvic floor stretch and become week, they are no longer able to support the uterus
Are there two methods of management for uterine prolapse
Conservative and surgical
How many gynecology cancers are there
5
Uterine
Ovarian
Cervical
Vaginally
Vulval
Signs and symptoms
Abnormal vaginally bleeding and discharge
Pelvic pain and pressure
Back and abdominal pain
Bloating
Increased urination, constipation, diarrhea
Itching or burning at the vulva
Changes in colour with thr vulva
