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Natural childbirth Midterm > Midterm > Flashcards

Midterm Flashcards

1
Q

PREGNANCY TEST:

A

Serum HCG 9 days off after ovulation
Urine from this period.
Quantitative HCG for complications (ectopic)
Serial b-HCG to see if numbers are rising or falling

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2
Q

VIABLE PREGNANCY?

A

TVUS @ 6 weeks

Looking for heartbeat

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3
Q

REASONS FOR 1ST TRIMESTER UltraSound

A
  • Accurate date (so we know its not premature, growth rate, appropriate preperations)
  • Uncertain conception date (irregular menses, unknown conception)
  • Developmental abnormalities (early kicking, late heartbeat, uterine growth/size)
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4
Q

REASONS FOR AN ACCURATE DUE DATE

A

Genetic testing
Pre-maturity,
out of hospital birth,

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5
Q

CASE: PREGNANT VAGINAL BLEEDING IN BATHROOM, ASK WHAT?

A 
Ask how long been going on?
Pad? Soaking pad?
Streak when wiping?
Color? Pink, Red, bright red, brown?
Size (dime?)
Cramping? w/ cramping is more significant
Bleeding is common, but talk about ddx.
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6
Q

CAUSES OF CERVICAL BLEEDING?

A

Cervicitis, vaginal lesions, polyps, threatened miscarriage, ectopic pregnancy, physiologic bleeding, intercourse, etc.

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7
Q

@ 7 WEEKS, WOULD US RULE IN/OUT SPONTANEOUS ABORTION?

A

6 weeks = heartbeat.
7 weeks should certainly see heartbeat.
Doppler = 10 weeks heartbeat

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8
Q

COMMON ETIOLOGIES FOR SPONTANEOUS ABORTION?

A 
Chromosomal abnormality (e.g., abnormal cell division)
Progesterone deficiency
Trauma
Congenital (differs from chromosomal abn)
Invasive procedures
Uterine infection
Thrombophilia
Unknown
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9
Q

VAG BLEEDING W RLQ PAIN

A

DDX: appendicitis, diverticulitis, ectopic pregnancy, ovarian cyst, round ligament pain

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10
Q

WHERE DO MOST ECTOPIC REGNANCIES IMPLANT?

A

Fallopian tube.

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11
Q

INCREASED RISK OF ECTOPIC PREGNANCY

A

Tubal surgery, other tubal issues, DES exposure, infertility, previous PID, having IUD, previous STI infection (GC/US)

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12
Q

AT WHAT POINT OF GESTATION IS AN ECTOPIC PREGNANCY?

RUPTURE?

Dangerous S/sx’s?

A

@ 6-8 weeks

@ 6-12 weeks

S/sx’s= Internal bleeding, shock, death.. medical emergency

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13
Q

DX AND RULE OUT ECTOPIC

A

Repeated US and serum HCG.

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14
Q

TX OPTIONS (ECTOPIC PREG)

A

Methotrexate and surgery.

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15
Q

START TREATMENT (NEW PREGNANCY) When?

By doing what?

A 
1st trimester (prevent miscarriage, n/v, preperations, relationship)
Prenatal panel: avorh, CBC, hepatitis, antibody screen, syphilis, HIV, urine culture, pap, gonorrhea, chlamydia, blood type testing (Rh- needs RHOGAM)
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16
Q

ADVICE (NEW PREGNANCY)

Avg weight gain

A

Avg weight gain 25-35lbs
Heavier then average weight might gain less
Gain about 1lb per week
Do not diet during pregnancy

17
Q

NUTRITIONAL Advice (NEW PREGNANCY)

A 
Increase protein to 60mg
Avoid raw fish
Take Prenatal vitamins
Avoid Heated deli meat
Eat quality food
Incorporate veggies
18
Q

TERATOGENS, WHEN DOES IMPLANTATION OCCUR

A

1 week after fertilization

19
Q

SMOKING DANGERS

A

Placental abrubtion, prematurity, stillbirth, decreased o2 to baby, SIDS, respiratory diseases in baby

20
Q

NAUSEA MECHANISMS & Remedies

A
  • Increased bHCG,
  • Inc progesterone → causes digestive track changes,
  • inc peristalsis,
  • inc gastric secretions,

Resolves bc placenta takes over making hormones after 1st trimester.

Remedies: B6, K, C, ginger, mint, nux vomica, sepia, pulsatilla

21
Q

HYPEREMISIS GRAVEDERIM, What is it?

A

Uncontrollable n/v

22
Q

HYPEREMISIS GRAVEDERIM DDX:

A

Could be stomach flu, Appendicitis, Gall bladder disease, Kidney infection

23
Q

SOB, FATIGUE, BAD LAB WORK INDICATING ANEMIA HELPFUL HERBS:

A

HERBS: rhumex, nettles, teraxicum

24
Q

RISKS DT ANEMIA (LOOK UP MORE)

A 
Post-partum hemorrhage, 
A preterm baby 
low-birth-weight baby
Postpartum depression
A baby with anemia
A child with developmental delays
A blood transfusion (if you lose a significant amount of blood during delivery)
25
Q

When in life are we most susceptible to TERATOGENS?

A 
weeks 5-10 fetal life during organogenesis
Neonate, 
newborn, 
adolescence, 
breast feeding (LUTEAL PHASE)
26
Q

OXYTOCIN (BEST WAY TO REALEASE)

A

Facilitate release during pregnancy: relax, dim lights, silence, not being watched

27
Q

SLEEPY PT’S 1st TRIMESTER, Cause?

A

Progesterone

28
Q

INSOMNIA Helping herbs

A

Valerian, chamomile,

*NO PASSIFLORA during pregnancy

29
Q

FAS/FAE (FETAL ALCOHOLIC SYNDROME) DX:

A 
Dec. in weight (Prenatal or postnatal)
Small head circumference, 
flat nose, 
cognitive impairment, 
underdevelopment of genitalia
Brain Dfxn
30
Q

Name 2 lab tests of new preg.

A 
ADORH, 
Blood typing (Rh-)=Rhogham
CDC
HIV
HEP A/b

Natural childbirth Midterm (1 decks)

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