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BSNC 5000 > Module 1 - OB > Flashcards

Module 1 - OB Flashcards

1
Q

Trimesters

A

1: 1-14
2: 15-27
3: 28-40

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2
Q

Definition of PPH

A

> 500 mL for vaginal birth
1000 mL for caeserean

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3
Q

Hegar’s sign

A

softening/compression of lower uterine segment

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4
Q

Goodell’s sign

A

softening of cervical tip

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5
Q

Chadwick sign

A

violet blue vaginal mucosa & cervix @ 6 weeks

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6
Q

When do Braxton Hicks contractions start

A

2nd trimester at 16 weeks
irregular, less frequent, go away

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7
Q

When can fetal movements be felt

A

20 weeks

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8
Q

Embryonic period

A

weeks 3-8
critical period of implantation + organogenesis

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9
Q

Fetal period

A

week 9 - 40

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10
Q

Parental adaptation stages

A

1) accepting the pregnancy
2) identifying with role of mother/father
3) reordering personal relationships
4) establish relationship w/ unborn child
5) prepare for birth experience

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11
Q

3 developmental tasks of expectant fathers

A

Ask Me Flamboyantly

1) announcement phase –> reaction to news of being pregnant
2) moratorium phase -> adjusting to new reality. period of introspection/soul-searching
3) focusing phase –> active involvement in pregnancy/relationship w/ child

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12
Q

Teratogens

A

environmental substances/exposures that cause functional/structural disability in developing fetus

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13
Q

Known human teratogens

A

drugs
chemicals
infections
exposure to radiation
certain maternal conditions: diabetes, PKU

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14
Q

When does teratogen have the greatest affect on growth/development?

A

during embryonic period (weeks 1-8)

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15
Q

Normal volume of amniotic fluid

A

700-1000 mL

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16
Q

oligiohydraminos

A

<300 mL of amniotic fluid
assoc w/ fetal renal abnormalities

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17
Q

Gravida

A
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18
Q

Gravidity

A

pregnancy

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19
Q

Multigravida

A

woman who has had 2+ pregnancies

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20
Q

Multipara

A

woman who has completed 2+ pregnancies to 20 weeks gestation or more

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21
Q

Nulligravida

A

woman who has never been pregnant & is not currently pregnant

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22
Q

Nullipara

A

not completed a pregnancy with a fetus/fetuses beyond 20 weeks

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23
Q

Parity

A

of pregnancies in which a fetus/fetuses have reached 20 weeks gestation
not affected if babies are born alive/stillborn

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24
Q

Primigravida

A

woman who is pregnant for the first time

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25
Q

Primipara

A

one completed pregnancy with a fetus
fetuses who have reached 20 weeks gestation

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26
Q

Viability

A

capacity to live outside uterus
usually 22-25 weeks gestation

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27
Q

Term

A

pregnancy from 37 weeks to 40

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28
Q

Preterm

A

pregnancy between 20-36 weeks gestation

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29
Q

Early Term

A

pregnancy between 37-38 weeks + 6 days

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30
Q

Full Term

A

pregnancy between 39-40 weeks + 6 days

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31
Q

Late Term

A

pregnancy in 41 week

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32
Q

Post Term

A

pregnancy after 42 weeks

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33
Q

What are TORCH infections

A

infections that can be passed from mom to baby in utero or during birth
have similar clinical manifestations

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34
Q

TORCH acronym

A

Toxoplasmosis
Other - syphilis, Zika, varicella-zoster
Rubella
CMV (cytomegalovirus)
Herpes simplex

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35
Q

GTPAL

A

Gravidity = total # of all pregnancies
Term births = 37+ weeks gestation
Preterm births = after 20-37 weeks gestation
Abortions = miscarriage, elective termination
L = # of children currently living

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36
Q

Signs of pregnancy

A

presumptive –> subjective changes/symptoms
probable –> objective changes observed by examiner
positive –> signs attributable only to living fetus

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37
Q

Presumptive signs

A

amenorrhea
fatigue
breast changes

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38
Q

Probable signs

A

Hegar sign
ballottement
pregnancy tests

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39
Q

Positive signs

A

fetal heart tone
visualizing fetus (sonography)
palpating fetal movements

40
Q

Stages of gestation

A

ovum/pre-embyronic (0-2)
embryonic (3-8)
fetal (9-40)

41
Q

When can HCG be detected in maternal serum?

A

as early as 10 days after conception

42
Q

What is rhogam?

A

immune globulin given to Rh- mother
prevents production of maternal antibodies that attack fetal RBC antigen (if Rh+)

43
Q

When is rhogam given?

A

1st dose = 28 weeks
2nd dose = 72 hours PP

44
Q

What rubella titer would the postpartum client receive MMR or MMRV vaccine?

A

<10

45
Q

When is Group B strep screening done?

A

first prenatal visit

46
Q

When is GDM screening done?

A

24-28 weeks

47
Q

When is EPDS done?

A

28-32 weeks in all pregnancies

48
Q

What is a teratogen

A
49
Q

What is a teratogen

A

environmental substances/exposures that can cause harm in the developing fetus
preventable disability

50
Q

What 5 factors are considered when assessing exposure to a teratogen?

A
51
Q

Categories of teratogens

A

drugs & chemicals
physical agents
maternal illness
infectious agents

52
Q

Which gestation period has highest risk for developing infant?

A

embryonic period
due to multiple organ systems developing at the same time

53
Q

How do teratogens affect more than 1 organ system

A

embryonic period –> organogenesis of all major organ systems occurring at the same time
structures originating from common embryonic tissue (germ layers)

54
Q

TORCH infections

A

maternal infections that can be passed to baby in utero, intrapartum or postpartum (breast milk)

55
Q

TORCH acronym

A

toxoplasmosis (parasite)
other (syphilis, parvo b19, hep B, varicella-zoster, zika)
rubella
cytomegalovirus
herpes simplex virus

56
Q

Types of herpes

A

HSV-1 –> above the waist (oral)
HSV-2 –> below the waist (genital)

both types of herpes can spread to either region

57
Q

TORCH infections that can be passed during birth

A

syphilis
cmv
hsv
hep b

58
Q

TORCH infections that can be passed in breast milk

A

higher risk in premature babies/SGA
CMV

59
Q

Treatment for toxoplasmosi

A

spiraymycin
antibiotic/anti-parasitic

60
Q

Endocrine organs during pregnancy

A

corpus luteum (12-17)
placenta (week 12)

61
Q

Placenta hormones

A

progesterone
estrogen
human placental lactogen
relaxin
CRH
human chorionic gonadotropin

62
Q

Progesterone function

A

suppress FSH/LH (ovulation)
relax smooth muscle of uterus
decreases bladder tone
inhibits lactation
acts on respiratory center to decrease threshold for PaCO2 = increase in minute ventilation
quiets immune response to foreign DNA
*levels decrease in later gestation to allow for childbirth

63
Q

Estrogen function

A

enhances uterine lining
causes spider veins
causes N/V and later increased appetite
stimulates fetal adrenal glands to grow

64
Q

Relaxin function

A

causes relaxation of pubic symphysis
+ pelvic ligaments to prepare body for child birth
dilates cervix during labour
inhibits uterine contractions to prevent preterm birth
relaxes blood vessels increasing perfusion to placenta and kidneys

65
Q

hCG function

A

maintains corpus luteum –> progesterone secretion
stimulates male fetus to secrete testosterone

66
Q

Prolactin function

A

*produced by APG
increase milk production
enlarged mammary glands
*progesterone inhibits lactation

67
Q

Cervical dilation for childbirth

A

10 cm

68
Q

Stages of first labour

A

beginning of contractions –> full cervical dilation
early/latent
active (</= 12 hours)
transition

69
Q

Second stage of labour

A

lasts few minutes to hours
full cervical dilation –> birth of baby

70
Q

Third stage of labour

A

delivery of placenta
umbilical cord clamped
usually lasts 5-30 minutes

71
Q

Fourth stage of laboru

A

recovery period + fetal transition
skin-to-skin/BF initiated with baby
first 2-3 hours after birth

72
Q

Induction of labour

A

forced labour either by giving medication, breaking amniotic sac

73
Q

Episiotomy

A

cut made at opening of vagina to facilitate birth
can be made midline or at a diagonal

74
Q

Types of assisted delivery

A

forceps
vacuum

increased risk of molding, caput and cephalohematoma

75
Q

Types of pain medication during labour

A

nitrous oxide (laughing gas)
narcotics
pudendal block (local anesthesia inserted into a nerve in vagina)
epidural/spinal (regional anesthesia)
general anesthesia (rare)

76
Q

Gestational hypertension

A

develops >20 weeks
recurrent HTN >140/90 on at least two separate occasions
NO proteinuria/signs of end-organ dysfunction

77
Q

Pre-eclampsia

A

HTN
new onset proteinuria
signs of end-organ dysfunction

78
Q

HELLP

A

hemolysis
elevated liver enzymes
low platelets

79
Q

HELLP treatment

A

delivery of placenta

80
Q

Severe pre-eclampsia treatment

A

magnesium sulfate (prevent seizures)
corticosteroids (promote fetal lung function)
anti-hypertensives

81
Q

RF for pre-eclampsia

A

genetic conditions (family/maternal history)
late maternal age
primigravida
new partner
collagen vascular disease
multiple gestation
unknwon causes

82
Q

Oxytocin function

A

produced by PPG
levels increase at labour
stretches cervix
facilitate uterine contractions
cause release of prostaglandins that also stimulate contraction
increases mother baby bond

83
Q

Preterm

A

24-36+6

84
Q

Late Preterm

A

34-36+6

85
Q

Term infant

A

37-41+6

86
Q

Post term

A

42+

87
Q

Hematological changes of pregnancy

A

plasma volume increases by up to 1L (40-50%)
lesser increase in RBC (physiological anemia)

88
Q

What placental hormone stimulates erythropoiesis?

A

placental lactogen

89
Q

Which hormones relaxes blood vessels

A

progesterone
relaxin
increase in blood vessel drops blood pressure –> activates ADH/RAAS

90
Q

Maternal cardiovascular changes

A

increased volume –> increased preload
increased contractility (Starling’s law)
decreased SVR = decreased afterload
cardiac output increased by 50%

91
Q

Coagulation changes in pregnancy

A

increased # of clotting factors
platelets decrease (hemodilution + get stuck in intervillous space)
returns to normal 6-8 weeks postpartum

92
Q

Risk of thrombosis after pregnancy

A

increases by 5.5x since platelets that were in the placenta now re-enter systemic circulation

93
Q

Respiratory changes of pregnancy

A

increase in tidal volume (450-650)
expiratory reserve volume increases
increased O2 demand
compression of diaphragm by uterus –> SOB
hormones loosen ligaments in ribcage to allow for greater expansion

94
Q

Acid-base changes in pregnancy

A

progesterone stimulates respiratory center –> increased RR + decreased PCO2
minor respiratory alkalosis with renal compensation

95
Q

Renal changes in pregnancy

A

glycosuria (pregnancy = insulin resistance)
positive urine dipstick
hyponatremia normal (to allow for amniotic fluid)

96
Q

Human chorionic gonadotropin

A

levels rise from day 8 peak 60-90
promotes angiogenesis in uterus
promotes cell diff to generate syncytiotrophoblast
blocks maternal immune system/macrophage activity

BSNC 5000 (11 decks)

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