Normal Pregnancy Flashcards
Thinning of the cervix, described as percentage of the 4-5cm cervix
effacement
eval for membrane rupture includes ______ exam to obtain…
sterile speculum exam
vaginal fluid
Most specific form of direct testing of vaginal fluid…
Fern testing
air dried sample looking for amniotic fluid directly examined under microscope…
fern testing
what test?
POC test
small sample
very specific
$$$
amniosure
The degree of descent of baby in relationship to ischial spine, divided into thirds…
station
What stage of labor?
contractions accomplish complete dilation and effecement
stage I
What stage of labor?
uterine contractions + maternal effort = expulsion of fetus
stage II
What stage of labor?
placenta detached from uterine wall and expelled
stage III
What stage of labor?
2 hours post delivery of placenta
hemodynamic changes
Stage IV
Stage 1, slow and less predictable.
occurs from 0-5cm
latent stage
stage 1, fast and more predictable
occurs from 5-10 cm
active
Which stage of labor?
urge to push
N/V
Stage II
Progression of fetal movements/cardinal movements of labor (6)
engagement flexion descent internal rotation extension external rotation
duration of stage III labor…
< 30 min
3 complications of stage 3 labor…
placenta retention
uterine inversion
hemorrhage
What procedure, what stage?
manual pressure against uterus
simultaneous pulling on umbilical cord to expel placenta
stage III, assisted removal
The below are signs of…
uterus rise in abdomen
globular config of uterus
gush of blood
lengthening umbilical cord
separation of placenta
critical time for women with CV/Pulm diseases…
stage IV
3 Ps of labor
Power (mom + uterine contraction)
Passenger (size/position of fetus)
Passage (size/shape of pelvis)
Uterine contractions increase in frequency and intensity due to…
prostaglandins
adequate labor = _____ contractions in ______ minutes over 30 minutes
3-5 contractions
10 minutes
> ______g = macrosomic infant
4500 g
4 abnormal presentations of fetus…
face
brow
breech
shoulder
Which pelvic shape?
MC
suited for childbirth
gynecoid
Which pelvic shape?
occiput posterior presentation is common
anthropoid
Which pelvic shape?
most unfavorable
android
Which pelvic shape?
least common
platypelloid
normal fetal HR
110-160
4 measures in fetal monitoring
baseline fetal HR
variability
changes
contraction pattern
What periodic changes?
mirrors shape of contraction
occurs due to head compression
physiologic
early deceleration
What periodic changes?
variable timing
shape, severity variable
cord compression
variable decelerations
What periodic changes?
fetal hypoxia
ominous sign
late decelerations
basic antepartum testing tests for risk of… (2)
placental insufficiency
fetal acidosis
4 components of basic antepartum testing
fetal kick count
non-stress testing
contraction stress testing
biophysical profile
reactive non-stress test is…
2 accelerations within 30 min a/w movement
What evaluates the below parameters?
amniotic fluid
gross fetal movement
tone
fetal breathing activity sustained for 30s
US
In building the biophysical profile, each of the 4 parameters are counted as ____ if present, and ___ if absent for a max score of ____
2+ or 0
max score 10
What result of contraction stress test?
3 contraction in 10 minutes
no late decelerations
negative (reassuring)
What result of contraction stress test?
late decelerations
OR
significant variable decelerations
with > 50% of contractions in 10 min
positive (non-reassuring)
What result of contraction stress test?
late decelerations with < 50% of contractions in 10 minutes
equivocal
What degree of obstetric laceration?
involve vaginal mucosa, perineal skin
not underlying tissue
1st degree
What degree of obstetric laceration?
involves underlying subcutaneous tissue
no rectal sphincter or rectal mucosa involvement
second degree
What degree of obstetric laceration?
extends through rectal sphincter, but not into rectal mucosa
3rd degree
What degree of obstetric laceration?
extends to rectal mucosa
4th degree
the below are risks of…
intra-amniotic infx
umbilical cord prolapse w. amniotomy
c-section delivery/unfavorable cervix
decreased oxygen exchange
labor induction
the _____ scoring system quantifies risk during induction of labor. __ to ___ = high likelihood of failed induction
modified bishop scoring
0-4 high likelihood failed induction
hospitalization in puerperium period should be ____ for vaginal birth and ____ for c-section
1-2 days vaginal
2-4 days c-section
post-partum exam occurs ____ after labor
4-6 weeks
complications wehre arteriovenous malformations occur in placenta of monochorionic/diamniotic pregnancy…
twin to twin transfusion syndrome
twin to twin transfusion syndrome presents in the ____ trimester and must be evaluated with US every ____ weeks beginning at week 16
2nd trimester
monitor q 2 weeks
