OB Flashcards
Mauriceau’s maneuver
method of delivering the head in an assisted vaginal breech birth
performed by placing the index and middle fingers over the maxillary prominence on either side of the nose. fetal body is supported in the neutral position
Total breech extraction
Fetal feet are grasped and the entire fetus is extracted
only used for noncephalic second twin
Frank breech
Buttocks comes first and legs are flexed at the hip and extended at the knees
Complete
(Breech)
Hips and knees are flexed so that the baby is sitting cross legged with feet beside the buttocks
Footling
(Breech)
One or both feet come first with the buttocks at a higher position
Kneeling
(Breech)
Kneeling position, with one or both legs extended at the hips and flexed at the knees
Hyper tonic/ Hyperstimulated Uterus
fewer than five contractions in 10 minutes but interval between contractions is less than one minute
Can be caused by oxytocin overdose
Early Deceleration (FHR)
Transient decrease in heart rate that coincides with the onset of a uterine contraction
mirror image of contraction
Not a bad thing
Late Deceleration (FHR)
Transient decrease in heart rate occurring at or after the peak of a uterine contraction
may indicate fetal hypoxia/ uteroplacental insufficiency
Variable Deceleration (FHR)
Transient series of declarations that vary in intensity, duration, and relation to uterine contraction
Periodic Changes (FHR)
accelerations or decelerations in the fetal heart rate associated with uterine contractions
Episodic Changes (FHR)
Accelerations or decelerations in FHR not associated with uterine contractions
Prolonged Deceleration (FHR)
last more than 2 minutes/ less than 10 minutes
More than 15 BPM below baseline
“The Big Three” of PIH
Hypertension(rise of systolic 30mmHG/diastolic-15mmHg/Blood pressure of 140/90 or higher)
Edema
Proteinuria
HELLP Syndrome
(Hemolysis, elevated liver enzymes, low platelets)
Complication of severe preeclampsia
**A platelet count lower than 100,000/mm-3
Methergine(Methylergonovine)
Blood vessel constrictor and smooth muscle agonist
Used to prevent or control excessive bleeding following childbirth and spontaneous or elective abortion
Most common place for ectopic pregnancy?
Fallopian tube
Can occur in cervix, ovaries, and abdomen
Betamethasone ( Celestone)
What is it used for?
Steroid used to stimulate fetal lung maturation(Prevention of ARDs and decrease the incidence and mortality from intracranial hemorrhage in premature infants
Mother receives injection
Intermittent, painless contraction that may occur every ten to twenty minutes after first trimester
Braxton Hicks
Nitrazine paper
Used to test vaginal (pH is normally acidic)/ pH above 7.0 can indicate amniotic sac rupture= blue color
Excessive mag sulfate/ overdose presentation
Respiratory depression and loss of deep tendon reflexes
Contraindications for mag sulfate
Myasthenia gravis and renal failure
Terbualine (Brethine)
Tocolytics
Beta- Sympathomimetic
relaxes smooth muscle in the uterus to inhibit uterine contractions
contraindicated for cardiac dysrhythmia
Nifedipine(Procardia, Adlat)
Nicardipine (Cardene)
Tocolytics
Calcium channel blockers
Antagonizes the action of calcium within the myometrial cells to reduce its contractility
Nifedipine is primary
Magnesium Sulfate
Tocolytics
Intracelluar calcium is displaced by magnesium ions to inhibit uterine contractions
Indomethacin
Ketorolac
Sulindac
Tocolytics
NSAIDs
limit use of to 48 hours
should not be used when women have significant renal or hepatic disease, active peptic ulcers, coagulation disorders, or thrombocytopenia
Nitroglycerin
tocolytic
Has been used to relax a hypertonic uterus during delivery
Adverse effects of Terbutaline
hyperglycemia, cardiac dysrhytmias, MI, PE, hypotension, and tachycardia
Fetal adverse effects are hyperinsulinemia= potential newborn hypoglycemia, tachycardia, hyperglycemia, myocardial and septal hypertrophy
Macrosomia
Newborn with excessive birth weight
Leading cause of preterm labor
Infection
Fetal dystocia
abnormal fetal size or position
Shoulder dystocia
presentation is vertex, but the anterior fetal shoulder is lodged behind the symphysis pubis, preventing vaginal delivery
recognized when fetal head is delivered onto the perneum but appears to be pulled back tightly against the perineum
Precipitate
Abnormally rapid labor with strong contractions, rapid cervical dilation, rapid descent of the presenting part and delivery usually occurs in 2 hours from the start of the contractions
Retained placenta
Normally separates from the uterus spontaneously in 5- 20 mins after delivery
Retained= doesn’t completely come out
Umbilical cord prolapse actions that need to be taken
elevating the presenting part off the cord with a hand in the vagina to prevent further cord compression/ patient is placed in trendelenburg or knee- chest position/ give tocolytics
Treatment goal for pregnant women with hypertension is
diastolic blood pressure of 90-100 mmHg
If there is a possible chance of concealed bleeding in pregnant female, how do you assess?
measuring fundal height
Uterine atony
major cause of postpartum hemorrhage due to loss of tone in uterine musculature
Lepold’s Maneuver
common and systematic way to determine position of the fetus
Overdose of what medication can lead to a hyperstimulated uterus?
Overdose of oxytocin
What can lead to a fetus presenting with variable decelerations
Cord Problems (prolapse, nuchal, short, compression)
Acceleration in FHR for pregnancies under 32 weeks is considered?
Baseline change of 10 or more for 10 seconds 
Causes of late deceleration
Pregnancy induced hypertension, diabetes, cardiovascular or kidney disease, smoking, and fetus past date
How does FHR variability present with mag sulfate administration
Possible decrease can present
When does preeclampsia occur
After 20 weeks/end of second trimester and beginning of third
Diastolic BP should be managed at what for pregnancy induced hypertension
90-100 mmHg
