OB Flashcards
Explain pano compute AOG
knuckles in hand =31 days
In between= 30 days
Fen=28 days
Ilang days sa mon ng LMP minus 1st day ng LMP= answer
answer lalagay sa month na un tas add days sa sumunod na months divided by 7 weeks
Term
38-42
1 mo=__wks
4
Define:
Gravidity
Parity
Pregnancy
Nadeliver
Stages of Labor/ delivery
Cervical dilation
Fetal delivery
Placental expulsion
Recovery
Stages of cervical dilation with cm
Latent 0-3
Active 4-7
Transitional 8-10
Latent in primi and multipara
Primipara 8-20 h
Multipara- 5-15 h
Placental delivery normal and abnormal
N: 5-15 mins
Abn: 30 mins (report)
1st __hrs ang recovery stage (stage 4)
4
Ilang weeks ang post partum
After 6 weeks
Return of vagina and uterus to their pre pregnancy state
Involution
Per ml ng ilang million ng sperm
20-40 million
Per ejac how many sperm
400 million
Hormone responsible for uterus and breast
Estrogen
Kelan start ng ovarian or men cycle
1st day of mens to the 1st day ng next mens
Ovarian/ mens cycle
Average days
Range
28 days
23-35 days
Gland that produces estrogen
Adrenal gland
Age of puberty / menarche
9-16
Young egg cell
Matured egg cell
Primordial cell
Graafian
Hormone for implantation inc endometrial cells
Estrogen
Phase where estrogen surge
Proliferation/ estrogenic/ follicular phase
Hormone pampa ovulate
LH
Yellow follicle
Corpus luteum
Corpus luteum contains___
Progesterone
Chorion and placenta alin mataas sa 1st and 2nd trisem
1st- chorion
2nd- placenta
Corpus luteum HCG how many days to wait
8-10
Not yellow but white na onti prog and estrogen
Corpus albicans
Corpus albicans is what phase
Isthreemic phase: 3 days
how many days an egg and sperm cell waits
Egg- 2 days
Sperm-5 days
mens
__ days average
—days range
__ml
3-5
2-9
30-80ml
Other term of fertilization
Conception
Impregnation
in order ng mens cycle (POLIM) and hormones nila
Proliferative- estrogen
ovulation- LH
Luteal- progesterone (14th day)
Ischemic- corpus albicans (10 days)
Mens (D1)- 3 days
How to compute for th day ovulation
Days ng mens cycle— 14 days
Fertilization process OZMEF
Ovum: single cell
Zygote: fertilization
Morulla: Mitosis
Embryo: Implant
Fetus: 8etus bc 8 wks
Most delicate part ng preg what trimester
1st
LUNAR MONTH: SC FUSION
1st
THIRD AND FOUR LUNAR MOS
TOOTH
HEART SOUND
IHI
REFLEX
DOPPLER
FETOSCOPE/LANUGO
ORDINARY STET
URINATE
REVEAL GENDER
SEVEN AND EIGHT LUNAR MOS
SCROTUM
EYES
VESSELS
EYE NINETY SURVIVAL
EXTENDS/MORO
IRON
GROW
HERMIT
TIP OF NAILS
SEVEN AND EIGHT LUNAR MOS
SCROTUM
EYES
VESSELS
EYE NINETY SURVIVAL
EXTENDS/MORO
IRON
GROW
HERMIT
TIP OF NAILS
Quickening rate good how many weeks
12 weeks
Heart contract of bby how many lunar mos
8
SPINAL CORD WHAT LUNAR MOS
4
What is the maternal serum screening
Chorionic villi sampling
Ml kinukuha sa amniocentesis
20 ml
Scrotum that dont descend
Cryptochordism
Moro reflex, arms doesnt extends dt?
Brachial plexus injury
Ilang cm fetus grows faster
50 cm
Deadline ng delivery
> 42 wks
Diff of delivery
Dec amniotic and placemtal fxning
Alin subjective at objective sa presumptive at probable
preSUmptive
prOBable
Leg pain reason
Low CA inc Phosphorus
Leg pain mngt
Dorsiflex w extended knee
Abn leg pain
Mngt
Prevention
DVT bc of uterine pressure
No massage, hot compress, ambulate
Bedrest
Doppler UTZ
Heparin
Embolectomy
Ambulate
Elastic stockings and Panty hose na di umaalis sa bed, if nag ambulate, higa for 30 mins saka suotin
Elevate
Pride of pregnancy and cause
Lordosis
Progesterone Relaxin (P-R)
P-R fxm
Softens pelvic joints
Lordosis exercise
Mngt
PR pelvic rock
Squatting
Back pillow
Stand straight
Shoes low
Headache normal
Mngt
Abn
mild occassional
Paracetamol
Severe continuous not relieved ng paracetamol
Hormones responsible sa stuffed nose
Estrogen
Cause ng SOB and inc RR
Enlarged uterus
IgA produces__
out___
Prolactin
Oxytocin
2 hormones ng lactation
Progesterone
HPL
Basta abt breast changes anong hormone
Estrogen (uterus and breast)
Skin changes dt what hormone and kailan babalik
Estrogen
After delivery
Mask of pregnancy
Kloasma/Melasma
Mask of pregnancy
Kloasma/Melasma
Dark thin line mid abdomen
Linia Nigra
Dark thin line mid abdomen
Linia Nigra
2 hormones urinary frequency
HCG aldosterone
What trisem urinary frequency fades
2nd
Inc or dec GFR and ano meron dito
Inc
Glycosuria (glucose +1)
Assessment ng quickening:
Frequency:
Position:
Time:
Rate:
If abn:
Assessment ng quickening: KICK COUNT
Frequency: OD
Position: LEFT RECUMBENT
Time: 1H POST MEAL
Rate: 10-12/h
If abn: ambulate then repeat
Morning sickness all day or not? Kelan malala
Anong trisem lang
Mngt
All day, pagkagising
1st kasi sa 2nd placenta
Dry toast/crackers without fluids after
Delay bfasg
Consult if more than 2 times ka nagsuka
Acupressure and acupuncture
Carbonateds
Sour candy
Snack bago tulog
No spicy seasoned sebo sudden movts
Baking soda
No mens dt what hormone
Non breastfeeding at breastfeeding kelan balik
Requirement ng lactational amenorrhea
Estrogen
Non breastfeeding: 6-10 weeks (involution)
breastfeeding >3 mos
Pure bf
di nagkakamens
6 mos feeding
Palmar erythema cause and mngt
Estrogen
Calamine lotion
Recommended dietary allowance
+300 cal/day
Fe (iron) ilang inumin
Rich in fe ano foods
Pano pag vegetarian kulang sa vit B12 kulang sila sa meat
800 (500 ke mom, 300 ke bby)
Meats, greens, nuts/grains
Vit b12 27 mg (15-30 mg)
Fe and Fa SE:
Ilang hrs bago oede magbugay ng Ca and Mg
Bat bawal bigay GI stimulants like enema, laxative, mineral oils
Ano lang pede na stool softener
Expected stool color
2h gap
Inc contractions
Docusate sodium/ Colace
Dark/ blackish greennish
Inc salivation what term and hormone caused
Ptyalism
Estrogen
Abn cravings
Pica
Inc secretions med term and hormone cause
Leukorrhea Estrogen
Leukorrhea mngt is to prevent infection. Anong 2 A’s if may infection sa bby in 1st tri? 2nd tri?
Anomalies Abortion
Preterm
Instead of tampons what to use
Pads and cotton tela panty
Instead of tampons what to use
Pads and cotton tela panty
NSD or CS if may vaginal infection
CS
Varicosed veins cause
Uterine pressure
Anong vitamins for varicose
CAB
Anong bawal sa varicose and ano position dapat
Crosslegs, constrictive clothing
Sims
Palatandaan sa Hemorrhoids
COCOMILK
COnstipation mngt
COld compress
Modified sims
Insert gently using fingers
Lotion na witch hazel
Knee chest 15-20 mins
Anong ass ang naga use ng measuring tape where 1 cm=1week
Mcdonalds
Bartholomew palatandaan
Sux “sucks”
Symphysis 3 mos
UMBILICUS 5 mos
Xyphoid 9 mos
Naegels rule pano
LMP tas jan to mar +9+7
The rest mos -3+7+1
Positive serum PT probable or positive
Probable
Positive serum PT created by?
Kelan naga inc, dec, absent
Chorion in trophoblasts (HCG)
1st tri, 2nd tri, 1-2 wks after delivery
Kelan maga Urine PT
1st day ng missed period then after 1 week
Ano drug naga pa false + sa urine pt
Methadone (opoid) and Chlordiazepoxide (anxiolytic)
Outline felt/palpated by examiner probable or positive? Kelan nafefeel anong tri
Probable, 2nd tri
Leopolds done during?
Late 3rd tri
Labor
Palatandaan sa leopolds and ano fina found out
F U Sy Pepe
Fundal grip-presentation (cephalic, breech, diagonal/oblique, and lie (occiput, sinciput, brow, face)
Umbilical- position (LOA ROA)
Symphysis/Pawlicks- Engagement
Pelvic- attitude
Anong fingers if maga IE at ano instruction
Middle at pointing
Slowed breathing
Kapag floating pa bby ano mafiffeel sa pawlicks grip
Magalaw
Opposite ng floating
Crowning (+1+2+3…)
sequence ng pag pelvic grip
Slide downward inward
Anong presentation lang ang pede sa pelvic grip
Cephalic
Flexion or extension gusto natin kay bby
Flexion
Full flexion
Vertex
Benefits ng Vertex DILA MO CO
DiLation of cervix
MOLDING
CORD PROLAPSE PREVENTION
Ballottment
Tri
How to perfrom
2nd
One hand abdomen, another sa cervix
Bluish vagina called
Hormone caused
Chadwick
Estrogen
Softening of lower uterine segment
Isthmus-
Cervix-
Hegars
Goodles
Sac
Characterisitic:
When:
Ring
4-6 wks
Movements felt by examiner positive of probable
Positive
Kasi pag “outline felt” thats probable
Heartbeat of fetus
Rate
Earliest seen
Earliest heard
Loudest
11-160
2nd mo
3rd mo
Upper back
(Seen muna bago heard)
Outline sa UTZ kailan at anong AOG
1st
8-10 wks
UTZ
Routine
Maaga
Instruction
Transabdominal
Transvaginal
Full bladder 1 glass q 15 and before 90 mins
Supine w rolled towel on right side
Placenta
Ig?
Barrier sa lahat except
IgG
Drugs virus
Amniotic fluid
ml
Oligo
Polyh
500-1200 ml
<200
>2000
compli
Oligo
Poly
Cord compression
Cord prolapse
Preterm
Hemorrhage
Quickening what tri and rate
2nd
10-12/hr
Xray
formed
seen
Mineral
Vit
3rd mo
4th mo
Ca 1g/day
D
Kelan lang naga hypotension
2nd tri kasi give way kay placenta
Dx ng HPN
140/90 2 times take 6 h apart
S+30
D+15
Gamot for HPN
Gamot na di ibibigay
Lab ni Hyd
Labetalol
Nifedipin
Hydralazine/ Apresoline
ACE inhibitors at ARBS
Kelan PIH screening
2nd tri
Kung may proteinuria sa urinalysis ng pre eclampsia ano naman mababa sa kanya dt sirang oncotic pressure
Hypoalbuminemia
ano Eliminate for prevention sa seizure
Bright loghts dat dim
No penlight
No sudden noise
Tuwing kelan mo iassess vs ng pre eclampsia, if severe?
q 4 h, q 1h
Gamot for seizure and thru/route
Ano babantayan
Mag sul
IV infusion
Toxicity
Diet pre eclampsia
CHON
Mod Salt
Pag IO <30 ano possible nangyari
Hypermagnesemia(toxicity)
Complication sa bata if may pre eclampsia
Liver prob (RUQ epigastric pain, sx of bleeding)
Therapeutic range ng Mag Sul
Antidote
Check kelan
S/sx ng toxicity
5-8 mg/dl
Ca gluconate
Every shift
Dec UO, DTR, RR
Normal DTR
Patellar +2
ECLAMPSIA
To stop convulsion what med
DIAZEPAM (Valium)
ECLAMPSIA
Position
Left side lying to drain secretions
ECLAMPSIA til when continue mag sul
Up to 24 h after deliver
ECLAMPSIA
Ilang 02 give and type ng O2 device?
8-10 L/min facemask
ECLAMPSIA bat instruct NPO
Delivery na
ECLAMPSIA bat assess bleeding
Baka mag abruptio placenta & affected liver
__vaginal bleeding are reported no matter how small the amount
ALL
1st tri bleeding 3 general sx?
AMENORRHEA, LOWER ABD PAIN, VAGINAL BLEEDING
ABORTION med na causes loss of extremities + anti emetic
Thalidomide
ABORTION loss extremities dt thalidomide? Short extremities
Amelia, Focomelia
ABORTION med for uterus contract and cervical ripening, prostaglandin to
Misoprostol
ABORTION med na di binibigay if di pa ripen cervix, pampacontract
oxytocin
ABORTION med na progesterone class, pampacontract din
Mifepristone
ABORTION closed cervix/os
Threatened
ABORTION open cervix/os
Imminent/inevitable
ABORTION all products expelled (fetus, placenta, membrane)
complete
ABORTION some products expelled
Incomplete
Complete ABORTION report?
Heavy bleeding 1:1
Incomplete ABORTION bat bawal CBR
Pooling of blood sa uterus
Incomplete ABORTION anong SST bawal
Sex 2 wks
Strenuous exercise 2 days
Tampon
Complete & incomplete ABORTION ano mga isa-save and y?
Clots, pads, tissues to rule out H mole kasi rx for choriocarcinoma
ABORTION no idea pt dt silent sx, aka early pregnancy failure
Missed
ABORTION 3 consecutive or Habitual
Recurrent
Recurrent ABORTION causes (ABCDE)
Autoimmune, Blood flow resistance, Chorioamnionitis, Defective sperm/egg, Endocrine factors
ECTOPIC ano iwa watch out
Peritonitis, Shock
Implantation outside uterine cavity
ECTOPIC
ECTOPIC mngt
Methotrexate and laparotomy (if ruptured na)
2nd tri 2 bleeding disorder
H mole, incompetent cervix
Aka Gestational trophoblastic dse
H mole
H. MOLE pattern
Snowflaked/ snowstorm
H. MOLE fundic ht larger or not
Larger
H. MOLE describe bleeding
Fast fresh
H. MOLE ano meron sa vesicles
Fluid filled clear
H. MOLE mngt
Suction Curettage
H. MOLE paano follow up
2 times weekly then monthly then yearly
H. MOLE instruction
Pills, no muna pregnancy
Painless dilation of cervix at 20 wks AOG so may chance pa mabuhay bby + show
CERVICAL INSUFFICIENCY
CERVICAL INSUFFICIENCY Anong procedure nakacause
Biopsy
CERVICAL INSUFFICIENCY 2 surgical mngt
Mcdonalds- nylon
Shirodkar- mersilene tape
CERVICAL INSUFFICIENCY cerclage/suturing permanent?
No, san dadaan si bby
CERVICAL INSUFFICIENCY pede ba mag cerclage ba if may amniotic fluid leak? Bleeding? Contractions?
NO
3rd tri bleedings?
Preterm labor, Previa, Abruptio, Accreta
Previa meaning
Before lowly implanted placenta
Diff ng bleeding at site ng ABRUPTIO PLACENTA sa PLACENTA PREVIA
DARK RED PAINFUL, UPper site
PLACENTA PREVIA Causes
Uterus advance, cervix dilate, braxton hicks kc nga 3rd tri na, twins, past CS
Premature separation ng placenta
ABRUPTIO PLACENTA
advance age
> 40 y.o
PREVIA pag 30% nearness sa opening ung placenta mngt
Delivery in double set up
ABRUPTIO describe fundus or uterus
Rigid to touch, sharp to dull pain bet contraction
ABRUPTIO cause
Anything na nagpapa tension (HPN, trauma, stimulant drugs)
ABRUPTIO compli
DIC
Abruptio and previa consideration na bawal
Internal Exam and abd palpation
PRETERM LABOR anong weeks
Before 38 wks
PRETERM LABOR goal
Patigilin
PRETERM LABOR cause “dati”
DHN/ DM/ tension
Amnionitis
Tension/trauma
Infection/ illness
PRETERM LABOR 2 meds
Tocolytics and corticosteroids
4 na Tocolytics (Mint)
Magsul
Indomethacin
Nifedipine
Terbutaline
PRETERM LABOR Anong Tocolytics unang ibibigay na beta 2/relaxant
Terbutaline
PRETERM LABOR Tocolytics contraindications
amniotic leak, bleeding, distress, active labor
PRETERM LABOR 2 corticosteroids
Beta/dexamethasone (lung surfactant)
PRETERM LABOR anong IV fluid at bat NPO
LR, kasi baka maglabor
Deeply implanted placenta
ACCRETA
ACCRETA arrange in order pinakamalala
- Accreta (endometrium)
- Increta (invades myometrium)
- Percreta (penetrates myometrium)
INCRETA mngt
Hysterectomy
ACCRETA mngt
Manual Removal w BEMONC training
Lahat ng bleeding during pregnancy anong dx
UTZ
BEMONC training meaning
Basic Emergency Maternal Obstetric Neonatal Care
CEMONC training meaning
Comprehensive Emergency Maternal Obstetric Neonatal Care + BT & CS
Lahat ng bleeding during pregnancy anong bawal gawin, ilang O2 lagi
Internal Exam & abd palpation
8-10 LPM facemask
BLOOD INCOMPATIBILITY 2 antigens?
ANTIGEN A, ANTIGEN B
Blood type Universal donor?
O
Blood type Universal recipient ?
AB
BLOOD TYPE B pede makareceive ng blood types?
B, O
BLOOD TYPE AB pede makareceive ng blood types?
A, B, AB, O
BLOOD TYPE O pede makareceive ng blood type?
O
Diff ng RH incompatibility sa ABO incompatibility
More severe, less common
Anong antigen seen sa RH+
Antigen D
Anong Ig lang nagapass through sa placental barrier
IgG
sino positive at negative RH sa RH incompatibility
Nega mom, positive bby
Fetus Jaundice normal and abnormal
Jaundice agad paglabas (pathologic/abnormal)
Normal: 2-3 days kc liver immature, return 1wk
Rh Incompatibility mga bagay na pede maghalo blood ni mom & bby
Invasive procedures
Nanganak na/ loss
Placental prob
Rh Incompatibility ml ng blood escape
> 10 ml
Rh Incompatibility sino affected na bby 1st or 2nd
2nd
Rh Incompatibility: med that prevents isoimmunization
Rhogam/ RhIg
Rhogam given
Route:
when:
Duration ng action:
Pag di maalala kung nabigyan ba:
IM
72h after delivery
2wk-2mo
Bigay lang bc di gamot + passive antibodies lang naman
Magsul SE
Hypersomnolence (tulog nang tulog)
Magsul toxicity (BURP)
- Dec BP
- Dec UO
- Dec RR
- Dec Patellar reflex
Where does bby implant
Fundus
Rhogam pede ibigay ket buntis palang basta as early as?
Di nabigay agad after 72 h?
28 wks age
Yes as long as not late after 28 days
Ket abortion give rhogam?
Yes
Sx of placental separation (GIRL)
- Gushing of blood
- Involution
- Rising of fundus
- Lengthening of the cord
Coomb’s Test (checking antibodies)
1. Direct-
2. Indirect-
- Direct- fetal blood (+) antibodies=(+) hemolysis
- Indirect- maternal blood, same
** mothers and bby na negative lang nagbibigay Rhogam (“prevents” formation of antibodies)
thickening of uterus kaya hormone of preg
Progesterone
triggers all, stimulate progesterone
Estrogen
Sterile local inflammation, bawal sa ectopic pregnancy kasi mauulit
IUD aka copper T (spermicide)
Swollen red area on urethral opening-
Swollen red area on vaginal-
skene’s gland
bartholin gland
husband para naring preg sx
Couvade
- ___endometrium found in other pelvic organ, another growth tissue leads to bleeding ng lahat ng ni proliferate-an nya so urine sa bleeding and back pain. Sabay sa mens ung pag bleed
- ___- endometrium penetrates the MYOMETRIUM
- Both walang cure so ✅PILLS
Endometriosis
Adenomyosis
Menarche +___ days= menopause
33 or 34
Turtle sign-
Bun-
male in UTZ (external genitalia)
female
Paracentesis
- ⬆️1st trimester- AFP (positive may__)
- ⬆️ at 2nd trimester (__), ⬇️at 2nd trimester (__)
- 3rd trimester- LS ratio (lecithin symphomyelin ratio__.. fetal lung
NTD
Normal, Trisomy 21
2:1
Betamethasone- IM, __h apart (__doses)
Dexamethasone- __h apart (__doses)
24, 2
12, 4
Neural tube defects
1.__- no skull
2.__- failure to fuse (spine)
-__- hidden dimpling + tufts of HAIR
-__- sac
___- CSF and meninges
___- CSF and meninges and SC
Anencephaly
Spina bifida
Occulta
Cystica
Meningocele
Myelomeningocele
- beginning ng contraction to beginning of another contraction
- ending ng 1st contraction to beginning if another contraction
Frequency Duration
Fetal well being/uterine contractions MONITORING
1. 1st stage labor-
2. 2nd-
3. Meconium-
fetal HR for 1 min q 15-30 mins
q 5 mins
q 30 mins
Urinary cath during labor fxn:
Encourage fetal descent
Umbilical cord prolapse- ✅
knee chest and ky jelly dressing
Diaphragm worn__ before coitus and stay__ and max__, pag cervical cap protection is— h
1h
6h 24h
48
