OB Flashcards
Variable Accelerations - Fetal Monitoring
Cord compression
Early Decelerations - Fetal Monitoring
Head compression
Late Decelerations
Placental insufficiency/fetal hypoxia
Uterine Relaxation
IV Nitroglycerine or nitro spray
Mag - 4g over 4 minutes
Terbutaline .25 mg SQ
Volatile/nitrous
Post Partum Hemorrhage
Bimanual massage
Uterotonics: oxytocin, carboprost, methergine, misoprostol, calcium
Uterine tamponade (balloons)
Selective uterine arterial embo (VIR)
Surgical - art ligation, suturing, hysterectomy
Preeclampsia
Mild: 2 BPs > 6 hrs apart > 140/90, proteinuria > 0.3g/24 hrs > 20 weeks gestation
Severe: 2 BPs > 160/110, proteinuria 5g/day, pulm edema, liver dysfx, TCP, elevated Cr/oliguria
CO in Pregnancy
Increases starting at 5 weeks, max at 32 weeks (30-50% inc)
Inc both SV and HR
Inc intrapartum 60-85% - autotransfusion, removal of aortocaval compression
Returns to normal over 12 weeks post partum
Cardiac Components without change in pregnancy
CVP, PCWP, PA pressure, LV Fx, EF
Hematologic Changes in Pregnancy
Plasma volume increases –> dec hematocrit
Rightward shift oxyhemoglobin curve
Hypercoagulable - inc fibrinogen, 7, 8, 9, 10, 12
TEG - Decrease in R and K values, increase in MA and alpha angleR
Respiratory Changes in Pregnancy
Minute ventilation - 50% inc
Inc - TV 40-45%, O2 carrying capacity, O2 consumption
Dec - FRC, Expiratory reserve volume, chest wall compliance
No change - closing capacity, vital capacity, FEV1
ABG Changes in Pregnancy
Compensated respiratory alkalosis
7.44 / PaO2 104 / PaCO2 30 / HCO3 - 20
Renal Changes in Pregnancy
Increased urea, creatinine, uric acid clearance. Renal plasma flow, GFR
Decreased plasma creatinine and urea
CNS Changes in Pregnancy
Decreased MAC
Decrease in CSF volume, increase in epidural fat & vein volume
